It is no surprise that many healthcare organizations have not yet begun planning for the highly anticipated ICD-10 transition. Many believe that the Centers for Medicare and Medicaid (CMS) will postpone the October 1, 2013, deadline, allowing for some wiggle room in implementation. Unfortunately the likelihood of that happening is slim to none. To date, CMS has no plans of delaying the implementation of ICD-10 and for many healthcare organizations around the country that means trying to locate the nearest panic button.
Underestimated Challenges
However, despite the numerous articles and constant buzz surrounding ICD-10, many still believe that transition from ICD-9 to ICD-10 is as easy as flipping a switch. WRONG! Many of the stragglers will soon realize that moving from ICD-9 to ICD-10 is not a simple one-to one mapping strategy, and in fact many of the codes require multiple general equivalence mappings (GEMs) and greater specificity in documentation. Poor mapping and documentation will lead to denials by payers and given that the average cost of reworking a denied claim is $25, filing claims incorrectly can become very expensive, very quickly1. This cost alone is enough to send many healthcare providers into early retirement.
The Value of Pre-Planning
Understandably, many providers and organizations are concerned with the daunting task of other competing priorities, such as Meaningful Use and the 5010 transition, but ICD-10 planning is something that absolutely cannot wait until the October 1, 2013, compliance date. Extensive planning, preparation, education and testing must take place to help to guarantee a smooth and successful transition and ensure limited budgetary pitfalls. Of these, the planning, specifically conducting the impact assessment, is by far the most important. According to the American Health Information Management Association (AHIMA), the completion of the impact assessment early on is critically important because without the impact assessment an organization cannot reasonably predict the length of time and amount of resources required for the implementation preparation and “go live” phases and therefore cannot plan an accurate timeline or budget for the work involved. Delayed completion of the impact assessment will jeopardize an organization’s ability to complete all ICD-10 implementation tasks by the compliance date, risking claim rejections and payment delays2.
Assessment’s Critical Role
The task of completing a comprehensive assessment in itself is a challenge. An organization needs to assess every aspect of the business in which the ICD-10 code will have an impact; this can take months. The organization needs to carefully analyze who, what, when, where, why and how ICD codes are used. More labor intensive is identifying the interdependencies once all the business and technical areas have been defined. By identifying the internally and externally affected business processes, systems and stakeholders, as well as their interdependencies, organizations can easily recognize where adjustments need to be made and try to mitigate the associated risks and more importantly take necessary steps for the improvement of overall effectiveness and efficiencies of the organizations operations. The more time an organization spends on the impact assessment, the smoother and more accurate the implementation and transition to ICD-10 will be.
How ICD-10 Can Impact You
According to the Academy of Professional Coders3:
Have you begun the ICD-10 transition? What have been your biggest challenges?
References:
- ICD-10: The Wave (or Tsunami) of the Future: file:///C:/Users/priyal.patel/Desktop/ICD%20STUFF/-article_495_ICD-10%20-The-Wave-%28or-Tsunami%29-of-the-Future.cfm.htm
- AHIMA’s ICD-10-CM/PCS Transition: Planning and Preparation Checklist: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_048737.pdf
- IMAGE: A Practical Guide To Navigating the ICD-10 Waters: http://www.neohfma.org/A%20Practical%20Guide%20to%20Navigating%20the%20ICD-10%20Waters%20Final%20.ppt
