4 Ways to reduce ICD-10 risks

Carl Natale
by Carl Natale

ICD-10 is a mammoth transition bound to bring many unknowns. Far too many variables exist to allow a crystal-clear picture of the new code set's impact on the healthcare industry, in fact. But even with compliance day still two-and-a-half years away, there are tactics healthcare organizations can engage today to control some of the dangers. 

“Although there is no way to eliminate the risk and uncertainty, there are steps organizations can take throughout ICD-10 implementation to manage the risk,” explains Pat Zenner, a healthcare management consultant at Milliman, in the article ICD-10 impact on provider reimbursement.

[Related: Major ICD-10 factors in provider reimbursement. See also: Top 5 ICD-10 myths, debunked.]

Zenner continues that there are four ways to mitigate risk, if they're conducted during the appropriate planning, preparation, implementation and post-implementation stages.

1 Planning
In this phase, Zenner recommends that organizations identify goals, allocate resources to making necessary changes, chart a road map for how to achieve ICD-10 compliance and communicate with external partners.

2 Preparation
“Analyze and test the portion of codes not cleanly mapped in order to assess the potential reimbursement impact, modify standardized schemes, modify contracts to provide for the uncertainty that will accompany the transition 'data fog,'” Zenner writes.

3 Implementation
What with the clock ticking, the implementation phase is the time to actually provide those allocated resources so your organization can achieve timely and accurate coding and reimbursement, Zenner adds. “Be over-prepared to address issues as they arise.”

4 Post-implementation
Once ICD-10 is implemented and compliance day, October 1, 2013 has come and gone, healthcare organizations will need to monitor KPIs (key performance indicators) for any potential issues, actively manage reimbursement, and continue to promote open communication, Zenner explains.

“One of the more unpredictable sources of impact may be in the change process itself,” Zenner writes. “It is not uncommon for issues to be unearthed when changes are made to a system or application. Likewise, the conversion may create new undetected and unintended changes.”