Maybe it's time to prescribe a healthy dose of panic

Carl Natale
by Carl Natale

I don't normally advise panic, but maybe it's time to make it part of our ICD-10 preparations.

About  87 percent of the healthcare professionals who answered Navicure's ICD-10 readiness survey aren't panicking. They're actually confident that they will be ICD-10 compliant by Oct. 1:

  • 22 percent are very confident
  • 23 percent are confident
  • 42 percent are somewhat confident
  • 9 percent are not confident
  • 4 percent are sure

That's usually is a good thing. But the survey that ended in Fall 2013 found that healthcare providers weren't very far along in their preparations and weren't sure where to start. But they're not worried because it's going to fall into place by Oct. 1.

The surveyed healthcare providers aren't worry free. They're concerned about cash flow after Oct. 1. Presumably because they're going to do everything right but you never know about those pesky health plans and testing-averse federal bureaucracy.

I'm suggesting medical practices find the money and time to start preparing and training.

WEDI ICD-10 Testing Concerns

Jim Daley, chairman of the Workgroup for Electronic Data Interchange (WEDI), wrote a letter to Health and Human Services (HHS) Secretary Kathleen Sebelius with these points:

  • The HIPAA Version 5010 transition was supposed to be a simple change. But issues arose when the applications had to process the transactions data.
  • ICD-10 implementation is much more complex than HIPAA 5010.
  • While it's good that the Centers for Medicare and Medicaid Services (CMS) has scheduled testing with MACs, more robust end-to-end testing is needed.
  • While end-to-end testing with all healthcare providers is not feasible, there needs to be some representation of the wide range of providers.

While this is all about testing, there was an interesting bullet point that read, "The single-date cutover does not allow for gradual implementation and identification of issues. Instead, issues will likely impact all trading partners at once."

Which sounds like WEDI is advocating for phased ICD-10 implementation deadlines.

Take ICD-10 survey by Jan. 31 to support AMA opposition to code set

The American Medical Association (AMA) isn't giving up its vigorous opposition to ICD-10 implementation. And it's using an interesting weapon: a survey. Here's how:

"Physician responses to the survey will help the AMA demonstrate challenges to adopting the new code set, which is expected to be costly and burdensome for physician practices."

So they know what the survey will say. They just need physicians to provide the data. And Government Health IT's Tom Sullivan suggests this survey is a good chance for physicians to do their part to delay ICD-10 implementation. (AMA Wire)

How Much Will the ICD-10 Transition Cost My Small Practice?

This is a pretty good post that has some tips for dealing with an approximate 50 percent drop in medical billing productivity after Oct. 1:

  • Test with software vendors and healthcare payers.
  • Create a rainy day fund to replace delayed reimbursements.
  • Develop billing metrics now so you know how bad things are going.
  • Training is an investment in cash flow.
  • Prepare to have enough staff.
  • Make sure all software is up to date.

(Practice Fusion)

ICD-10 Coding Basics

(CMS on YouTube)


  1. Read background information on ICD-10 (please see WEDI web site for additional resources)
  2. Assign someone to lead your ICD-10 effort. (office manager perhaps)
  3. Identify every place your office uses ICD-9-CM diagnosis codes or procedure codes and determine the impact (e.g. applications, forms, records, contracts, etc.)
  4. Determine if there are any clinical documentation implications (e.g. laterality or use of unspecified codes) and training that may be needed.
  5. Discuss ICD-10 with all your vendors (e.g. billing companies, clearinghouses, etc.) to determine their readiness and how it impacts your business operations. Determine what your vendor can and CANNOT do for you.
  6. Identify trading partners, health plans, public reporting requirements, etc. and potential impacts to these interactions
  7. Identify any budget impacts (do you need to purchase software upgrades, how much will training cost?).
  8. Compile a list of all the things you will need to do (action list) or verify (test)
  9. Form a project team; assign responsibility with timelines for completion (compliance plan).
  10. Begin your remediation.

(Workgroup for Electronic Data Interchange)

DIY ICD-10 conversion – Part 6

  • Using GEMs to convert ICD-9 policies is different from converting medical codes.
  • You need to look for exact matches.
  • You need to read Ron Mills' post about how to convert policies.

(3M Health Information Systems)