ICD-10-CM Implementation Deadline Less Than A Year Away

Experts to Share Best Practices, Tips for ICD-10-CM Transition at AHIMA Convention

With less than one year to go before the compliance deadline for ICD-10-CM and ICD-10-PCS, experts will discuss implementation challenges, successes and strategies at AHIMA’s 85th Annual Convention and Exhibit October 26-30, in Atlanta.

“At Convention, the American Healthcare Information Management Association (AHIMA) offers attendees the opportunity to hear from experts on implementation processes and receive guidance about best practices for organizations of all sizes,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA. “As the industry’s leading authority on ICD-10-CM preparedness, AHIMA is excited to help all healthcare stakeholders with the transition to ICD-10-CM, a more robust coding system that will lead to improved patient care documentation and granular data.”

Presenters will share insights on the elements of an effective implementation plan, including payer and vendor collaboration and related revenue cycle system preparation; training and testing; and clinical documentation improvement. 

According to the presenters, the first and most important step for ICD-10-CM implementation is to obtain senior executive and clinical staff buy-in. Recognition and understanding are critical at the executive level, that significant and careful planning  are needed for a successful transition. Commitment is needed to assure that the right mix of time, staff, and technological/technical resources are available.

Payer Collaboration/Revenue Cycle Management
“This affects not just hospitals and their physicians/staff, it affects payers and the health providers’ billing systems; implementation strategies must address these issues that affect reimbursement,” said Donielle Bailey, RHIA, ICD-10 Project Coordinator, Rex Healthcare, Raleigh, N.C. Bailey’s co-presenter for “How to Prepare Your Documentation and Complete ICD-10 Education Before Time Runs Out,” is Tom Ormondroyd, BS, MBA, Precyse, Alpharetta, Ga.

“Collaboration with payers, vendors and others who affect successful implementation is one of the most important things we’re doing,” said Danielle Reno, MHA, CHC, CCS, CCS-P, ICD-10 Program Director, Sutter Health, Sacramento, Calif. “We have to look at every aspect of the process.” Co-presenters with Reno for the panel discussion, “The Good, the Bad, the Reality:  365 Days until ICD-10 Adoption (Take Two),” are Christine Armstrong, MBA, RHIA, Deloitte Consulting, Los Angeles; and Virginia Sullivan, PMP, Scripps Health, San Diego.

According to the presenters, implementation challenges include:

• Preparing system staff and vendors who play a role in  the revenue cycle (e.g. accounts receivable, billers, radiology, laboratory, clearinghouses and fiscal intermediaries)
• Setting up the IT infrastructure with payers
• Ensuring you have enough coders and training them for the transition
• Determining how claims will be adjudicated
• Implementing systems, tools and key performance measures to track potential under payments and claims denials 
• Collaborating with payers to develop processes for coding records when the care spans the transition from ICD-9-CM to ICD-10-CM
• Developing a testing plan and scripts to test applications
• Facilitating necessary vendor upgrades to conduct testing
• Ensuring physicians and coders have ability to dual code ICD-9-CM/ICD-10 prior to going live

Training
“The time to panic is not now, but it’s getting close,” says Cindy Seel, MSA, RHIA, HRS, Baltimore, who will present “Transitioning Physicians to ICD-10:  Seven Steps to Take Now.” The seven steps include:

1. Developing  implementation and training plans 
2. Providing specialty-specific education programs
3. Tailoring training models to the organization’s clinical staff and leveraging lessons learned
4. Identifying of key documentation needs to reduce physician queries and increase productivity, including strengthening clinical documentation improvement (CDI), programs with peer-led education, dual coding and end-to-end testing based on a continuous P-D-C-A (plan-do-check-act/adjust) Cycle
5. Training coders and providers to start using the ICD-10-CM in advance of implementation
6. Recognizing  the potential (mis)uses of Generic Equivalent Mapping (GEMS)
7. Providing  training for  physicians’ office staffs

While each of the steps described for implementation of ICD-10 is important, the presenters emphasized that a key element for success is the collaboration and coordination of all stakeholders as they work through the testing and implementation process.

About AHIMA
Celebrating its 85th anniversary this year, the American Health Information Management Association (AHIMA) represents more than 67,000 educated health information management professionals in the United States and around the world. AHIMA is committed to promoting and advocating for high quality research, best practices and effective standards in health information and to actively contributing to the development and advancement of health information professionals worldwide. AHIMA’s enduring goal is quality healthcare through quality information. For more information, visit www.ahima.org.