Account Manager with Management Resource Group
With all the reporting initiatives that CMS has put into effect, it is easy to see why ICD-10 implementation has taken a back seat at most practices. After all, the start date isn’t until October 1, 2014 and there are other initiatives more demanding of your immediate attention. We have e-Prescribe (which subjects providers to a financial penalty for not using), Physician Quality Reporting Standards (PQRS), EHR and meaningful use, not to mention the fear of RAC Audits, Cert Audits-the list goes on and on. So who has time to get ready for ICD-10?
ICD-10, as we all know, is the new transaction code set for reporting diagnoses and inpatient procedures. All HIPAA covered entities (providers, insurance carriers and clearinghouses) must be ICD-10 compliant beginning October 1, 2014. This is not going to be an easy transition but, with the right mindset and strategy, it can be more manageable. But, the time to act is now. Delaying this transition can seriously interrupt your revenue cycle and cash flow, not by weeks but by months. The main question to ask yourself is whether you can afford to not implement a plan?
So what should you be doing now, if you have not already started?
• Establish a transition team and appoint a team leader. In order to formulate an effective transition plan, they should begin by analyzing your specific practice needs.
• Develop a plan for making the transition to ICD-10; include a timeline that identifies when specific tasks and milestones are to be completed. Identify who will perform each task, identify what resources are needed and estimate the start and end dates for each task.
• Determine how ICD-10 will affect your organization; incorporate a review of how you currently use ICD-9 codes. Include the use in authorizations/pre-certifications, physician orders, medical records, superbills/encounter forms, practice management and billing systems, and coding manuals.
• Review how ICD-10 will affect clinical documentation requirements and electronic health record (EHR) templates.
• Communicate the plan, timeline and new system changes and processes with everyone in your organization and ensure that your organization leadership and staff understand the extent and importance of the ICD-10 transition.
• Secure a budget that accounts for software upgrades, hardware procurement, staff training costs, revision of forms, work flow changes during and after implementation and risk mitigation.
• Talk with all your payers, billing, IT staff, practice management system and/or EHR vendors. Find out where they are in the transition process and coordinate your ICD-10 transition plans with them.
• Finally, talk to your trading partners about testing and create a testing plan.
If you take the time now and follow the steps listed above, transitioning to ICD-10 will be easier and less frustrating for you and your practice. If you still feel that you don’t have the time or resources to sit down and analyze what you need, consider outsourcing to a company that can make the ICD-10 transition a priority. They will offer expertise and assistance through the whole process. Outsourcing can also be more cost effective depending on your practice size and needs.
Remember, to avoid costly delays and gaps in your revenue cycle and cash flow, the time to act is now. An effective long term plan, established early, can ease the ICD-10 transition for you and your organization.