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● Roundup: ICD-10 T e key to successful implementation is, by far, creating a

program that utilizes code sets around the project to be imple- mented. T e biggest obstacle for ICD-10 implementation is time and fi nancial resources, so it’s imperative that providers set internal expectations and align appropriate resources to handle the big switch. Providers can begin by preparing for the following: delayed payments, offi ce frustration, temporary productivity handicaps, gaps in bill review systems and con- tinual use of ICD-9 codes from HIPAA-exempt institutions. As long as internal expectations are set, providers can

proactively eliminate risk by staffi ng their team with the most skilled and knowledgeable professionals, allocating suffi cient fi nancial resources and re-evaluating vendor relationships. It’s also important that external expectations are set in order to facilitate internal transitions. Ask any vendor that integrates with your system and supports ICD-9 code what they’re do- ing to connect various streams to create seamless transition during this mandatory process. No plan will be fool proof, but if providers have a plan of action they’re already 10 steps ahead of the game.

is using antiquated hardware, you may have to upgrade to support the new release.

4. What happens on Oct. 1, 2014? Asking your vendors how they will communicate with you as the code set goes into eff ect and how they will help you navigate changes and unexpected issues can demonstrate what kind of partnership you expect from your vendors as legislation continues to evolve.

5. What training resources does the vendor have? Your vendors may off er webinars, downloadable resources and training tools to help clients prepare for ICD-10. Find out what resources are available and leverage those to ensure both your clinical and administrative staff s are prepared for the transition.

Mark Morsch, MS, VP, technology, Optum

Ana Croxton, VP, EDI products and services, NextGen Healthcare

Five key questions to ask technology partners As the ICD-10 implementation deadline looms, healthcare organizations are continuing to struggle with preparation ef- forts. In fact, recent research from the Medical Group Manage- ment Association revealed that more than half of responding physician practices have not started work on the ICD-10 transition. According to the survey, one of the primary reasons for this delay is a lack of communication and coordination between physician practices and their technology partners, including EHR and practice management vendors. While some vendors are proactive in contacting their clients,

healthcare providers should not sit around waiting for the call. T e time to reach out to your vendor about ICD-10 is now. Here are fi ve questions to jump-start conversation. 1. Where do I direct ICD-10 questions? Most ven- dors have dedicated staff available to address both administrative and clinical questions related to the new code set. Knowing who to contact with questions and establishing a relationship with that individual or department can get questions answered faster and more accurately.

2. What is the upgrade schedule? If you don’t already know, you should be asking all your technology part- ners when their updated software will be available and how much it will cost. In some cases, the upgrade may be part of your vendor contract, but in others it will require an additional fee.

3. Do we need to upgrade our hardware to support the new software? ICD-10 requires a fairly extensive upgrade to most vendors’ software. If your organization

12 September 2013

Natural language-processing technology critical to success Many hospitals are considering computer-assisted coding

(CAC) technology to assist their ICD-10 readiness eff orts and address other billing and compliance challenges. To maximize return on these investments now and into the

future, it is critical to understand how varying methodologies behind the natural language-processing (NLP) technology powering CAC aff ect its performance. T e NLP engine is responsible for reading clinical docu- mentation to identify diagnoses and procedures and then recommending the codes assigned to clinical cases. Five distinct methodologies drive the ability of NLP engines to organize and extract meaning from clinical documentation. In simple terms: • Medical dictionary matching maps words in the clinical documentation to medical terminology.

• Pattern matching fi nds word patterns that describe a diagnosis or procedure.

• Statistical uses pre-coded documents to train and evolve algorithms.

Symbolic rules identify codes from language using linguistic rules and symbols.

• Symbolic rules and statistical components – a more advanced approach – uses a hybrid of mathematical modeling and linguistic rules to identify meaning and context.

Of the fi ve NLP methodologies, the symbolic rules and statistical components approach is best suited to the scale and rigors of ICD-10. It is uniquely capable of interpreting words and phrases in their medical context, determining whether they are relevant to current or past diagnoses or the patient’s family history, and coding granular details, ranging from laterality to severity and acuity, that are critical to timely, accurate payment. CAC technology will be addressing ICD-10 and other busi- ness challenges facing hospitals. Getting familiar with what’s under the hood of CAC applications is essential to achieving optimal performance for medical coding and beyond. HMT


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