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Preparing a Successful ICD-10 Transition

Countdown to ICD-10
May 22, 2014 9:19 AM by Elsevier

When it comes to ICD-10 implementation efforts, clinical documentation improvement (CDI) continues to be one of the most pressing concerns on the minds of healthcare providers. For some, the recent ICD-10 delay announcement couldn't come at a better time.  

ICD-10 isn't just a "coder" problem. With industry analysts predicting 50-70% productivity losses due to ICD-10, the development of complete and accurate CDI program will be critical to smooth transition. As reimbursement, revenue, compliance and care management are all at risk, the impact of a quality CDI program within ICD-10 implementation efforts shouldn't be underestimated.

With the increased level of specificity due to ICD-10, provider documentation will need to accurately pinpoint elements such as severity of illness, laterality, complications, episodes and stages, and symptom etiology. This means major impacts to not only coders, but physicians as well.

With this in mind, physician champions can help act as liaisons to help physicians understand their role and impact on reimbursement and patient care. Physicians and coders alike will play a critical role in the accurately capturing DRG data, with the potential to also capture thousands in previously unrealized revenue.

The Essentials

What are the keys to gaining clear, concise documentation through an effective CDI program?

A CDI program will need to:

  • Promote medical necessity documentation to support admission, readmission, and therapies, treatments and procedures.
  • Ensure accurate and complete documentation for accurate coding and reimbursement, including an accurate case mix index (CDI), correct payments and reduced compliance risk, and the correct identification of the principal and/or secondary diagnoses, MCCs and CCs.
  • Align with Joint Commission and Conditions of Participation regulations
  • Support evidence-based care for quality reporting measures

Overall, communication will be key. CDI staff will need to analyze data, formulate physician queries, track CDI program performance, and successfully communicate with physicians, administration, HIM staff and others.

On the road to ICD-10, how does your CDI program measure up?

Resources

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_047343.hcsp?dDocName=bok1_047343

http://icd-10online.com/wp-content/uploads/2011/12/The-Why-and-How-of-Clinical-Documentation-Improvement-Programs_V4-ppt.pdf

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Is ICD-10 Too Much, Too Soon?
February 17, 2014 11:07 AM by Elsevier

"The need to prepare for ICD-10 and the Affordable Care Act and to achieve so-called meaningful use of electronic health records all at once could overwhelm computer staffs throughout the healthcare industry."

This quote from a recent New York Times article ("Roughed Up by an Orca? There's a Code for That") should get the attention of those who (1) still believe the transition to the new coding system will be a breeze or (2) still pray for a delay in the Oct. 1 start date.

Looking past the frightening predictions, what we drew from the article was substantiation of the need for organizations to have a transition team in place, with representation from a broad spectrum of departments.

The point is that nothing as huge as ICD-10 can be done in isolation - especially when it is only one mountain in the range that must be scaled. And, given the sheer volume of the regulatory landslide, it's extremely difficult for one person or one department to see the full, clear picture of potential impact.

Like the delivery of healthcare itself, the ICD-10 transition should be a team effort. Do you have your line-up in place? 

http://www.nytimes.com/2013/12/30/technology/medical-billing-nears-a-new-era-of-ultra-specific-codes.html?_r=0

 

 

 

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The Path to ICD-10 Success

A multi-faceted approach includes investing in people, processes and technology.

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ICD-10 Preparation: Teamwork Required
November 15, 2013 12:34 PM by Elsevier

Reflecting on our time at the AHIMA Convention & Exhibit in Atlanta, obviously there was a lot of focus on ICD-10. In addition to the usual interest in the upcoming implementation, there was also increased concern regarding the challenges of planning for the transition.

A few of the issues we heard most often included:

  • Is my organization moving fast enough to make the transition a smooth one?
  • Do we have enough staff and are the coders we have up to the task? What's the best way to train coders?
  • What can we do to mitigate the impact on productivity - while training, during the transition and after implementation?
  • IT already has a lot on its plate with Stage 2 Meaningful Use and other mandates. Will that negatively affect our ICD-10 transition?
  • What really will be our final costs?
  • How do we manage revenue cycle effectively early on, while we're just implementing the new coding system?
  • How ready are our clearinghouses and payers, particularly Medicare?

While we can help on a number of those fronts, particularly in the area of training, the answers to many of those questions can only come from within. That's why enterprise-wide involvement is needed at the top levels.

No matter the size of the practice or organization, the transition to ICD-10 is a team effort. Now's a good time to get your line-up in place.

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What Are Your Goals at AHIMA 2013?
October 17, 2013 9:18 AM by Elsevier

With less than two weeks to go, do you have your AHIMA game plan figured out? As always, there's a lot to do - and learn - so it requires a bit of forethought. 

ICD-10 likely will be top of mind for many, and participants will be looking for tips and tools to make their next move or fill in the gaps on preparation and training. As to the latter, here are some key questions you may want to ask yourself:

  • Do you have coding and awareness training in place for ALL your users and stakeholders, from coders to doctors to C-Suite?
  • Have you taken into consideration their learning preferences?
  • Have you built in time to fill in learning gaps well before the implementation date?
  • What are you greatest fears? Non-compliance? Backlogs? Specialty coding? An inadequate budget? Not enough coders?
  • Do you have a clear understanding of how ICD-10 intersects with overall HIM and CDI goals? With meaningful use? With reform mandates?

As we've said before, it helps to know what you don't know when working with a change as profound as ICD-10. Asking the right questions up front can go a long way in assuring a successful transition.

So, we ask:  What's on your mind as the ICD-10 countdown continues?

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Retention: Support is Key
August 23, 2013 9:54 AM by Elsevier

We recently addressed the importance of confidence building in transitioning to ICD-10. Perhaps nowhere is this more important than with your experienced coders. For these folks, this means not only instilling confidence that they're up to the task, but also confidence that they have your support and respect.

Taking action now can help you retain your experienced medical coders – those who will be the most valuable at the onset of ICD-10 and most sought-after by other providers. While retirement is always a personal decision, strong employer support may be the key to engaging the most experienced staff to stay on to help with the transition, which may include mentoring less-experienced staff or leading transitional projects.

In this regard, carefully thought out training can go a long way in showing all your coders that you understand the difficulty of the task before them and are working to simplify it as much as possible. Including coders in ICD-10 planning is another confidence-building tactic and a mutually beneficial activity that allows you to gain their perspective while demonstrating your respect for their input. And don't forget to keep them updated on the transition and assured their efforts are appreciated.

There are, of course, monetary and other types of incentives an organization can offer to keep experienced coders on their team. But, for many employees, that's only part of their job satisfaction. That's why, while you're striving to keep your team strong, it helps to do a little cheerleading. Another consideration as the ICD-10 Countdown continues.

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Beginning at the Beginning
July 2, 2013 11:05 AM by Elsevier

When something is as potentially overwhelming as ICD-10 implementation, it can feel like a flood roaring past, with no obvious place for you to jump in or way to take control. The good news is that, if it's done correctly, there will be no flood in the first place, and the occasional eddies can be navigated safely.
It begins with finding out what you don't know, with an assessment that takes the guesswork out of where to start and allows you to develop focused, prescriptive training.


A good evaluation program will allow you to:

➢ Identify those affected and why (stakeholders and unique needs)
➢ Pinpoint gaps in skills and knowledge
➢ Gain support for allocation of resources
➢ Gather baseline data to develop transitional plans 

Activities involved with evaluation include:

➢ Assessment of readiness 
➢ Securing executive sponsorship to help with allocation of resources
➢ Identifying an overall project owner
➢ Assembling an implementation team and assigning project managers
➢ Identifying stakeholders and determination of unique stakeholder needs
➢ Performance of GAP analyses of staff and systems, including data flow, work flow and workforce knowledge
➢ Assessment of payer, business associate and vendor readiness

With such a readiness assessment in hand, you'll have more than mere information. You'll have a navigational chart to help you avoid rough waters and sail safely through ICD-10 implementation.

For more on getting started on your own ICD-10 countdown, visit http://icd-10online.com/

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More ICD-10 Myths
June 5, 2013 2:30 PM by Elsevier

(This sponsored blog was written by Tom Ormondroyd, vice president/general manager, Precyse Learning Solutions.)

Here is a continuation of some common ICD-10 myths, from my previous blog Dispelling Some Myths About ICD-10. These are common ICD-10 myths that continue to plague all of our efforts to obtain buy-in and motivate our impacted populations to want to learn more about and prepare for the transition. Some of these myths are just nuisances, while others are true showstoppers that undermine the efforts of our industry.

Myth 1: Physicians who choose their own codes will not have to worry about training as their EHR will do this for them.

Truth: Although EHRs are starting to do some great things in regards to prompts, problem lists, and other assistive tools for ICD-10, they do not take the place of required education for those physicians selecting their own codes. One of the biggest concerns with ICD-10 is driving accurate representation of the severity of our patients' illnesses and hence, the medical necessity of the procedures and tests we will perform. If a secondary condition is not on our problem list or we do not have quick access to more specific code choices, the physician may miss out on opportunities to capture this greater specificity and severity of illness leading to possible greater scrutiny. Documentation education is also key because if we do not have the documentation to support the code selected, then we open ourselves up to significant risk. EHRs are a vital aspect of our transition to ICD-10, but understanding of the core concepts of ICD-10 physician documentation and coding are required to be successful.

Myth 2: ICD-10-CM is a reimbursement system, not built for clinicians.

Truth: With all of the debate currently going on about ICD-10, one of the key aspects of ICD-10 that is often forgotten is the creation and development of ICD-10. The system itself started its origins at the WHO through the efforts of a team of physicians, clinicians, coders, and other healthcare professionals and then further modified by the United States again by a team of clinicians and other healthcare professionals. The system is far more rooted in current clinical thought and practice than the ICD-9 system, but it has not been able to shed its coding-only, reimbursement-only type moniker.

Take one example of how it is more clinically focused: hemorrhoids. Today, a physician lacks the ability to show the true severity of a patient's hemorrhoid. There are very few choices in ICD-9, and most end up being classified as simply external or internal. No matter how severe the case, we often need to choose from these limited choices. In ICD-10-CM, however, hemorrhoid codes are structured clinically, the opposite of the myth. With ICD-10-CM, we will be able to choose the grade/degree of the severity from first to fourth. As we all know, more severe cases of conditions take longer to diagnose and treat. Today in ICD-9, for this example, we have no way to show why we spent as many goods and services as we do, but ICD-10-CM offers the opportunity. Interestingly, ICD-10 does not do this with just more code choices (in fact, there are fewer ICD-10 codes for hemorrhoids), but instead, just better and more clinically relevant ones.

This is only one example, but one we must communicate to ensure the clinical nature of the system is understood.

About our partnership: HealthStream is proud to be partnered with Precyse Learning Solutions to ensure your staff and facility are prepared for the ICD-10 transition on day one. The Precyse ICD-10 Solution Suite is offered exclusively through HealthStream.

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ICD-10: An Important and Positive Change
May 24, 2013 2:36 PM by Elsevier

(This sponsored blog was written by Lee Ann Bryant, associate product manager, HealthStream.)

If you work in any healthcare environment, you know how inundated we have become with information around ICD-10 - most of it leaning toward the negative end of the spectrum. Yes, there is a lot to learn. Yes, there are time and financial burdens involved. Yes, it is one of the most significant changes ever for the healthcare industry. And Robert Tagalicod, director, Office of E-Health Standards and Services, reminds us why it is an important and positive change and why it should matter to us.
 

Why ICD-10 Matters

1. ICD-10 advances healthcare and the implementation of eHealth initiatives.

  • ICD-10 is essential to healthcare reform and the CMS eHealth Initiative and is part of the overall goal - the triple aim to achieve better care, better access, and better health while lowering costs.
  • eHealth programs such as ICD-10, administrative simplification, the Medicare and Medicaid EHR incentive programs, and quality reporting programs like the Physician Quality Reporting System are all aimed at accomplishing this goal. 
  • Together, these eHealth programs will provide greater interoperability, easier data sharing, better quality measurement, improved clinical outcomes, and lower costs.

2. ICD-10 captures advances in medicine and medical technology.

  • ICD-10 captures new procedures that lead to innovative healthcare and medical breakthroughs.

3. ICD-10 improves data for quality reporting.

  • Many quality measures rely on ICD diagnosis codes. ICD-10 provides better data for quality reporting and outcomes measurement.

4. ICD-10 improves public health research, reporting, and surveillance.

  • ICD-10 is more effective at capturing public health diseases due to its greater specificity. Federal, state, and local officials, including researchers, will use ICD-10 diagnosis codes for public health research, reporting, and surveillance.

For more information on ICD-10 and training solutions available from HealthStream and Precyse, click here.

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Are Hospitals Lagging Behind on ICD-10 Training? Survey says … Yes!
May 8, 2013 3:01 PM by Elsevier

(This sponsored blog was written by Lee Ann Bryant, associate product manager, HealthStream.)

According to a recent survey conducted by the Workgroup for Electronic Data Interchange (WEDI), an industry leader on the use of healthcare IT to improve the exchange of healthcare information, healthcare facilities as a whole are not on track for a smooth transition to ICD-10 Oct. 1, 2014. Close to 1,000 industry participants were surveyed on readiness in February of this year, including 778 providers, 109 health plans, and 87 vendors.

Stanley Nachimson, director of the NCHICA/WEDI (North Carolina Health Information and Communications Alliance) stated "... it has become clear that many entities postponed their work until much later.  It remains to be seen how this postponement will affect the progress to compliance. Indications remain that significant numbers of industry participants have a considerable amount of work to do in a very short time."

Based on survey results, there was a shift in ICD-10 timelines across all facility types. Some contributing factors to this slow progress include the change in compliance dates, competing internal priorities, and other regulatory mandates.

Some key results from the survey include:

  • Almost half of the health plans expect to begin external testing by the end of this year. In the 2012, survey all health plans had expected to begin in 2013.
  • About half of the providers responded that they did not know when testing would occur and more than two-fifths of provider respondents indicated they did not know when they would complete their impact assessment and business changes.
  • About two-thirds of vendors indicate they plan to begin customer review and beta testing by the end of this year. This is similar to the number who expected to begin by the end of 2012 in the prior survey.

"The survey results show that projected timeframes for testing have shifted, and many organizations will not begin this task until 2014," stated Jim Daley, WEDI chairman. "Because of the magnitude of ICD-10, it is critical that organizations complete their remediation efforts as quickly as possible in order to allow adequate time for testing." (For a full copy of WEDI's letter to CMS, click here.)

It is critical that providers get started with their training right away. CMS has provided numerous timelines and checklists based on facility type and size. To access the ICD-10 Implementation Timelines and Checklists, click here.

If you have not yet begun your training for ICD-10 and want more information from HealthStream on the ICD-10 Solution Suite of products we offer through our partner, Precyse, click here.
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Advance Your Documentation Quality and Accuracy Now While Preparing For ICD-10
May 1, 2013 11:07 AM by Elsevier

(This sponsored blog was written by Lee Ann Bryant, associate product manager, HealthStream.)

Many think ICD-10 is only a coding problem, but the true challenge of ICD-10 is the need for increasing specificity and granularity in documentation in order to receive optimal reimbursement, meet all reporting requirements, and most accurately reflect the level of care provided.

The term "clinical documentation improvement (CDI)" has been used in the healthcare information management industry for decades, yet never has it played a more crucial role than it does right now or that it will in years to come. The speed with which physicians adapt to reimbursement documentation requirements and guidelines has a direct impact on the rate of improvement of an organization's overall workflow quality and productivity and also its ability to enhance cash flow and receive appropriate revenues for work performed. The upcoming conversion to ICD-10 makes this even more important. Improving CDI workflow processes to advance documentation quality and accuracy is paramount as organizations prepare for the ICD-10 environment and the other challenges that lie ahead in the near future.

Documentation has always been necessary for the communication between the providers caring for a patient. But the need for increasing specificity has evolved along with industry trends.

Current Challenges and Trends

As the healthcare industry continues to evolve, there are global drivers and industry trends that are creating ongoing challenges:

  • Increased government reform: With initiatives like the Accountable Care Act, Meaningful Use, Pay for Performance and National Agency Reporting, never before have healthcare providers been so exposed to the public on the quality of care they provide.
  • Globalization: Travel and migration, prevention of epidemics, and medical tourism are creating new challenges to the healthcare industry.
  • Aging population: People are living longer and, as a result, more complex healthcare is needed, coupled with shrinking reimbursement.
  • Economic recession: The healthcare industry is being asked to provide better quality but with less resources; facilities have less money to spend on innovation, and providers continue to consolidate.
  • Growth of data: The healthcare industry is rich in data but information poor. As medical knowledge grows, there is an increased need for comparative data; however EHRs are not built to analyze data.

As a result of these trends, the challenge is to reduce costs while enhancing the quality of care. Specific challenges include:

  • Quality: Provide consistent and accurate documentation that provides the specificity necessary for ICD-10and reduces exposures for fraud and abuse.
  • Financial: Reduce labor costs, denials, and DNFB while optimizing reimbursements.
  • Strategic: Create clinical data integration to support IT, HIM, and financial goals.
  • Human resources: Resource management monitoring, outsourcing, and role consolidation all create unique challenges, in addition to the need to educate employees not only on ICD-10 but on other initiatives like MU, value-based purchasing, etc.

A white paper is available that includes:

  • the evolution of CDI
  • current healthcare challenges and trends
  • the need for increased specificity and granularity in documentation
  • the main groups affected by ICD-10: physicians/providers, CDI specialists and coders
  • key processes related to CDI
  • the role technology will play in supporting a successful CDI program of the future.
Download the white paper here.
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Small and Medium Practices: ICD-10 Implementation Timeline
April 4, 2013 3:05 PM by Elsevier

(This sponsored blog was written by Lee Ann Bryant, associate product manager, HealthStream.)

With small and medium practices in mind, CMS has put together the following checklist of ICD-10 tasks, including estimated timeframes for each task. Depending on your organization, many of these tasks can be performed on a compressed timeline or performed at the same time as other tasks. This checklist is designed to provide a viable path forward for organizations just beginning to prepare for ICD-10. CMS encourages those who are ahead of this schedule to continue their progress forward.

Planning, Communication, and Assessment: Actions to Take Immediately

To prepare for testing, make sure you have completed the following activities. If you have already completed these tasks, review the information to make sure you did not overlook an important step.

  • Review ICD-10 resources from CMS, trade associations, payers, and vendors
  • Inform your staff/colleagues of upcoming changes (one month)
  • Create an ICD-10 project team (one to two days)
  • Identify how ICD-10 will affect your practice (one to two months)
    • How will ICD-10 affect your people and processes? To find out, ask all staff members how/where they use/see ICD-9
    • Include ICD-10 as you plan for projects like meaningful use of electronic health records
  • Develop and complete an ICD-10 project plan for your practice (one to two weeks)
    • Identify each task, including deadline and who is responsible
    • Develop plan for communicating with staff and business partners about ICD-10
  • Estimate and secure budget. Potential costs include updates to practice management systems, new coding guides and superbills, staff training (two months)
  • Ask your payers and vendors-software/systems, clearinghouses, billing services-about ICD-10 readiness (two months)
  • Review trading partner agreements
    • Ask about systems changes, a timeline, costs, and testing plans
    • Ask when they will start testing, how long they will need, and how you and other clients will be involved
    • Select/retain vendor(s)
  • Review changes in documentation requirements and educate staff by looking at frequently used ICD-9 codes and new ICD-10 codes (ongoing)

For the full ICD-10 Implementation Guide for Small and Medium Practices, click here.

If you would like more information on how HealthStream and Precyse can help your organization prepare for ICD-10, click here.

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Helping Physicians Succeed in an ICD-10 World
March 21, 2013 2:07 PM by Elsevier

By Stephen McClure, marketing manager-content, HealthStream

As the healthcare industry draws closer to the go-live date, ICD-10 remains a polarizing topic among healthcare professionals. While some healthcare organizations are actively preparing for a strategic rollout, others are, more or less, bracing for impact.

In April 2012, CMS extended the ICD-10 implementation deadline to Oct. 1, 2014, at the request of some physicians, hospitals, and other industry stakeholders. Since then, the American Medical Association (AMA), in partnership with other groups, has urged CMS to eliminate ICD- 10 implementation altogether due to the significant administrative and financial burden it imposes on physicians. There is no sign this will happen, however, or indication of any further postponement.

In fact, the acting CMS Administrator, Marilyn Tavenner, recently stated, "Many in the health industry are under way with the necessary system changes to transition from ICD-9 to ICD-10. Halting this progress midstream would be costly, burdensome, and would eliminate the impending benefits of these investments."

ICD-10 Complements Our More Advanced Healthcare System

There are many differing opinions concerning the transition to ICD-10. But, in reality, ICD-10 is necessary to all levels of a technologically progressive healthcare system. Given the magnitude of change happening in the U.S. healthcare delivery system, ICD-10 is a natural and necessary advancement that will address the critical gaps and operating flaws inherent in ICD-9, which was developed more than 30 years ago. Since then, healthcare science and technology have greatly advanced, making ICD-9 inadequate to deal with the advances in healthcare. Moreover, the content of the ICD-9 Clinical Modification (CM) was not designed to be used as a data system for disease management, nor was it intended to support reimbursement of medical services.

ICD-9 is an antiquated classification that has a puzzling mixture of code descriptions-some very specific, and others that are so broad they fail to even identify the site of the disorder. Today, we have a system that does not always fully capture the severity of our patients' illnesses, which prevents physicians from receiving full credit for the care performed in quality reporting.

Focusing on ICD-10's Benefits is Important

To be sure, implementing ICD-10 is a major undertaking for all healthcare professionals who are faced with many other challenges, including meeting the requirements of Meaningful Use legislation. ICD-10 compels greater specificity in documentation practices; it also involves a new coding classification system and an increase from 17,000 to more than 140,000 codes.

It is estimated that ICD-10 implementation costs will range between $83,000 and $2.7 million, depending on the healthcare organization or physician practice size, according to the AMA. The Advisory Board Company calculates that the three-year incremental impact of ICD-10 could range from $2.5 to $7.1 million for a typical 250-bed hospital, with coder productivity decreasing by close to 20 percent and physician productivity taking a 10 percent to 20 percent hit due to significant increases in queries.

A white paper is available that includes:

  • clinical roots: how physicians shaped ICD-10
  • why physicians should care about ICD-10
  • how ICD-10 data will benefit physicians
  • what's the physician return on investment for ICD-10?
  • case study: applying ICD-10 to crohn's disease
  • a guide to taking control of ICD-10
  • a list of major ICD-10 documentation changes.

Download the White Paper Here.

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ICD-10: (Un)Risky Business
March 6, 2013 7:03 AM by Elsevier

By Lee Ann Bryant, associate product manager, HealthStream

With so much uncertainty and overwhelming change associated with a transition to ICD-10, how could we ignore the potential risks involved?

The Centers for Medicare and Medicaid Services (CMS) offers some helpful steps that facilities can use to properly prepare and hopefully mitigate the risks involved with such an important, yet daunting, conversion.

Establish a transition plan.

Outline the steps your practice intends to follow to comply with ICD-10 requirements. Establish milestones to keep your practice on track. Share your transition plan with your EHR and practice management system vendors and billing services. Talk to them about how you can set up testing before the deadline.

Communicate with your vendors regularly.

Encourage them to take action now to avoid reimbursement delays. Talk to your vendors about making sure your practice management systems will be able to handle ICD-10 transactions. Ask them about their schedule for training your practice's staff on the system changes. Make sure you and your vendors allow ample time for testing ICD-10 systems.

Identify everywhere that your practice uses ICD-9.

Any function where you currently use ICD-9 will be affected by the transition to ICD-10. By taking a look at where you use ICD-9, you will see where you need to be prepared to use ICD-10 codes.

Plan for staff training.

Decide who needs training, what type of training they need, and when they need it. Anyone who will test ICD-10 systems before the transition will need training in advance so they can perform meaningful testing. Others who use ICD codes can be trained six to nine months before the Oct. 1, 2014, transition.

Network with peers.

Talking with your peers in other practices can help you to identify best practices and opportunities for sharing resources.

Set up an emergency fund to cover potential cash-flow disruptions from claims processing.

If you think you might have a serious disruption in getting claims processed after the transition, having a cash reserve on hand could be helpful.

Process ICD-9 transactions before the deadline.

Get claims with ICD-9 transactions processed before the deadline to avoid facing a major backlog after the Oct. 1, 2014, ICD-10 transition.

Click here to see how HealthStream and Precyse can help you mitigate these risks by having you and your staff ready to succeed from day one.

If you are at the HIMSS tradeshow this week (March 4-7), visit HealthStream and Precyse at the Precyse booth # 4369.

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ICD-10 is Coming: Are You on Track and Ready?
February 19, 2013 12:34 PM by Elsevier

By Lee Ann Bryant, associate product manager, HealthStream

Although nearly all healthcare providers are aware of the Oct. 1, 2014, deadline, studies show that most are unprepared for this transition. Recognizing that these changes require widespread education and planning initiatives beyond just the coding population, Centers for Medicare and Medicaid Services (CMS) provided a timeline for preparation between now and the "go-live" date of Oct. 1, 2014.

Transition and Testing

March 2013 to September 2014

  • March 1, 2013 - Dec. 31, 2013: Conduct high-level training on ICD-10 for clinicians and coders to prepare for testing ... e.g., clinical documentation, software updates (ongoing)
  • April 1, 2013: Start testing ICD-10 codes and systems with your practice's coding, billing, and clinical staff (nine months)
    • Use ICD-10 codes for diagnoses your practice sees most often
    • Test data and reports for accuracy
  • Monitor vendor and payer preparedness, identify and address gaps (ongoing)
  • Oct. 1, 2013: Begin testing claims and other transactions using ICD-10 codes with business trading partners such as payers, clearinghouses, and billing services (10 months minimum)
  • Jan. 1, 2014 - April 1, 2014: Review coder and clinician preparation; begin detailed ICD-10 coding training (six to nine months)
  • Work with vendors to complete transition to production-ready ICD-10 systems

Complete Transition/Full Compliance

Oct. 1, 2014

  • Complete ICD-10 transition for full compliance
    • ICD-9 codes continue to be used for services provided before Oct. 1, 2014
    • ICD-10 codes required for services provided on or after Oct. 1, 2014
    • Monitor systems and correct errors if needed

While this timeline is a good high-level guide for what your organization should be focusing on now, it does not provide guidance on the day-to-day task of educating all necessary staff for this transition. With more than 50 affected populations in a healthcare facility, the ICD-10 transition is a great one and shouldn't be taken lightly. ICD-10 is coming - are you ready?

For more information on how to get your organization and staff on track and ready to succeed from day one, click here.

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HealthStream's ICD-10 Resource Library
February 5, 2013 7:40 AM by Elsevier

By Lee Ann Bryant, associate product manager, HealthStream.

The decision has been made to move forward with your ICD-10 education and training, but the transition process is just beginning. Some lingering questions might be ...

"Where will we look for our education?"

"How will we manage all of these changes while ensuring our employees are getting the education required?"

"What resources are out there than can help us on this journey?"

While improving documentation is at the forefront, it is a mere fraction of what facilities must factor into this evolution. Adapting to and managing change, providing training and ongoing testing, and revenue planning - these are all aspects that must be considered and will be impacted by the transition to ICD-10. Aside from the actual education, there is so much to learn!

With our growing Resource Library, see how HealthStream and Precyse are quickly becoming your thought leaders when it comes to managing such a transition - from beginning to end. Here you will have access to webinars, white papers, articles, course demos and pricing requests and more:

Click here to check out HealthStream's ICD-10 Resource Library, and see how it can help you with the ICD-10 journey today!

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