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Addressing ICD-10
Implementation Challenges
Challenge: Expense
• AMA estimates cost for 3-MD
  practice = $83,290
• You can’t budget for your
  organization until you understand
  what it will involve:
  • Conduct an impact assessment
  • Budget time and resources
    accordingly
Impact Analysis
  • What systems / workflows does
    ICD-9 touch today?
  • Who needs training?
     • Coders, billers, physicians
  • How will EHR adoption impact
    practice mgmt., billing, coding,
    reporting, etc.?
• Budgeting may require you to
  make educated guesses on
  expenses that cannot be
  calculated
  • Ex: Diminished productivity for
    coders and providers during the
    transition
Challenge: Vendor
    Readiness
• Ask vendors about their ICD-10
  prep and anticipated timelines.
• Not confident your EHR vendor
  will smoothly transition your
  system to ICD-10?
  • Consider switching to an EHR
    partner that is committed to
    ensuring your success.
Challenge: Productivity
        Impact
• BCBS Association estimates coding
  errors will increase 10-25% in 1st
  year of transition
• Improving clinical documentation
  is one of the best ways to prepare
  for the transition’s impact on
  productivity of physicians and
  coders.
• More codes means more
  documentation
• Documentation Considerations
  • Linking relevant conditions
  • Initial Encounter → 7th
    Character Extension “A” for
    Patient under Active Treatment
• Documentation Considerations
  • Subsequent Encounter → 7th
    Character Extension “D” for
    Routine Injury Care during Healing
    / Recovery
  • Sequela → 7th Character Extension
    “S” for Complications / Conditions
    resulting from an injury (E.g., Scar
    resulting from a burn)
• Clinical Documentation Assessments
  • Do random samples support ICD-
     10 coding?
• Implement Documentation
  Improvement Strategies
  • Train → reassess → train again
• Appoint an ICD-10 Implementation/
  Documentation Champion
Challenge: Cash Flow
       Impact
• The ICD-10 transition is likely to
  cause disruptions in cash flow for
  a number of reasons.
  • Clean claims may take longer to
    be submitted due to
    productivity declines.
  • Denials may spike due to
    mapping or coding errors.
• Take steps to protect cash flow
  during the transition:
  • Budget for additional cash
    reserves
  • Ask major payers about their
    readiness to process claims
    coded in ICD-10
• Take steps to protect cash flow
  during the transition:
  • Improve clinical documentation
    to minimize denials
  • Plan your strategy to manage
    denials before, during & after
    ICD-10 implementation
Challenge: Testing
• Plan to conduct testing using the
  ICD-10 codes as a critical step in
  preparing your organization for
  the ICD-10 transition.
  • Internal testing
  • External testing
Want to learn more
      about ICD-10?
  Watch a free recorded
       webinar at
successehs.com/archived-
        webinars.
Need a health IT partner
       to help you achieve
success with ICD-10, Meaningful
          Use & more?
     SuccessEHS can help.
  Visit www.successehs.com
      to request a demo.
Addressing ICD-10 Implementation Challenges

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Addressing ICD-10 Implementation Challenges

  • 3. • AMA estimates cost for 3-MD practice = $83,290 • You can’t budget for your organization until you understand what it will involve: • Conduct an impact assessment • Budget time and resources accordingly
  • 4. Impact Analysis • What systems / workflows does ICD-9 touch today? • Who needs training? • Coders, billers, physicians • How will EHR adoption impact practice mgmt., billing, coding, reporting, etc.?
  • 5. • Budgeting may require you to make educated guesses on expenses that cannot be calculated • Ex: Diminished productivity for coders and providers during the transition
  • 6. Challenge: Vendor Readiness
  • 7. • Ask vendors about their ICD-10 prep and anticipated timelines. • Not confident your EHR vendor will smoothly transition your system to ICD-10? • Consider switching to an EHR partner that is committed to ensuring your success.
  • 9. • BCBS Association estimates coding errors will increase 10-25% in 1st year of transition • Improving clinical documentation is one of the best ways to prepare for the transition’s impact on productivity of physicians and coders.
  • 10. • More codes means more documentation • Documentation Considerations • Linking relevant conditions • Initial Encounter → 7th Character Extension “A” for Patient under Active Treatment
  • 11. • Documentation Considerations • Subsequent Encounter → 7th Character Extension “D” for Routine Injury Care during Healing / Recovery • Sequela → 7th Character Extension “S” for Complications / Conditions resulting from an injury (E.g., Scar resulting from a burn)
  • 12. • Clinical Documentation Assessments • Do random samples support ICD- 10 coding? • Implement Documentation Improvement Strategies • Train → reassess → train again • Appoint an ICD-10 Implementation/ Documentation Champion
  • 14. • The ICD-10 transition is likely to cause disruptions in cash flow for a number of reasons. • Clean claims may take longer to be submitted due to productivity declines. • Denials may spike due to mapping or coding errors.
  • 15. • Take steps to protect cash flow during the transition: • Budget for additional cash reserves • Ask major payers about their readiness to process claims coded in ICD-10
  • 16. • Take steps to protect cash flow during the transition: • Improve clinical documentation to minimize denials • Plan your strategy to manage denials before, during & after ICD-10 implementation
  • 18. • Plan to conduct testing using the ICD-10 codes as a critical step in preparing your organization for the ICD-10 transition. • Internal testing • External testing
  • 19. Want to learn more about ICD-10? Watch a free recorded webinar at successehs.com/archived- webinars.
  • 20. Need a health IT partner to help you achieve success with ICD-10, Meaningful Use & more? SuccessEHS can help. Visit www.successehs.com to request a demo.