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Trends & Developments - October 2012 - ICD-10 Implementation is Coming!

The Centers for Medicare and Medicaid Services (CMS) have released the new ICD-10 Implementation Date:  October 1, 2014.   There are currently 17,000 ICD-9 codes; ICD-10 will increase that number to 140,000.

ICD-10 Implementation is lengthy and intensive so now is the time for all physician practices and hospital facilities to start the process.  How does your practice/facility prepare for this change? For a smooth transition, an implementation plan needs to be established which includes the following key elements.

PREPARING FOR ICD-10 IMPLEMENTATION

The first step is to educate the key decision makers of the practice or facility with a high-level overview of ICD-10.   In addition to understanding the impact of the numerous changes to the coding system, it is imperative they are aware of the planning process including time and staff efforts.

A steering committee of individuals/teams to oversee implementation also needs to be established during this time period.  The steering committee should include management staff from all areas of the practice or facility that will be affected by the transition.   This would include senior management, physicians, IT management, clinical managers, coding managers, and other key personnel as well as external resources if necessary.   A project manager should be assigned to keep the lines of communication open and oversee all assigned tasks determined by the steering committee.

CREATING YOUR ICD-10 IMPLEMENTATION PLAN 

A practice/facility assessment needs to be performed to determine the areas (people, processes and systems) that will be affected by the change.  The areas affected can vary based on the size of the practice or facility.   

Information Technology (IT) assessments should include product upgrade and testing timelines, any down-time associated with testing, budgetary needs with system remediation and/or replacements and review of reports and interfaces that will be affected.   It also has to be established that the software can perform dual coding of ICD-9 and ICD-10 for transactions prior to October 1, 2014.

Clinical Data Quality Assessments and Documentation Evaluations should be performed to determine how much education and training will be required for both physicians and staff for the increased specificity requirements of ICD-10.

Vendor and payer readiness, timelines and what impact the changes will have on your current contracts need to be reviewed.

An ICD-10 Implementation Plan will be created based on the assessment findings.  This covers budget, training, readiness of vendors and payers, timetables and policies/procedures.  

EDUCATION, TRAINING AND TESTING 

Coding staff need to be educated in the changes in documentation requirements.   There also needs to be training of staff and providers for additional changes for the practice/facility.   This would include items such as software updates, documentation requirements, policies and procedures, etc.

IT system and vendor changes should be completed and internal and external testing times and schedules of software should be performed in preparation to “go live.”

POST-IMPLEMENTATION 

Post-implementation covers any system errors, reimbursement denials and additional documentation assessments and training for coding and documentation. 

Reimbursement can strongly be affected during this time period.  Reimbursement issues can include coding backlogs, changes in reimbursement schedules and payment policies, delayed payment and claim adjudication.

Since the implementation plan alone can take a minimum six months to put in place, most practices/facilities should have already started the process.   Now is the time to start meeting with the key decision makers and assigning your steering committee. 

Trends & Developments - October 2012 Issue

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