How to get some help assessing ICD-10 financial risk

Carl Natale
by Carl Natale

The financial impact of ICD-10 implementation goes beyond paying for new software. The new medical codes could affect healthcare providers' revenue.

Figuring out that financial risk can be as complicated as the actual programming required to become ICD-10 compliant. Which means you may need to outsource an ICD-10 risk assessment and craft a request for proposal (RFP) to find the right vendor or consultant to do the assessment.

According to Steven Gerst, chief medical officer at Jvion, and Aman Khanna, director of medical informatics at Jvion, discuss key questions healthcare providers need to ask while creating the ICD-10 financial risk assessment RFP so they can achive:

  • "The ability to project impact to revenues for the entire organization"
  • "The ability to identify the specific negative dollar impacts to the mandated ICD-10 conversion down to the code, department/specialty, and physician level"
  • "The ability to better prioritize training, documentation, and system/IT conversion activities"
  • "The ability to identify potential clinical documentation improvement (CDI) opportunities within the ICD-9 code set that will optimize reimbursements today and mitigate financial risk in ICD-10"

They also list ICD-10 risk assessment questions and assessments that should be in the RFPs . The two posts are very thorough and worth reading for anyone who needs to evaluate vendors.

More help with vendors

Working with vendors is a popular topic here at ICD10Watch.com. Here are a few more resources:

Taking a Revenue-focused Approach to ICD-10

This is a two-page PDF from jvion that breaks down how ICD-10 implementation can affect your finances. And there are plenty of tips to move your organization along the way. (ICD-10 PlayBook)

Successful ICD-10 implementation starts with attitude

The people at BridgeFront share some tips that focus on winning the hearts and minds of physicians who need to support better clinical documentation. (ICD10 Watch)

HIMSS, WEDI launch pilot program to standardize ICD-10 testing

This is an interesting initiative that aims to help healthcare organizations test ICD-10 systems and learn from shared results. Stay tuned for more information on this program and what its doing. (ICD10 Watch)

ICD-10 Delays Present Opportunity to Improve, Upgrade Technology

David Lareau has some pretty good things to say about how electronic health records (EHRs)  are going to work with ICD-10 implementation. Here are five very good questions that he addresses:

  • "Does your EHR include content and tools combined with structured coded data to manage ICD-10?"
  • "Is your EHR capable of managing the inevitable HIE Data Tsunami?"
  • "Does your system map to all terminologies? Offer intelligent prompting?"
  • "Does your EHR allow for future updates to address new requirements?"
  • "Is your system easy to use and does it get used? Does it work for clinicians?"

(Healthcare Finance News)

Medical Coding Expert Doug Palmer Talks About the Future: Computer-Assisted Coding, and ICD-10

There is a nice interview with Doug Palmer, a practice management, billing and coding and revenue cycle consultant. Toward the end of the Q&A he has an interesting comment on CAC:

MMP: "Do you think computer-assisted coding (CAC) will ever take the place of coders?"

Doug: "Absolutely not. At least not as long as the coding methodology is as it is now. I have actually worked with a number of these systems, and there are too many areas where context is involved and these systems are yet to be able to accurately and reliably handle context. If that hurdle is ever solved, then perhaps. But, until then, I can not envision this being nearly as reliable as the human element."

(Manage My Practice)

Providers Prepare for ICD-10 with Computer-Assisted Coding

A fairly quick introduction to computer assisted coding (CAC) with a link to an earlier article on using CAC to address medical coder productivity concerns. (Health Data Management Magazine Article)

ICD-10: Prepare for documentation changes

Now we're being constructive. It's not detailed but nonetheless a reasonable introduction into the documentation needs in ICD-10 coding. (MGMA-ACMPE)

Q&A: Preparing for ICD-10, competing HIT initiatives

There isn't much here beyond a reminder that healthcare providers need to fit ICD-10 implementation, meaningful use and accountable care organizations (ACO) into schedules and budgets. (EHRintelligence.com)