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Deb Grider

EDITOR’S NOTE: This is the first in a two-part series addressing ICD-10 implementation tasks.

I find it interesting that many hospitals, physician practices and other healthcare providers just put the brakes on their ICD-10 implementation tasks.

Some organizations, I am finding, have not even started the implementation process yet. The other day I actually became aware that one large hospital system in the Midwest just earmarked funds that originally were budgeted for ICD-10 preparations for another competing project instead, and now they do not have money to move ICD-10 forward until 2014 – and even that might be pushing it. The final rule recently was sent to the Office of Management and Budget (OMB) for final approval, and we should have a decision very shortly. But in the meantime…

A word of advice: this could become a car wreck if you don’t hit the gas pedal and forge ahead. Successfully implementing ICD-10 in any organization is possible if you budget the time, expenses and personnel to make it happen. You even might find ways to increase revenues, streamline processes and improve efficiency in the long term, which will save your organization money.

Implementation of ICD-10 is not as daunting as it initially may appear if you have a steering committee of professionals who work well together and follow through.

Where to Begin, Again

So, what should you do? Pick up where you left off, for starters. And if you have not started yet, begin today. Why? Because even though implementing ICD-10 may seem as though it only affects coding and information systems, it actually involves much more.

Many hospital and large group CFOs have reached the conclusion that information systems and health information management are the only departments affected, but that is not the case.  Your committee should be comprised of directors and managers from various departments within the organization, and it should guide the implementation planning and execution of ICD-10.

All systems, processes, forms, software, education and much more must be evaluated. Since I have written implementation training material and personally have been involved in assisting hospitals and other organizations with this process, I have outlined several recommendations below.

Begin with a 10-step planning phased approach in 2012 and 2013. Once you have completed these steps, you will be ready for the next phase of ICD-10 in 2014, which includes education and training as well as full-scale implementation. The first five are included here; we’ll tackle the others in my next installment.

Step 1:

Keep executive stakeholders, the steering committee and all subcommittees up to date on the status of ICD-10.

Hold monthly steering committee meetings to discuss ICD-10 challenges and successes of your implementation planning.

Step 2:

Continue to hold monthly executive steering committee meetings.

The steering committee is key to approving plans, making decisions and approving the budget. Make certain you have at least one physician and one finance professional involved to approve the budget and project costs. The committee should meet more frequently as the go-live date approaches.

Step 3:

Complete your impact assessment and identify all areas, departments and systems expected to be impacted by ICD-10.

You will be surprised at how ICD-9 currently is being used within your organization. Even though coding is a prominent component of ICD-10, registration, patient access, documentation and other areas also will be affected. You may uncover processes that no longer work or are not as efficient as they should be. Now is the time to improve efficiency, which will save money in the long term. For example, how will patient access handle patients who visit your facility for treatment of an injury? Injury coding in ICD-10 is much more complex than with ICD-9, so how will you capture necessary information for practitioners?

Step 4:

Conduct a gap and solutions analysis, identifying who ICD-10 impacts, the current state of readiness and where you need to be – in other words, seeking an overarching preparatory solution.

A gap/solutions analysis will uncover the current state of your organization relative to data capture and illustrate what state your organization must transition to in order to achieve successful ICD-10 implementation.

Step 5:

Build and execute a communication plan, updating the schedule periodically.

A good communication plan is critical for keeping everyone informed on the status of ICD-10. The plan should cover communication to all staff, the steering committee, executive stakeholders, the ICD-10 subcommittees and practitioners. Communication may be different for the different audiences and can take the form of emails, newsletters, memorandums, meetings, education sessions, intranets and more. Make certain the communication to these groups is well-written and straightforward.

Next week, I’ll continue with my Top 10 Implementation Tasks.

About the Author

Ms. Grider, an AHIMA-approved ICD-10 trainer and an American Medical Association coding author, is a senior manager with her firm, possessing more than 30 years of experience in coding, reimbursement, practice management, billing compliance, accounts receivable, revenue cycle management and compliance across many specialties. Her specific areas of expertise include medical documentation reviews, accounts receivable analysis and coding and billing education.

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