ICD-10: Here at Last and a Last-Minute Checklist


The talk around the healthcare community regarding the quickly approaching October 1st ICD-10 transition is mixed.

Findings on athenahealth’s current website are alarming: three out of four practices are worried about the upcoming ICD-10 transition, 44% have not started preparing for it, and 82% weren’t completely ready at last year’s deadline (which was postponed until this year).

But as mentioned a few weeks ago in a related blog, many of the earlier financial phase-in projections won’t be nearly as exorbitant as expected, nor will the changes to current processes appear to be as extreme. And from what I learned at Greenway Health’s recent Engage 2015, most people believe they’re ready for the transiton and are just waiting to see how things work out in real time.

Two things are sure: The upgrade to ICD-10 is extremely involved, including 68,000 diagnostic codes, compared with the current 14,000, and the number of codes for inpatient hospital procedures will expand to 87,000, from 4,000. And it will likely be months before we find out the extent to which each practice has adequately prepared for the ICD-10 change.

The American Hospital Association has provided a helpful checklist for people to be as prepared as possible. Here are a few of their recommendations:

  1. Verify whether organizational systems and applications – including vendor software updates – are ready for ICD-10.
  1. Ensure that all coders, clinicians, and other staff are adequately trained.
  1. Ensure the coding team can access ICD-10 coding guidelines and AHA Central Office advice (www.ahacentraloffice.org).
  1. Verify external partner readiness to ensure health plans are ready for ICD-10 and establish communication plans and policies with the organizations.
  1. Collect emergency contact information for Medicare contractors and commercial insurers in case claims are delayed.
  1. Make sure you know your major trading partners’ rules and processes for submitting replacement claims if you identify a coding problem that should be corrected.
  1. Make sure you understand the steps needed to limit delays in payment from these payers.
  1. Begin monitoring the status of submitted claims to learn whether problems are occurring so they do not turn into financial hardships.
  1. Learn the policies and processes of trading partners if you experience payment delays.
  1. Consider establishing credit lines that can be used if processing delays adversely affect the normal revenue cycle.

In the upcoming ICD-10 upgrade, there will be numerous situations you can’t control simply because no one knows what the effects of such an ambitious change will be. But there are multiple things you can do now to make the transition as smooth as possible.

How prepared are you for the upcoming ICD-10 implementation?






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