March 04, 2014
By Jackie Griffin
It's less than 10 months until the ICD-10 deadline, but many providers are finding it difficult to get started with their ICD-10 planning. Others have started their efforts, but a transition of this magnitude can be overwhelming, and many don't know what the next step should be.
Whether you're stuck in the middle of planning or still trying to get
started, here are five steps to help make your ICD-10 plan more manageable:
Identify all the places where your practice uses ICD-9 in current workflow.
Some examples of areas where ICD-10 will impact are clinical documentation,
EHRs, superbills, paper claims, electronic claims and reporting for government
agencies. Wherever ICD-9 is used, there will be an ICD-10 impact, so identifying
these areas now will help you plan how to transition them.
Conduct a gap analysis to understand where you need to be by October 1,
2014. The results of the analysis will help identify any gaps within your
workflows, documents and technology systems that will make it difficult to
transition to ICD-10. You'll need to focus your preparations here to avoid
any negative impacts to your practice, such as delays in reimbursement or
inefficient use of staff time.
Identify solutions that can help your practice transition in these areas,
such as new coding books, new superbills and new paper claim forms. For nearly
every practice, these solutions should include updating your existing software
to accommodate ICD-10 codes. Your practice management software vendor and
your clearinghouse may have already notified you about how they are updating
their systems for ICD-10. If you haven't done so, contact your vendors to
learn whether you need to install new upgrades for ICD-10.
In addition, you need to think about how you will train your clinical and
front office staff for ICD-10. Some industry associations, such as AAPC, offer
training boot camps to get your staff up to speed. Other organizations, including
CMS, offer ICD-10 resources on their websites for you to use to help prepare
Outline your ICD-10 plan. Start by listing the solutions you plan to pursue,
steps needed to implement them, expected cost for each step and timeline for
completion. This will help you budget your time and resources appropriately.
Industry research estimates that transitioning to ICD-10 will cost the average
10 physician practice more than $200,000. In addition to the costs associated
with preparation, many practices will experience delayed reimbursements and
decreased productivity once ICD-10 takes place. It's recommended that you
secure a line of credit at least six months prior to the ICD-10 deadline so
you can keep your practice afloat.
Implement your ICD-10 plan. This will include training your staff, learning
how to use new versions of your EHRs, installing software upgrades, adjusting
internal processes, testing your claims with your clearinghouse or payers,
and establishing a line of credit.
In addition to these steps, this ICD-10 Planning Worksheet is a helpful tool to guide your practice through each part of your ICD-10 transition.
Planning for ICD-10 is overwhelming, but attempting the transition without
a well-organized plan could be catastrophic for your practice. I encourage you
to take the time now to organize your efforts, one step at a time, to ensure
you are ready for the deadline.
Griffin is an Associate Vice President in Client Services
over the training and operational support teams at TriZetto Provider Solutions.
The training team is responsible for the coordination and delivery of all training
to build the skills of new and existing associates. The operational support
teams focus on the overall direction, implementation control and completion
of specific projects ensuring consistency with company strategic objectives.
The team's goal is to increase readiness and decrease the time and resources
required to achieve results.
Currently, Jackie serves as the company's ICD-10 expert, leading efforts
to educate customers and the industry about ICD-10 planning, issues and concerns.
She previously managed much of Gateway EDI's 5010 transition strategy, planning
Jackie began working at Gateway EDI - A TriZetto Company in 1999 to help
with Y2K planning. She has served in several customer service positions throughout
her career, including supervisor for executive accounts, before moving into
her current role.
Jackie was a feature speaker for the Workgroup for Electronic Data Interchange
5010 Forum and the GetReady5010 webinar series, presenting on topics such as
HIPAA 5010 Testing for Small Practices and Planning for the What ifs of 5010.
She is an active member of the Workgroup for Electronic Data Interchange
and Accredited Standards Committee X12. She also actively participates in other
industry groups such as American Medical Association and Medical Group Management