Barring a drastic turn of events, it looks like it is full steam ahead for ICD-10. Legislation approved by the House to fix the sustainable growth rate did not include a provision to further delay transition to the new coding set. Most Beltway watchers expect the Senate to pass on doing so as well. Hopefully, you have been working on the implementation process already. If not, you have six short months in which to prepare for this critical event.
Have you checked to make sure that all of your software is ICD-10 compliant? Remember, this is not just a coding and billing project. Many of your other clinical software systems also use ICD-10 codes. Do you have a stand-alone laboratory information system? If so, is it ready to accept ICD-10 codes? What about radiology and pharmacy?
Are your coders ready? Have they been dual coding for some time so that they have an idea how the different code sets are related and how they are different? Do they understand what additional documentation they will need from providers to correctly code each case?
Have you tested your system to see how it works with your Medicare administrative contractors and as many private vendors as possible? It is not only important to know if your systems works correctly; now is the time to find out if your payers are ready for this conversion.
How is your physician training going? I am sure that you are going to have some providers that will be resistant to going through this training process, and I guess that is OK. Don’t beat them over the head to get them trained. You need to make sure that you have a critical mass of your providers familiar with the new codes and willing to provide the extra documentation necessary. I am probably considered an optimist, but I believe that reluctant providers will not want to be seen as different from their colleagues and will come around eventually.
Have you thought about what you are going to do if glitches to the system are found and payers are not able to process claims for some time? Can you survive on your reserves until the problems are resolved or do you need to make plans for a line of credit with your bank? Several years ago we had a problem with Medicaid accepting our 835 electronic remittance transactions and it was several months before we received payment for billed claims from them.
Implementation of ICD-10 is major, organization wide process. When we combine this with every other major change that we must deal with, it is easy to feel overwhelmed. But, if we start early and schedule the various processes involved in the implementation, it is doable. And, when the process is complete, we will have better records and plenty of reasons to celebrate our success!
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.
