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7 Tips to Prepare You and Your Provider Organization for ICD-10

It seems these days that you can hardly go to any conference, trade publication or industry soiree without hearing ICD-10 chatter fluttering about. Even though many of us have grown weary of the talk it is a fact of life that will soon be affecting any of us that deal in the world of healthcare revenue cycle management and reimbursement. The federal government has drawn a final line in the sand around ICD-10 and its implementation.  The date set forth is October 1, 2014 and the requirement is that on this date any payor or provider organization must be able to properly send, receive, process and pay based off of these new code sets.  So what is this quantum leap that everyone is talking about?  Well in numeric terms it represents a significant expansion in the allowable code universe.  For instance, ICD-9 (the current industry used code set) has just over 14,000 diagnosis codes and another approximate 4,000 procedural codes. In contrast, ICD-10, the new kid on the block, contains over 68,000 diagnosis codes and over 72,000 procedural codes.  So in simple quantitative terms, we have a total universe of 20,000 that is expanding to 140,000.  WOW you say? Scared yet?

Even though the numbers and the entire effort seems daunting there is hope and with the proper preparation you and your organization can ensure you successfully tackle the looming deadline head on.  Here are 7 tips you and your provider organization may find helpful when it comes to ICD-10 preparation

  1. Identify the Stakeholders – A critical piece of any successful initiative is identifying the key stakeholders.  A prudent step that you can take is to identify key departmental representatives as project stakeholders. These persons should be well respected and authoritative figures that can help motivate, empower and lead their respective departments.  Example departments that would or should be included are: technology (IT), provider management, facility management, training / education, etc. The goal with stakeholder identification is to ensure the right leaders are on the bus and get them moving in the same direction towards a successful ICD-10 implementation.
  2. Map the Business Process – Our company has found too often that entire initiatives often times fail miserably because no one properly understood the business process from beginning to end.  As part of your success plan for ICD-10 implementation make sure that you and the stakeholders take as much time as necessary to properly document the entire business process. Generally, these business processes start at the point when first contact is made with the patient and continue throughout the patient encounter and all the way to the point of invoicing and funds receipt.  A  Having a precise understanding of this business process not only helps to identify critical points of interface but also helps to eliminate any potential confusion amongst the various departments.
  3. Identify Critical Path Items – A secondary benefit of mapping the business process (Step #2) is that you are able to identify critical system linkages or other critical interface items.  Make sure as part of your ICD-10 initiative that you identify and properly list out all of these “critical path” items.  The purpose of this endeavor is to ensure that the team is directing effort towards areas or initiatives that if not done correctly would cause disaster for the entire initiative.  An example of this might be focusing on the interface between the EMR and the Billing System.  If data related to the ICD-10 initiative could not flow correctly from EMR to Billing … then your initiative would be up in smoke before it began. Focus on critical path and make sure you identify items that are key to the team’s success. 
  4. Setup the Communication Plan – As important as identifying the right team and understanding the process is ensuring that you have a comprehensive and well laid out communication plan.  Initiatives like ICD-10 are tremendously complex and require not only the right tactical skills to manage for success but also require the right personnel and morale management skills.  Too often in complex implementations certain departments or groups don’t get heard or feel left out.  Make sure that your plan for ICD-1o includes a comprehensive communication plan that everyone understands.  For instance a simple communication plan might be a weekly email summary of achievements, to-do’s and an initiative summary sent to all departmental stakeholders followed by a brief 1 hour review call.  The point of the communication plan is to drive the project towards success by having health dialogue amongst the key departmental teams.
  5. Leverage All Your Communication Mediums – In the world of social media and always connectedness, take the opportunity to step up your communication and stakeholder interaction to include diverse media forms.  If you use Twitter, leverage it. If you use Facebook, use the polling capabilities to gauge knowledge or reaction to aspects of the ICD-10 roll out within your organization.
  6. Enlist Your Partner Network –  “It takes a village”… so the adage goes.  Your ICD-10 initiative will require proper coordination amongst your partners.  From medical coding entities like Edelberg & Associates, to external compliance personnel, IT vendors and consultants. Make sure you start early in enlisting your extended partner network.
  7. Test & Test & Test – Last but not least, make sure you leave plenty of time for testing.  Testing doesn’t just mean the traditional IT run through.  Instead, think of testing in more holistic terms.  Test that the business process will still function, test that your medical coders can still code at a productivity rate that is acceptable, test that your level distributions are not going to get sideways due to system or training malfunctions…. in short, TEST.  From the interactions of the IT platform to your personnel, doing walk throughs well ahead of the implementation date is both practical and can highlight tasks that need more attention or further refinement.

With the above quick tips we believe you will be on your way to ensuring a smooth and successful transition for your provider organization to ICD-10.  If you would like more information on how Edelberg & Associates can help you in your ICD-10 initiatives please fill out the contact us page to the right or call us at 855-EA-CODES.

Other Resources for ICD-10 that you might find helpful are: