There are just 75 days remaining before the Oct. 1 go-live date for ICD-10. Are you and your providers ready or are you procrastinating like some of my colleagues here in Nebraska?

When I visit with my friends from the American Hospital Association who spend lots of time on Capitol Hill, they say that there is no appetite for another delay in Congress so we had better be ready.

We have tried to be proactive in preparing for this major change in coding, but we still find ourselves surprised from time to time by how insidious these diagnostic codes are in our information systems.

For instance, we are a site-visit hospital for our health information technology vendor and we recently had a meeting with the other site-visit hospitals. The topic of interfaces came up. We found out that almost all of our interfaces share diagnostic codes that need to be ICD-10 compliant. Interfaces with such things as a reference lab, teleradiography, and health information exchanges should be checked for ICD-10 compliance.

I was visiting with our coders and asked them what kind of issues they are encountering as they prepare for this major change. One of them said that the biggest problem she faces is the granularity now needed in documentation. For instance, under ICD-9 when a patient is admitted to the emergency department with an injury, she had to provide the place where the accident occurred — in the home, at work, etc. In ICD-10, she’ll have to add which room in the house the accident occurred. It will take some time to work with our providers so that this level of documentation is normal. 

Our health information management department has been proactive in preparing for ICD-10 implementation for about two years. Still, they have scheduled an ICD-10 specialist to come in to train our coders. This tells me that as prepared as I know that they are, they are not leaving anything to chance. The hope is that the expert will come in and find out that we are doing everything correctly. But if mistakes are being made, we want to catch them before the go-live date. Maybe this is why we never have a problem with this department.

It appears that ICD-10 implementation is going to become a reality and I sincerely hope that it does. With all of the delays, we have all had ample time to prepare and it is now time that we keep pace with the rest of the world.

Marty Fattig is CEO of Nemaha County Hospital in Auburn, Neb. He serves on the Health IT Policy Committee's Meaningful Use Workgroup. He's a past president of the Nebraska Rural Health Association.