Expert Offers ICD-10 Implementation Guidance

By Greg Bengel, contributing writer

With the ICD-10 implementation date rapidly approaching, one expert offers eight steps that providers can take to prepare themselves

Ready or not, here it comes. At a recent keynote presentation on making the transition to ICD-10, CMS Senior Technical Advisor Pat Brooks announced that there would be no more delays of the October 1, 2014 ICD-10 implementation date.

Brooks is quoted in an EHR Intelligence article. “Those who are postponing ICD-10 implementation planning, thinking there might be additional delays, should really begin to plan implementation now,” he says. “There will be no more delays to the ICD-10 implementation date.”

It’s no secret that providers are uneasy about ICD-10 implementation. As recently reported, an  athenahealth survey titled the Physician Sentiment Index found that only 7 percent of physicians are “very confident” that their EHR vendor will help them make a successful transition, and 27 percent are reportedly only “somewhat confident.”

With the date now set in stone, not to mention that date rapidly approaching, one expert recently gave his best advice to providers who need to prepare for ICD-10 implementation. Jim Daley, Director of IT Risk and Compliance at BlueCross BlueShield of South Carolina and Chairman of WEDI, offers his advice in this EHR Intelligence article titled, “WEDI: Eight ICD-10 tasks for providers to complete now.”

His advice includes the following:

1. Read up on ICD-10. This seems obvious. But according to the article, there are still some provider organizations that, believe it or not, do not understand what ICD-10 is.
2. Designate a leader. According to Daley, it’s important to put someone in charge of leading the effort, especially in a larger organization.
3. Make a list of what needs to get done. The article summarizes Daley’s suggestion, “You should be looking at what your biggest risks are, your high-volume items or your high-dollar procedures, and your most critical trading partners. For example, look at your biggest payers. At least validate that everything is going to work well with them.”
4. Identify areas that use ICD diagnosis or procedure codes, and study their impact. More than just the systems themselves, providers should take a hard look at the forms and contracts they have.
5. Determine how the use of unspecified codes occurs in your practice. The article explains, “There’s a big debate over what “unspecified” is because sometimes you don’t know the diagnosis when you send something out to a lab.  You’re trying to hone in on the specific diagnosis.  Some codes that don’t say “unspecified” really are, because they deal with a general ailment.  Some codes that say “unspecified” may actually be fairly detailed and the best you can do.  You really have to understand when it’s appropriate and not appropriate to use them.”
6. Talk to your vendors. Engage in open dialogue to find out how ready your vendors, your billers, clearing houses and business associates are for ICD-10.
7. Figure out what your vendor can and can’t do for you. When it comes to software upgrades, providers may be surprised to learn that individual customization to support the software needs to take place.
8. Study impacts on your budget. Providers need to account for the software or training they need to purchase. Daley also recommends setting up a reserve fund in case of a short-term deficit in payments.