ICD-10-CM: Have you mapped out your transition plan?
6 Apr 2010 Ken Bradley 2 Comments
Even if you’ve worked in healthcare only a short time, you’ve probably noticed that many providers are overwhelmed by the idea of ICD-10-CM and may not know quite where to start. In addition, transition to these new code sets has been pending for so long that healthcare professionals still aren’t convinced these deadlines are “really real.” The common quip for years now: “I’ll be retired before it happens!”
But the truth is that you already lag behind suggested timelines if you haven’t mapped out your transition plan.
The Oct. 1, 2013, implementation date seems a long way off. But you can expect the compliance deadline to hold firm; many of the current administration’s new value-based purchasing initiatives depend on the level of detail available in ICD-10 codes.
Time is of the essence. One study by the Workgroup for Electronic Data Interchange (WEDI) and the North Carolina Healthcare Information and Communication Alliance (NCHICA) suggests providers need nearly 1,286 business days to complete the transition – roughly 4.9 years. At the very minimum, you already should have conducted an impact assessment of stakeholders across all functional areas of your practice, as well as plotted high-level cost estimates. You should have assessed staff educational needs, and – perhaps most important – evaluated information/technology requirements and implementation plans.
Informed providers and vendors understand that ICD-10 is not just a “routine” coding update. Practice management systems and applications throughout the claims management cycle must be altered to the new data format – or you risk facing delayed or denied reimbursement once the compliance date rolls around.
Here’s one example: ICD-9 diagnosis codes are 3-5 digits long, and while the first digit is either alpha (E or V) or numeric, digits 2-5 always are numeric. To accept ICD-10 diagnosis codes, however, systems must be restructured to accept codes 3-7 digits in length, of which digit 1 is alpha, digit 2 is numeric, and digits 3-7 are alpha or numeric.
It’s not a quick or easy change: the WEDI/NCHICA study estimates that vendors will require nearly a year longer than providers to successfully upgrade their various products – 1,521 business days (almost 5.9 years).
Remember the problems caused by the transition to National Provider Identifiers (NPIs)? Fortunately, lessons learned from that transition can be applied to help avoid the massive 6%-10% claims-error rate CMS predicts could occur right after the switch to ICD-10.
Foremost is the need to keep in contact with your payers and clearinghouse about their implementation timelines and testing plans. Build ICD-10 requirements into any technology upgrades you’re considering, whether for EMRs, practice management systems or revenue cycle management solutions. There are certainly resources out there – including partners like Navicure that successfully navigated the NPI waters – which can help ease the transition.
Where do you stand in your ICD-10 transition? Post your response here and contribute to the dialog about how to make the process as pain-free as possible.
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Loading ...- Tags: compliance, ICD-10 codes, ICD-10 transition, ICD-10-CM, NCHICA, WEDI
2 Responses for "ICD-10-CM: Have you mapped out your transition plan?"
Where do we start?
Thank you for your question. A smooth transition to ICD-10 depends in large part on advance planning.
A good place to start is to assemble a team with representatives from practice management, clinical and administrative staffs; a good team would have representatives from, for example, billing, registration, information systems (administrative and clinical if separate), clinical processes and finance. Of course, the size of the team will vary depending on the size of the practice.
The goal of the team is to ensure that the practice has an understanding of all places where diagnosis codes are used or referenced, that detailed ICD-10 educational/knowledge requirements are documented, and that a plan is prepared and implemented that allows use of ICD-10 codes on and after October 1, 2013. With a full understanding of the impact that the ICD-10 transition will have, resources, budgets and time can be determined, allocated and in place at the right time.
Once the team’s assessment of where and how diagnosis codes are used, the requirements for ensuring these manual, hardware and software systems are appropriately updated or replaced to handle ICD-10 codes, along with potentially the need to continue handling the ICD-9 codes, can be prepared, communicated and distributed as necessary.
Most experts agree that a significant portion of the cost and time associated with the move to ICD-10 will be in education. While an in-depth understanding of ICD-10 should be scheduled so that staff can return to the office and begin actually using the new ICD-10 codes, Webinars, like the one given by Navicure on May 6, 2010, to begin to understand the basic concepts of ICD-10 and the true magnitude of the change are highly recommended. To learn more about the Webinar on May 6, take a look at the blog post here: http://dailypracticeblog.com/2010/04/webinar-for-ceu-credit-how-to-survive-icd-10-cm/.
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