ICD-10 Transition: Maybe it's time to panic a little

Carl Natale
by Carl Natale

We are about 14 months away from the ICD-10 implementation deadline. Surveys report that healthcare providers are in various states of readiness.

QualiTest Group surveyed more than 300 professionals about their ICD-10 testing plans. The two major findings are:

  • Most respondents have either completed ICD-10 assessments or are in the process of assessments.
  • 75 percent of respondents have not yet begun ICD-10 testing.

While starting sooner than later is important, this survey doesn't raise too many alarm bells. It does report a great deal of planning and progress in the ICD-10 transition. Other surveys released in the past few months have found less preparation.

Perhaps a more troubling indicator is the amount of newly released literature that suggests there is an audience that hasn't heard of ICD-10 implementation. If the healthcare industry is on its way to a smooth ICD-10 transition, we wouldn't need so many guides to planning ICD-10 implementation.

Seriously. That's so 2012.

The latest example I found is the white paper ICD-10: The Top 10 Things You Need To Do NOW from the medical billing firm MediGain. They advise:

  1. "Set up a team and appoint a leader."
  2. "Evaluate current software systems and office procedures in which you use ICD-10."
  3. "Pinpoint possible changes to your workflow and office processes."
  4. "Communicate with your payers about any modifications that need to  be made  to your contracts due to ICD-10."
  5. "Think about training efforts and costs."
  6. "Converse with your trading partners."
  7. "Test with your trading partners."
  8. "Survey your current PM vendor."
  9. "Assess your internal office systems and functions."
  10. "Revise and account for any plan adjustments."

Healthcare providers should have completed half those steps by now.

If not, then they should download the MediGain white paper. It's actually a pretty good document to start. The more detailed ICD10 Watch Implementation Timeline will help explain what needs to be done.

MGMA anticipates problems, disruptions with ICD-10: Q&A

  • Robert M. Tennant, MA, Senior Policy Advisor at the Medical Group Management Association (MGMA), can't figure out why CMS won't conduct end-to-end testing.
  • Before the HIPAA 5010 transition, National Days of Testing were very helpful.
  • Healthcare payers need to test more than if they can accept ICD-10 codes. They need to see how their payment policies will be affected.
  • Clearinghouses report 20 percent of their clients are still using HIPAA 4010 — which cannot handle ICD-10 codes.
  • Tennant worries that state Medicaid agences won't be ready for ICD-10 implementation so healthcare providers will need to use dual coding practices to get reimbursed.
  • Healthcare providers need to start practicing assigning ICD-10 codes to medical claims.


Cash on hand: You'll need it for ICD-10

  • Expect delays in reimbursements after Oct. 1, 2014.
  • Hoard enough cash to cover three to six months of operational expenses.
  • Talk to banks now when you don't need it.
  • Ask healthcare payers about contingency plans.

(Healthcare Finance News)

Increasing Revenue and Planning for ICD-10: How Clinical Documentation Improvement Accomplishes Both

Mel Tully, senior vice president of clinical service and education at technology firm Nuance, has three tips:

  1. Improve documentation now for ICD-9 coding.
  2. Analyze the DRGs and procedure codes that account for most of your revenue.
  3. Medical coders should start clarifications and queries now for information that supports ICD-10 coding.

(Becker's Hospital Review)

Dual-Coding: An ICD-10 Strategy You Can Take to the Bank

Bonnie Cassidy writes about why healthcare providers need to consider dual coding:

  • It will require time and effort but should be worth it.
  • There are risks by not dual coding:
    • Not assigning the right ICD-10 codes.
    • Losing revenue.
    • Increasing claim denial and audits.
  • Medical coders will gain practice.
  • ICD-10 transition team can assess its education and training programs.

(For the Health of IT)

Three questions to ask your payers about ICD-10

  1. Will you conduct external testing?
  2. Will you be dual processing, and if so, when will you start?
  3. What will happen if something goes wrong?

(Health Security Solutions)

Getting to the Good Stuff: An Active User’s Opinion of ICD-10

Barbara Aubry sings the praises of specificity. (3M Health Information Systems)

Diagnosis and Procedure Codes: Abbreviated and Full Code Titles

CMS has released the final update for the ICD-9-CM code set. It goes in effect Oct. 1. (Centers for Medicare & Medicaid Services)