ICD-10 Prep on a Budget

When the ICD-10 implementation date moved to October 1, 2014, just about everybody in the medical community and healthcare industry heaved a big sigh of relief. The collective reaction is understandable. Transitioning from the current ICD-9 code set to ICD-10, involves an upgrade of tens of thousands of new codes—no small matter for busy physicians and their harried staffs who must do the new coding right if their practice is going to be paid by insurance companies.

In the annual conference of the Medical Group Management Association-American College of Medical Practice Executives (MGMA-ACMPE), Robert Tennant, convention resource speaker, proposed some practical strategies for physicians to prepare for ICD-10 without the high costs.

As reported by Stephanie Bouchard in Healthcare IT News, Tennant pointed out that practices can choose to do the following now to avoid spending big later: Deploy an ICD-10 team. This team is not only the whip cracker but also the overseer and the council of elders all rolled into one. Include clinicians in the team for peer-to-peer education. Set milestones. If anything at all can be accomplished among very busy professionals such as physicians, it’s through the setting of milestones (or deadlines) based on a doable timeline. Keep ICD-10 top-of-mind. Absence makes the heart grow fonder—of something else. Keep ICD-10 in the agenda at regular staff meetings. It’s that important. Evaluate internal systems and infrastructure. There are many gotchas when dealing with internal systems and their intricately woven ecosystem of software and hardware, so be thorough. An administrator has to find out, for instance, how the practice’s installed software programs are going to handle (if at all) the deluge of new codes in the ICD-10 environment. Can the software handle it? Can the hardware, including storage, handle it? Are upgrades needed? Make a budget. As investments go, the transition to ICD-10 is a major one, so make a budget. Beware of the fact that the cost of transition varies widely. Even MGMA’s estimates, according to Tennant, are conservative. Be savvy in the transition tools available. Research as many transitions tools and resources as you can and familiarize yourself with them. Practice clinical documentation improvement (CDI). This ensures a smooth journey for your documents as they make their way to the insurance companies for claims payments. If an insurer that’s ICD-10 compliant determines that your document is defective (say, the codes used inadequately document a hip-replacement procedure), how will you claim payment? Pinpoint those who need training. Most will have to undergo ICD-10 training, but not all. If the practice does its own medical coding, then the personnel responsible for the medical coding will definitely have to undergo ICD-10 training. Also, it isn’t just a matter of whom, but also a matter of what and when. What precisely is the training level needed? When should this training be carried out? Make sure to stress-test with all health plans. There’s a mistaken notion that only Medicare will be impacted by the ICD-10. Nothing can be farther from the truth. All health plans will be affected by the new codes, so make sure to stress-test them all under ICD-10 conditions. Expect that not everyone will be ready by Oct. 1, 2014. ICD-10 is a huge leap in faith and resources and not everyone will be able to make the jump in time. Still, this shouldn’t be a rationale for failure. Best to be ready when the industry makes the jump. Be prepared.