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 Claims and Coding

Five steps to avoid ICD-10 stress

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   By Ken Bradley, July 2012

To keep from being overwhelmed by ICD-10 preparations, organizations should take manageable steps toward the end goal, and start planning for and working on the effort now.

Headlines over the past several months have touted the sheer magnitude of the ICD-10 implementation, causing some practices to worry about whether a successful transition is even possible. Compounding these concerns, the deadline for implementation may shift as the Centers for Medicare and Medicaid Services (CMS) reevaluates the original Oct. 1, 2013 compliance date.

Given practices’ apprehension and the lack of a clear deadline, it may be tempting to put off thinking about ICD-10 until the implementation timeframe becomes more definite. However, procrastinating may not be wise. Putting off until tomorrow what can be started today will likely only cause more stress and anxiety. Regardless of the final implementation deadline, it will occur, and practices must be ready when it does.   

To avoid being overwhelmed by ICD-10 preparations, all organizations should take manageable steps toward the end goal, and should start planning for and working on the effort now. Following are five specific ways practices can prepare for ICD-10 to avoid the stress and anxiety of a last-minute rush to the finish.  


Before getting too far into implementation, practices may want to talk with their staff members to get a sense of whether they will be resistant to change or embrace the effort, pick up new things quickly or require repeated training opportunities.


1. Examine existing documentation and coding. To code successfully using ICD-10, detailed documentation of patient visits must exist. Examining the specificity of current documentation can help a practice determine whether its level of detail is sufficient. Performing this review now allows plenty of time to educate physicians on the need for further detail and supports them in their efforts to enhance documentation appropriately.

This kind of assessment will not only assist with ICD-10 coding in the future, it will also benefit the practice today. Tightening up documentation ensures physicians capture all pertinent information from a patient visit, which in turn yields more accurate coding, avoids undercoding and prevents inadvertently leaving money on the table.

2. Understand the unique scope of a practice’s ICD-10 efforts. A large-scale project becomes less daunting if one truly understands its scope. Since the nature and complexity of ICD-10 implementation will vary depending on the practice, it is helpful for practices to identify the parameters of their particular ICD-10 endeavor. A simple way to do this is by documenting all of the places where diagnosis codes are currently used, such as in billing programs, superbills, contracts, reports and so forth.

Documentation does not have to be fancy. In fact, using a spreadsheet program to list where diagnosis codes are used, who is using them and how they are being used can help practices start to quantify what needs to be changed and what specific efforts will be involved in the change. For example, a running list can provide insight into how much ICD-10 training practice staff will require, as well as the level of training complexity and detail staff will need. Although the prospect of using a code set that has more than 100,000 codes may seem daunting, it is important to remember that practices most likely will not use every ICD-10 code. Just as most practices do not currently use all 17,000 ICD-9 codes on a regular basis, the same will likely be true with ICD-10.

3. Get a sense of coding staff’s attitudes toward ICD-10. Although a successful implementation will require commitment and buy-in from all practice staff, coding staff probably will be most affected by the transition. These individuals will require significant education and training in order to change the way they code. Regardless the job title, however, adjusting to a new way of working may be harder for some staff members than others.

Before getting too far into implementation, practices may want to talk with their staff members to get a sense of whether they will be resistant to change or embrace the effort, pick up new things quickly or require repeated training opportunities. Based on these conversations, practices can plan an effective training program and anticipate how productivity will be affected throughout the implementation process. Thinking about possible productivity slowdowns can help inform a staffing plan and indicate whether additional staff will be required.   

4. Understand vendor partners’ plans. Now is the time to reach out to clearinghouse vendors, practice-management software vendors and other vendor partners to get a sense of their plans for ICD-10. Practices should ask their partners about how they plan to support ICD-10, as well as when they will be ready to support it.

The more ICD-10 support products a practice can install before the deadline date, the better. However, practices must ensure that any updated software can process both ICD-9 and ICD-10 codes. This will allow the practice to train staff members ahead of time and become familiar with using new products. Ideally, a practice should try dual coding so staff members adjust to the new code set before they are required to use it. Also, having dual-coding capability allows a practice to participate in testing for ICD-10 and work through any possible hiccups before the go-live date.

5. Garner buy-in from the entire practice. While it is important to designate an individual or individuals to spearhead the ICD-10 endeavor, practices must understand that one person cannot singlehandedly drive this effort. It is critical for the entire practice to realize that the transition to ICD-10 will be a practice-wide initiative requiring everyone’s buy-in, support and participation. Staff members must actively commit to understanding the importance of ICD-10 and using it where necessary.

There are many organizations offering ICD-10 resources that can help build awareness and garner buy-in. Some of these resources include CMS, the Centers for Disease Control and Prevention (CDC), the American Health Information Management Association (AHIMA), AAPC and the Healthcare Financial Management Association (HFMA). Not only can these sources provide background regarding ICD-10, they can also help a practice stay current on new developments related to the code set.

It is certainly true that ICD-10 implementation will require hard work, but it is not an insurmountable task. Keeping focused, dividing the project into manageable steps and setting aside dedicated time to work on the effort will keep practices on the right track and prevent an overwhelming implementation experience.

About the author

Ken Bradley is the vice president of strategic planning at Navicure, a medical claims clearinghouse. For more information about the 5010 and ICD-10 implementations, including detailed preparation timelines and more, visit www.icd10hub.com. For more on Navicure, click here.


Tags:  Claims and Coding  ICD-10