5 Ways to Take Advantage of the ICD-10 Delay [Part I]

Posted by KUNAL JAIN on Jan 22 2015

ICD-10_DelayThe official ICD-10-CM/PCS implementation deadline was pushed back from Oct. 1, 2014 to Oct. 1, 2015, giving physicians and other healthcare professionals an additional year for preparation. However, the countdown is on – which means that we now only have a little over 8 months left to successfully transition in physician practices.

If you haven’t started your ICD-10-CM preparations yet, then I would strongly advise you to begin ASAP and make it a priority. Why? The inability to achieve full ICD-10 readiness by the current deadline will result in claim denials and major disruptions to your revenue stream. As a physician and owner of your own practice, you know you can’t afford to fall behind on your overhead due to an under-developed ICD-10 administrative process. The sooner you begin your ICD-10 preparations, the less stress, administrative chaos, and cash delays you will have to deal with.

In order to make the ICD-10 transition as smooth and painless as possible for you and your personnel, we will cover a few simple tips that can shed some light on where to start and what to do in your specialty practice.

Create a comprehensive budget for your ICD-10 implementation

Let’s face it: ICD-10-CM integration is going to cost some money because ICD-10 means additional staff training, EMR/EHR software upgrades and installations, some revenue disruption, and a host of other things. My advice: plan out exactly what you will need for ICD-10 and obtain precise quotes for each item. Careful planning and budgeting is essential to ensuring that you don’t lose valuable time and money.

According to projections by America’s Health Insurance Plans (the national trade association for health insurance), overall ICD-10 implementation will cost the nation between approximately $3.2 billion and $8.3 billion. Consulting firm Nachimson Advisors LLC estimates that ICD-10 expenses will range from $83,000 to $285,000 for small to mid-sized practices, and up to $2.7 million for large practices. Naturally the exact ICD-10 costs depend on the size of your practice, your medical team, and EMR technology

Maintain tight communication with your EMR/EHR software vendor for system upgrades

Your EHR software vendor is super critical to your ICD-10 transition because they have to update, modify, and provide technical support for all of their applications in light of ICD-10. Always keep abreast of their latest ICD-10 emails and developments. Don’t hesitate to contact them if you have any questions or concerns, such as:

  • How much will these EHR updates cost? (As a side note: EHRs come as cloud-based applications or client-server-based software, meaning the software is hosted on the practice’s private server. EHR cloud computing will be generally less expensive because it doesn’t require additional fees for technical specialists to conduct the manual installation process.)
  • Will the software vendor educate you on new ICD-10 functionalities?
  • What should you do if IT issues arise with the ICD-10 updated software?
  • How often will the software vendor update the EHR for ICD-10, and how will you receive these updates?
  • Will the software vendor discontinue some of its EHR or practice management applications due to ICD-10?

Ensure your software vendor provides answers to all of these questions so that you know what to expect as the ICD-10 deadline gets closer.

Additionally, certain EHR applications exist that may assist you in gaining knowledge and familiarity of ICD-10 codes. I recommend you ask your software vendor if these IT tools will be incorporated into your updates.

  • EHR clinical documentation templates: A physician’s clinical documentation needs to match the level of detail and specificity required of ICD-10-CM/PCS. Omitted or irrelevant medical data on the patient encounter will delay or hinder finding the correct ICD-10 code for medical records and insurance claims transactions. These electronic templates facilitate the input of precise, structured, and complete clinical data into the EHR so an accurate ICD-10 code could be found quickly. Templates for specific patient conditions and treatments are also available.

  • Interfaces for ICD-10 code search: An EHR/EMR software system should come with a user-friendly interface that allows you to enter a medical keyword search term before the application brings up matching ICD-10 codes to the forefront. It shouldn’t be complicated or hard to navigate.

  • ICD-10 General Equivalency Mappings (GEMs): GEMs are bi-directional translation tools for ICD-9 and ICD-10; that is, plugging in an ICD-9-CM code will bring up all comparable ICD-10-CM codes and it also works in reverse. However, don’t depend on GEMs exclusively to learn ICD-10-CM codes because ICD-10 is far more comprehensive than the previous code set. Further, ICD-10 includes medical concepts that ICD-9 does not. For these reasons, GEMs should be used as a component of your overall ICD-10 training regimen to prevent coding inaccuracies and discrepancies.

We hope this information proved useful to you as you transition to ICD-10, and there’s more to come. Stay tuned for Part II of 5 Ways to Take Advantage of the ICD-10 Delay!



Topics: ICD-10 Transition, ICD-10 Delay

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