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Last month on Talk Ten Tuesday, I thought it would be fun to do something a little different, so I performed an ICD-10 rap song I wrote called “Coder’s Paradise.” Except for my singing on the chorus (by the way… I thought I could sing. My mom says I can sing. I sound great in the shower. Alas, apparently I can’t sing.), the response from the TTT audience was so positive, they sent me to Los Angeles to professionally record it for posterity. This was hilarious. You can imagine how surprised the recording engineer was when he saw me. Old, bald, white guy trying to rap. I’m not a rapper. I actually wanted to be a doctor, but I didn’t have the patients.

Shortly before my workshop at MGMA’s national conference in San Antonio last week, we received the final mix of “Coder’s Paradise” and the song was a huge hit, so… now I have to travel back to Los Angeles to shoot the music video. The proposed story lines for the video include dressing me up in a pimp outfit, devil costume, and/or nurse’s uniform. For those of you who sent positive feedback, I want to personally thank you for giving me all these opportunities to humiliate myself.

Now, about MGMA national. I have manned our booth at dozens of trade shows over the last two years. Until last week, when people walked by at other conferences and I asked if they wanted to talk about ICD-10, they started walking faster, averted their eyes, and mumbled something like, “It’ll never happen,” “Too far off,” “I’m not ready to talk about it,” or just an “[Expletive] NO!” Trying to talk to people about ICD-10 when they weren’t ready made me feel like the two fish that were swimming along and ran into a cement wall. One looked at the other and said, “Dam.”

Not so at MGMA. The response was 180 degrees different from past conferences. What were people saying to me at this show? “I don’t want to talk about ICD-10 but I know I have to so… whaddaya got?” With issuance of the final rule, the awareness tide has finally turned. Hallelujah!  Our booth was mobbed nonstop by MGMA-ACMPE members and vendors alike, all wanting to talk about ICD-10 education, software, consulting.

For those who have to drive the implementation, the predominant question at the booth was, “What should I be doing right now?” For the last several months I have preached a sane, measured, and phased approach with the prerequisite for all ICD-10 efforts being staff and provider awareness education. Once you have your providers’ and staff’s attention, what should you be doing right now? Grab a pen and paper and just walk around your organization. Note everywhere diagnosis codes touch a work process, make a note, and those notes give you the basis for creating your implementation plan.

Start talking about ICD-10 to your people in terms of how it will affect their roles in the organization. Take small bites at first and don’t overwhelm anyone with more information than they can handle. What’s the ICD-10 elevator speech for the providers? “Hey doc, you just have to write down more stuff so we can meet the more specific coding requirements.” Tell them they get to play with a lot of fun new codes like R46.1, “Bizarre Personal Appearance.” By the way, you could probably code “Bizarre Personal Appearance” on any given day in your practice for numerous patients and at least one of your staff mates. I have a good joke for that code but I’ll save it for the end.

Make a preliminary call to your IT vendors and see if you can get a timeline for when upgrades and training will occur. Right now, today, you should check your EHR and PM contracts and see who has to pay for the new ICD-10 packages. You don’t want to be surprised by a big, unforeseen bill. Take a look at some of the great off-the-shelf solutions offered by ICD10Monitor. Real time savers like easy conversion tools to help you identify new documentation requirements and do-it-yourself toolkits will get you through the transition so you don’t have to call in some bozo like me at the last minute. Call your billing companies and insurance payers and find out about their ICD-10 plans. We have the gift of time, so check out what’s out there. There’s no rush. Yet. Don’t wait too long to figure it all out. After all, you have your real job to do, and trying to cram in a last-minute major implementation is expensive and UNNECESSARY.

I promised you a R46.1 “Bizarre Personal Appearance” joke. A guy walks into his doctor and says he doesn’t feel well. The doctor notices he has a stalk of celery sticking out of one ear, a carrot sticking out of the other ear, and a green olive stuck up his nose. The doctor says, “Ahhhh, I know what’s wrong with you. You’re not eating right.” (Ba-dump-bump!)

ICD-10 is just another project. Make it fun. Make it as painless as possible. And don’t wait too long.

You can do this!

About the Author

Denny is the president of Complete Practice Resources, a healthcare education, consulting, and software company headquartered in Slidell, Louisiana. He formerly served as the CEO of a large, multi-specialty physician group, full service MSO. Denny has authored or co-authored numerous “common sense” practice management books and implementation manuals. He is an award winning, nationally known consultant, speaker, and educator bringing his expertise to making the complex “simple.” He currently serves on the editorial board of ICD10 Monitor.

Educated at the United States Air Force Academy, Denny had a distinguished career as an Air Force pilot and has a long history of commitment to excellence and dedication to his clients’ success.

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