We're all familiar with countdown tickers, from Time Square's giant display on New Year's Eve to the tiny icon on your TV screen promoting an approaching season premiere. Of course, these visual countdown reminders usually promote something fun: A holiday. A wedding. Your favorite TV show.

Coders and revenue cycle staff may not have a ticker on their desktops to track the arrival of ICD-10, but the countdown is now officially on with less than a year left to prepare. Whether your organization is in kick-off mode or nearly finished, it is a great time to take stock: Is your transition progressing as planned? Does it thoroughly address key strategic factors such as clinical documentation review and updates, staff training, and internal and external audits and testing? Through your testing and quality assurance (QA) activities to date, have you confirmed updates work as expected and pinpointed any unanticipated work that needs to be added?

In particular, reviewing three key components of your plan-documentation review, training and testing-can help you gain momentum and ensure you're on the right track during the final countdown.

Sharpening Your Focus for Documentation Review and Updates
One of ICD-10's most daunting aspects is transitioning clinical documentation to meet more complex coding standards that don't always directly map to ICD-9 requirements. ICD-10 includes a fuller definition of severity, comorbidities, complications, manifestations, causes and other key information to help characterize the patient condition.

If you haven't started, this is the area that needs your foremost attention. Creating the foundation for accurate, detailed and comprehensive documentation requires time and effort. ICD-10's increased level of detail means required documentation will change substantially, and the jump from ICD-9's 14,000 to ICD-10's 69,000 codes represents a tremendous 400 percent increase.

To create a manageable work plan, first conduct a diagnosis code inventory and look for anything meeting three criteria: commonly used, complex patient encounter types and highest revenue producing. Especially in the final months, knowing the highest priority codes can keep your team focused. Taking inventory can be tedious yet very necessary work, so be sure to leverage available tools such as Navicure's ICD-10 Analyzer", which can jump-start efforts by identifying your top 20 ICD-9 codes.

Second, examine current clinical documentation to pinpoint any gaps with ICD-10's higher level of detail and specificity. Again, you can focus efforts by identifying critical areas of focus that necessitate change. Although ICD-10 brings an abundance of changes, there is a silver lining: ICD-10 is rooted in eight to 10 core documentation concepts (1), so when physicians learn these basic constructs, they can apply them to any disease. In short, documentation will need to change, but physicians don't have to learn a different strategy for each of the thousands of diagnoses.

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Reinvigorate Staff Training
Nearly one-third of respondents in a KPMG survey (2)identified training as the most critical factor in ensuring successful change management. According to a Porter Research survey (3), however, providers see training as the most challenging area of the ICD-10 transition. This is no surprise considering the number of topics to be covered; for instance, specific documentation requirements, code structure and language changes, and anatomy and physiology terminology-along with possible and necessary training for new technology such as computer-assisted coding.

As you conduct training, be sure to include coders, physicians, revenue cycle staff and any other appropriate parties. The most beneficial training is role-based, giving each group customized content they'll perceive as relevant-a detail that can keep trainees interested and help boost comprehension. If possible, accommodating different learning styles is also helpful; for instance, you may want to offer both written and audio tutorials.

Tracking Preparedness via Readiness Testing
One of the best uses of the ICD-10 extension is conducting internal testing and participating in external testing. Remember in order to test, you must update your business processes, including IT systems, to accommodate ICD-10. Even if you've already updated and tested your internal business and IT systems, it's a good strategy to continue testing internally and begin to include external partners when testing. Why? Because acquiring substantial new information and adapting to new processes takes time, especially for busy staff and physicians. And because the alternative, which is identifying errors after October 2015, it can have many negative ramifications such as denied claims.

Through thorough testing, you can pinpoint inaccuracies and errors now, which will enable further training and corrections while you're still in "practice mode." For example, all physicians-especially specialists-must acclimate to many new documentation requirements. By identifying potential issues early, you can give them more time to make necessary adjustments. In addition to setting up physicians and staff for success, you'll reap another significant benefit: Better financial outcomes once ICD-10 is in effect. Remember, any errors you don't identify before next October can have a negative impact on reimbursement and cash flow.

Whether your ICD-10 plan is in kick-off, momentum or refinement mode, you still have time to be proactive and get your organization ready for next October. The countdown is officially on, and it's time to review, train, and audit!

Ken Bradley is vice president of strategic planning and regulatory compliance at Navicure, a cloud-based healthcare billing and payments solution.

1 Healthstream (2013). Helping Physicians Succeed in an ICD-10 World. Retrieved from https://www.munsonhealthcare.org/upload/docs/ICD10/Precyse%20White%20Paper%20-%20Helping%20Physicians%20Succeed%20in%20ICD-10_032013.pdf.
2 KPMG (2014). Healthcare Entities Largely Unprepared For ICD-10 Implementation: KPMG Survey. Retrieved from http://www.kpmg.com/us/en/issuesandinsights/articlespublications/press-releases/pages/healthcare-entities-largely-unprepared-for-icd-10-implementation-kpmg-survey.aspx.
3 Navicure and Porter Research (2013). Physician Practice ICD-10 Readiness Survey Part Two: Survey Findings and Action Items. Retrieved from http://info.navicure.com/rs/navicure/images/ICD-10%20Preparation%20Survey%20Part%202%20-%20updated.pdf