Planning to Meet the ICD-10 Deadline

The deadline for the transition from ICD-9 to ICD-10 is drawing near – yet many healthcare providers have not yet started to ready their organizations for the monumental change ahead.

Consider the following: A survey that was published in June of 2013 by the Medical Group Management Association (MGMA) indicated that only 4.8 percent of physician practices had made significant progress when rating their overall readiness for ICD-10 implementation.

“The transition to ICD-10, with its substantial impact on documentation of clinical care, physician productivity and practice reimbursement, is unprecedented,” said Susan L. Turney, MD, MGMA President and CEO, in a statement. “It is proving to be one of the most complex and expensive changes our healthcare system has faced in decades.”

Indeed, the job is quite ominous. Healthcare organizations will need to transition from using about 13,000 ICD-9 codes to more than 68,000 ICD-10 codes. In addition, the codes are more complex as well. ICD-9 codes are three to five characters in length, while the ICD-10 codes are three to seven characters. The more complex ICD-10 codes provide greater specificity to identify disease etiology, anatomic site, and severity.

Even with MGMA and a variety of other industry groups rallying for a call to action, many healthcare organizations, both medical practices and hospitals, have yet to jump on the bandwagon, according to Jonathan Levoy, Vice President of Business Development & Technology at Alego Health, a healthcare information technology consulting firm in Westlake, Ohio.

“Nobody is really gearing up the way they need to be,” Levoy warns. “Most healthcare organizations across the United States, including doctors’ offices, are not yet addressing the challenge. The real problem they are going to run into, though, is that everybody has the same go-live date. So, if you wait too long, the deadline will come and go and you won’t have the resources to get the job done.”

To meet the quickly approaching October 1, 2014-deadline, Levoy is advising organizations to do the following:

1. Get started – now, not later. “In order to meet the deadline, healthcare organizations need to sign up and get committed to the process. A lot of physician practices and other provider organizations have not yet taken this first step and they really need to do that if they are going to meet the deadline, which is now less than a year away.”

2. Develop a one-of-a-kind plan. “Healthcare organizations need to realize that there is no one way to get to ICD-10. We work individually with each provider in a very client focused manner.  There is no cookie-cutter approach that will work. When Alego partners with healthcare organizations, we make sure that the providers are integrating their own philosophies and approaching the transition in a way that will make them successful. The plan will include an analysis of current systems to see where they are at with everything. We will then develop a unique roadmap that ensures that the organization accomplishes all that needs to be done before the deadline.”

4. Zero in on the technology. “You need to look at how the changes will affect information technology. For ICD-10, it is especially important to start planning and building the interfaces between electronic medical records systems and billing systems.”

5. Get smart. “Organizations should make sure they have the technical expertise to make these changes. If not, then, they need to recruit staff or engage with a consulting organization that can provide the expertise.”

6. Educate coders. “Billers and coders will need to be educated to truly understand the new codes. Some organizations might decide to bring in new ‘green’ billers and coders and train them on the ICD-10 codes. Others might want to keep their current billers and coders and train them on the differences between ICD-9 and ICD-10.”

7. Make sure payors are ready. “Healthcare providers need to talk with each of their payor organizations.  A big piece of the transition is making sure that all the insurance companies will be ICD-10 compliant by the Oct. 1, 2014 date.”