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 documentationis 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.