The AMA lobby is strong. And U. S. government program delays are common. The two came together on February 16, 2012 when Health and Human Services Secretary, Kathleen Sebelius, announced a potential delay in the October 1, 2013 deadline for ICD-10 implementation.
The announcement, made just before the start of the HIMSS12 Annual Conference, left a lot of attendees scratching their heads and asking themselves, “now what”? Most agreed a delay of one year or less gives everyone more time to prepare, train and test. However, a delay of greater than one year spells chaos for healthcare providers and payers.
While at HIMSS, TrustHCS had the honor of sponsoring an executive roundtable on ICD-10. During the roundtable, speakers discussed five ICD-10 projects that should be continued, full steam ahead, despite the delay. It’s a good list and worth sharing.
In general, the panel’s advice was to identify ICD-10 tasks that have collateral benefit for ICD-9 coding. These are the tasks that should be continued until such time as HHS makes another announcement regarding their plans, intentions and deadlines.
Vendor and Payer Assessments
Continue checking-in with vendors and payers to see when systems will be ready for testing. Know what the ICD-10 upgrade will cost your organization, if anything. And if your vendor simply can’t accommodate, start evaluating new systems to replace them. Conduct ICD-10 testing with your payers whenever and wherever possible to help reduce backlogs and denials upon go live.
Clinical Documentation Improvement
Any improvement in clinical documentation specificity and granularity will help support better, higher quality coding. And reduce time wasted querying physicians. Coders can only code what is documented. This same core principle applies in ICD-10. CDI programs must be continued regardless of a delay.
Coder BioMedical Training
While educating coders in the finer nuances of ICD-10 coding can be postponed, strengthening their knowledge of the basics can’t. Many coders graduated from programs ten, fifteen, even twenty years ago. Medical science and our knowledge of anatomy, physiology and disease processes has grown exponentially. Now’s the time to make sure your coders are brilliant at the basics. Anatomy and physiology training should continue to be conducted: online, through a service provider or at a local community college.
Computer Assisted Coding (CAC) Technology
Coder productivity is predicted to drop by 50% during the implementation of ICD-10. And perhaps remain 10-20% below normal output for ICD-9 coding. CAC systems help offset this productivity loss by electronically “reading” the record and suggesting codes to the human coder. While CAC systems don’t replace coders, they do make them more productive and efficient. The delay provides more time for organizations to evaluate and implement this technology.
Assess and Refine Your Work Plan
Conduct a methodical step-by-step review of your initial plan. This process will identify which tasks can be pushed out and which cannot. The review will also uncover other tasks that have “collateral benefit” for ICD-9. For each task in your work plan, ask yourself, “does the delay impact this task” or “does the delay not impact this task”.
Industry experts are already predicting the cost of an ICD-10 delay. Other experts are predicting law suits by providers to help recoup monies already spent. This expert simply suggests that you stay the course and keep working toward ICD-10 preparedness. We will all have to get there eventually. Better to be early than late on this one!