If you haven't started your ICD-10 transition, you need an impact assessment.

Figuring out what needs to be done to be ICD-10 compliant is a project in itself. One that could be outsourced to consultants or handled in house. Either way, it's about finding gaps.

"You identify those gaps.. those issues where those places where you need to spend your time, and energy between now and Oct. 1, 2013," said Bridgefront executive vice president Lorraine Schnelle.

What makes it so difficult is finding the time to make this assessment said Schnelle. Competing priorities in the healthcare industry make it evenmore challenging.

"It's a big nut to crack," said Schnelle. "You have to break it down into incremental bits and pieces. Otherwise you're going to continue to spin... not really continue to make forward momentum."

Here are some of the pieces that need  to come together in an ICD-10 impact assessment:

Systems

Identify the systems and applications in your organization that will be affected by the ICD-10 transition. Basically, that's every piece of software that uses an ICD-9 code. One suggestion for healthcare providers is to track a patient's encounter with the staff. Look at every step from scheduling to examination to billing. See where the ICD-10 codes will be needed.

[See also: Don't start ICD-10 implementation until you warn the staff it's coming]

Vendors

Talk to the software vendors you're currently using and evaluate their readiness. Schnelle recommends asking the right questions:

• Where are you in the ICD-1o transition?
• What's your plan?
• How does this impact the software?
• How are we going to reach full compliance?

And the same conversation needs to happen with service vendors. They are providing services such as billing, medical coding and transcription. You need to evaluate them for readiness too.

Payers aren't vendors but Schnelle says their readiness needs to be evaluated also as if they are vendors.

Training

The ICD-10 impact assessment needs to identify who needs to be trained and what they need to learn

[See also: ICD-10 Implementation: How to get your staff ready to use ICD-10 codes]

Documentation

Systems aren't the only thing that needs to be upgraded. Apply a clinical documentation improvement (CDI) documentation gap analysis to forms, super bills, encounter forms, charts, etc.

Cost

This is the part that hurts. You have to create a budget for making all this happen. How much money you will spend depends on who you talk to. But you won't get accurate estimates until you have a good impact assessment that tells you and the vendors what needs changed.

People

Schnelle emphasizes that while a lot of the focus of an impact assessment is on systems, you cannot forget the people involved in your organization. None of this will work unless you get them all on board and working toward the same goal.

[See also: Lorraine Schnelle on "ICD-10 Transition: Why you need to engage the whole organization"]