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ICD-10 delay: Seven things you should do with the extra time By Shelly Guffey and Dawn Duchek


On April 9, the Depart- ment of Health and Human

Shelly Guffey is manager of premier accounts and vendor partners and Dawn Duchek is industry initiatives coordinator for Gateway EDI. For more information on Gateway EDI:

Services (HHS) announced a proposed rule to delay the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014. Some providers experienced “implementation is- sues” while transitioning to 5010, and they fear the 2013 deadline won’t allow enough time to fully implement ICD-10. Now that an extension has been pro- posed, many practices wonder if they should delay their transition or continue as planned. Regardless of the pos- sible deadline delay, we

recommend continuing to move forward on your ICD-10 preparation. As the industry learned from recent 5010 transition challenges, it’s never too early to prepare! Here are seven ways that you can make the most of any extra time the delay provides.

1. Conduct more thorough in-offi ce analysis to iden- tify each of the day-to-day processes and areas of your practice that will be impacted. For example, both your clinical documentation and your offi ce superbill will need to be converted to include ICD-10 codes.

2. Ensure that you have a strong plan in place to train your billing and clinical staff in ICD-10 coding changes. At a recent AAPC Boot Camp on ICD-10, it took participants four hours to code 20 cases – and that’s with the help of a teacher. Having the right type of training will help cut down this time. 3. Conduct time studies where you identify how much extra time coding will take with ICD-10. The American Health Information Management Asso- ciation estimates that, initially, it will take roughly twice as long for a coder to code under ICD-10. Medical practices should expect a permanent 10 to 25 percent loss of coding productivity. What is


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Formation Guide,” co-authored by well- known health information consultants Laura Kolkman, RN, MS, FHIMSS, and Bob Brown of Mosaica Partners, was named the HIMSS Book of the Year in February. Published by HIMSS in

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4 May 2012 May 2012 Dawn Duchek Shelly Guffey

your plan to keep up with your increased coding needs, and how will it impact you fi nancially? Will you pay overtime, hire another coder or outsource some of the work?

4. Check with your business partners, vendors and software applications to see how they plan to handle the transition. 5. To maintain compliance requirements, medical of- fi ce policies and written procedures will need to be updated to refl ect ICD-10 changes. The Offi ce of Inspector General has developed some guidelines to help practices develop internal controls and processes that may assist your offi ce with these changes. 6. Review your payer contracts, which may be based on older codes, and work with payers to update these for ICD-10. Don’t assume payers will do it for you.

7. Establish a line of credit. The industry encouraged providers to do this with the 5010 transition, but many didn’t take this step and were caught off guard by the revenue impact of 5010. The ICD-10 switch will impact your cash fl ow, and most lines of credit need to be in place for six months to a full year before funds become available. Get one set up now.

In light of the proposed delay, it may be tempting to take a break from ICD-10, but the items we mention here take a long time to complete. We urge you to continue moving forward on your preparations. Doing as much as possible to prepare your practice for ICD-10 now will save you headaches as the deadline nears and will ensure that your practice continues to operate effi ciently throughout the transition. For a compilation of helpful industry resources on ICD- 10, visit

2011, this title provides the knowledge and tools that emerging state-, regional- or community-based HIE initiatives need to develop a framework for long-term sustainability.

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This practical guide is available for purchase in the HIMSS online store and as a HIMSS e-book. For more information, including the table of contents and chapter summaries, helpful downloadable figures and checklists, visit


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