AHIMA's ICD-10 starting points

Carl Natale
by Carl Natale

Even now in 2011 readiness surveys are still showing many healthcare entities lagging on HIPAA 5010 and ICD-10 conversions. Bearing that in mind, an article in the February issue of The Journal of AHIMA outlines three steps health entities can take to kickstart ICD-10 projects.

“While almost every department and service within an organization will be affected by the transition (including physicians), the HIM and IT departments will do the heavy lifting,” writes Katie Carolan, vice president at Health Records Services.

With that, here are AHIMA's recommended starting points:

1. Develop a schedule for system upgrades.
ICD-10 will necessitate upgrading myriad IT systems from various vendors. Applications are one thing but interfaces between systems are a tangled web, and could be a “a catastrophic weak link in an otherwise successful ICD-10 conversion,” Carolan explains.

Begin by creating an integrated plan that involves all relevant vendors, ask when systems will be ready, which versions bring any ICD-10 upgrades, and query vendors on what changes they expect between now and the October 1, 2013 compliance deadline. Those steps will also help to build a budget, which should include upgrade and support fees as well.

[Related: HIMSS top 5 obstacles to HIPAA 5010. See also: 7 tactics for making ICD-10 urgent.]

“If upgrade or new support costs are substantial enough, 2011 may be an ideal time to consider changing systems,” Carolan adds. “Many of the newly developed software applications were designed with ICD-10 in mind. Any system purchases at this point should include negotiated support for ICD-10.”

2. Line up human resources. Healthcare organizations will need ICD-10-seasoned personnel for testing, training and the transition.

“In addition to ensuring their own staffs are trained on ICD-10-CM/PCS, HIM directors also must make sure their vendor staffs are up to speed. Again, with resources stretched, knowledgeable staff may be limited,” Carolan writes. “Directors can ask their vendors if they have an ICD-10 training plan for staff and if it is open for review.”

3. Collaborate with payers and physicians. Coordination and communication are key on both sides of the house. Payers need to be included with testing, and physician with training.

“The most delicate changes will be those affecting physicians. HIM directors must have medical staff participation and buy-in from the very start. Physician-based systems will need to be evaluated, and physicians will require some level of training,” Carolan continues. Peer-to-peer training is perhaps the most effective, and it should be timed in accordance with the medical staff.

Although ICD-10 promises to impact almost every department within healthcare organizations, the HIM staff are uniquely situation to lead the planning. 

“HIM governs the health information environment and has the most expertise in structured codes and quality and core measures. It can coordinate the planning process within the organization and with system vendors,” Carolan explains in An ICD-10 Vendor's Checklist. “At the very least, HIM will need to take a leadership role on the ICD-10 team, as its expertise will be invaluable.”