To implement ICD-10 successfully, organizations 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 senior living providers.
“Organizations 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) codes on claims.
- Billing and clinical documentation systems will require software updates.
- Staff must be trained in the appropriate selection of diagnosis, treatment, and sequela codes (a code for a residual affect after the initial illness) to assign to the Uniform Billing Form (UB-04). (ICD-10 codes can be assigned when patients are admitted, after they return from the hospital, at death, discharge, or when they develop another condition during a hospital stay.)
- Diagnosis codings that flow to the Minimum Data Set (MDS) or Outcome and Assessment Information Set (OASIS) will impact the group assignment for payment. Staff education should address the expansion of codes and the new choices for common services, such as care following orthopedic procedures and care following strokes.
- Staff will need to be trained to select from the additional diagnosis codes that represent patient condition(s) that will impact the plan of care.
- Physical, occupational, and speech therapy providers, either employed or contracted, must also understand how to use proper documentation and ICD-10 coding on claim forms submitted for payment.
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.
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
- Education for internal staff
Since diagnosis and treatment codes for ICD-10 have expanded, it is imperative to thoroughly understand how ICD-10 will impact your organization and the resident assessment tools unique to skilled nursing facilities and home health agencies.