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

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Addressing Top ICD-10 Concerns

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