In my first blog for this series, I emphatically stated that I would not say this out loud, but it looks as though ICD-10 is going to happen. While H.R. 2126 was introduced on April 30 calling for a complete ban on ICD-10 coding implementation and H.R. 2247 was just introduced May 12 to impose an 18-month testing cycle on the Centers for Medicare & Medicaid Services, resistance at this point seems tepid. Additionally, given that the American Medical Association has called for members to have readiness and contingency plans, as well as positive statements coming from CMS and the Office of the National Coordinator, it appears we can begin the countdown to Oct. 1.

All doubts aside, with about only 140 days until go-live, it is time to really implement all those recommendations we have been telling our boards about.

By now, system upgrades and configurations should be done and some level of testing should have occurred. Financial situations should have been assessed and claim denial patterns analyzed. Lines of credit determined and coder staffing shored up. So what's left? The easy stuff: Training all those people who will work with ICD-10 codes. All kidding aside, many organizations are still miffed about the time and effort they put into training the last go-round and that all that training has to be redone. While that may be true, it is time and there is a lot to do. In fact, some believe that if you are starting now, you are already too late. Coders, general health information management staff, registration staff, billers, quality staff, data analysts, physicians, other clinicians and affiliated community physician offices all need varying amounts of training. 

Many training tools have been developed by content providers, vendors and industry groups; all varying in scope and depth. Your organization even may decide to use different training tools according to the group being trained. By now, your coders should have had significant exposure to the ICD-10 schema, perhaps along with your registration and billing staff. The training that needs to start without delay — and is possibly the most difficult — is for clinicians and physicians.

Depending on your organization's approach, ICD-10 training could be costly. While large hospitals and health systems can absorb the cost, independent physicians and small community hospitals and clinics may struggle. The good thing is that in addition to purchased tools, there is no shortage of free information and training materials. AHIMA, the American Hospital Association, HIMSS and even the AMA, all have some kind of ICD-10 training materials and assessment tools available. The World Health Organization offers an online training tool that, while it does not include U.S. modifiers, is a great place to start. There is also an abundance of training material on YouTube. Whatever your approach, understand the specific need and tailor your training to that group. And don't forget your community-based docs; while they might not be your responsibility, their ICD-10 fluency will impact your organization at some level. Helping them with this endeavor now is a good way to foster good will and avoid potential patient impacts later.

Linda Reed, R.N., is vice president, behavioral and integrative medicine, and chief information officer at Atlantic Health, a five-hospital health system based in Morristown, N.J.