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On July 31, 2014 the Department of Health and Human Services announced it was delaying the ICD-10 deadline to October 1, 2015. This news may have come as a blessing for some organizations, but for a majority it just added to the mounting list of ICD-10 and CMS frustrations. With billions of dollars already spent on time and resources, organizations are faced with a tough decision to either stay on course and cutover anyway, or halt the implementation all together.
With a new deadline in place, organizations have options when it comes to transitioning to ICD-10 codes. Determining the right approach may be impacted by the ICD-10 readiness of Electronic Health Records (EHR) vendors and external payor organizations including government and commercial entities. Nevertheless, electing to forge ahead allows organizations to maintain momentum, save on the overall budget and buy more time to remediate people, process, and technology issues ahead of the deadline.
Today most EHR vendors are ahead of the ICD-10 curve, allowing organizations to continue towards the previous deadline of October 2014 through the use of technology crosswalks. These crosswalks along with the use of algorithms enable organizations to diagnose with ICD-10 codes, but continue billing with ICD-9 codes. This approach requires close collaboration with payors during the testing process to ensure there will be no negative impact to the revenue cycle process, and claims will not be rejected. Also considering staff will be trained on ICD-10 almost a year ahead of the deadline, organizations will have more time to improve and increase staff education on ICD-10 which in turn lessens the impact when the light turns green on October 1, 2015.
Another less favorable option for organizations would be to either halt or slow their current ICD-10 implementation and restart closer to the new October 1, 2015 deadline. Since most organizations have already gained momentum purchasing or upgrading technology, training users and improving processes and workflows, choosing to stop the ICD-10 transition will create new challenges such as resource availability and retention, leading to increased costs for training and backfill resources. This approach will have a significant impact on all staff and will require organizations to re-train users on ICD-10 concepts, coding and system functionality.
No matter if your organization is large or small, the complexity of implementing ICD-10 codes significantly impacts current workflow processes and systems. Many industry professionals tend to view ICD-10 codes as impacting only clinical functions; however, the impact spans into all areas within an organization. The first step of planning needs to focus on all workflow processes from patient registration and admissions to diagnosing and treating, to billing and collections, to reporting and data integration with external systems. The key is to identify and document the ICD-9 touch points within current workflows to understand where the ICD-10 touch points will be. This not only helps to the processes most impacted by ICD-10, but also assists in developing a training plan specifically tailored to each role within the organization based on the assessed degree of impact.
Technology remains a cornerstone of the healthcare industry and will have a major impact on the overall success of the ICD-10 transition. A critical path all organizations must take during the planning phase is to inventory and assess all systems that import or export ICD-10 data. This process will act as the foundation in developing both the internal and external ICD-10 testing strategies. The internal systems testing strategies need to focus on the setup requirements, functionality and the end to end user testing relating to ICD-10. The external testing strategies need to be developed in conjunction with external vendors testing requirements aimed at validating the data integration of ICD-10 transactions.
With billions of dollars already spent and frustrations mounting, reaching ICD-10 success is at the mercy of the providers. Developing a comprehensive plan that focuses on people, process and technology will drive any organization through the initiation, planning and execution phases of the ICD-10 implementation. Addressing the People component by leveraging an Organizational Change Management (OCM) strategy will positively influence the user experience and organizational buy in. Analyzing the Process component will measure the areas within the organization impacted by ICD-10 and assist in creating a training plan based on the roles of the organization. Developing the Technology component will align internal systems testing with external vendors testing to meet data integration requirements and achieve ICD-10 compliance.
In conclusion, CMS estimates the one year delay will cost the healthcare industry an additional 1 to 6 billion dollars and impact more than 25,000 students entering the healthcare field that have been educated exclusively on ICD-10 codes. Regardless of the numbers, the ICD-10 compliance date is coming so it’s better to be prepared and forge ahead with an effective strategy, then hope for another delay and risk being out of compliance and on the brink of financial disaster.
Jeff Brevik, Senior Consultant has over 6 years’ experience in the implementation and delivery of complex Electronic Health Records (EHR) solutions to healthcare providers nationwide. To find out more about how MSS can help your organization implement ICD-10, contact us at firstname.lastname@example.org.
Cite this blog post:
MLA: Brevik, Jeff. “Now is not the time to put the transition to ICD-10 codes on the shelf!” MSS.MSS. Blog. 08 April 2015.
APA: J Brevik. (2015, Sept 11). Now is not the time to put the transition to ICD-10 codes on the shelf!