To implement ICD-10 successfully, physicians and medical group practices will need to embrace it and understand its impact to senior living providers.
Update 4/1/14: ICD-10 implementation is delayed for one year to October 1, 2015. CLA recommends providers continue to evaluate their internal readiness to ensure their organizations are fully prepared for this transition well before any deferred deadline.
The International Classification of Diseases, Tenth Revision (ICD-10) is a system of data collection and processing that promotes clear classification and presentation of mortality statistics. Organizations are running out of time to make the transition to the new, mandatory coding system.
To implement ICD-10 successfully, organizations will need to embrace it and understand its impact on physicians and medical group practices.
“Physicians and medical group practices should already have an ICD-10 project manager or committee in place,” says Karla VonEschen, a health care managing consultant at CliftonLarsonAllen. “They should also have completed a chart-documentation gap analysis, identified major impacts, and created a clear transition plan.”
Every organization is at a different place in their transition to ICD-10, but compliance is mandatory, and this transition will take time.
How ICD-10 will change your operations
ICD-10 will have a significant impact on how staff accomplish the necessary task of coding. Below are several issues that will need to be addressed before October 1.
- Clinical, health information management, and billing staff will all need to be trained in order to apply new guidelines for selecting and sequencing ICD-10 Clinical Modification (CM) diagnosis codes and/or ICD-10 Procedure Coding System (PCS) codes on claims.
- A documentation gap analysis should be done to determine what changes physician and non-physician practitioners will need to make to correctly code for ICD-10.
- Billing and clinical documentation systems will require software updates.
- An internal assessment should be done to determine what documents currently used by the organization contain ICD-9 codes that will need to be updated for ICD-10. This may include patient forms, superbills, coder “cheat sheets,” and internal policies and procedures.
- The finance team should review payer contracts for any ICD-9 codes that will need to be updated with ICD-10 codes.
- The billing team should determine if there is a claims backlog and address it prior to the ICD-10 implementation.
A transition timeline
To be ready for ICD-10, here is a basic timeline to guide the implementation process:
- March 2014 — Begin internal/external claims testing with payers and continue testing as needed through September 2014.
- April 2014 — Identify staff education needs and begin ICD-10 training.
- May 2014 — Complete a contingency plan for claims processing and payment issues.
- October 1, 2014 — Deadline for ICD-10 implementation.
Additonal resources
- Presentation Slides: ICD-10
- Webinar Recording: ICD-10 Transition and How It Impacts Your Organization
How we can help
CliftonLarsonAllen can help your organization be ICD-10 compliant by the October 1, 2014, deadline. Our services include:
- Readiness assessment
- Analysis of most frequently billed ICD-10 diagnosis codes to determine the impact of the new coding on your organization
- Documentation gap analysis
- Staff training
Since diagnosis and treatment codes for ICD-10 have expanded, it is imperative to thoroughly understand how ICD-10 will impact your organization and how to prepare for the implementation deadline.