What's Happening ICD-10?

In April, U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius made an announcement that the original ICD-10 implementation date of Oct. 1, 2013 might be in a 365-day delay. The current proposed compliance date has been moved to Oct. 1, 2014, but a final rule has yet to be released.

On Thursday, July 12, CMS released a one-page document titled: "Steps to Assess how the ICD-10 Transition will Affect your Organization." Is that a hint that CMS is taking baby steps and making things happen or is this just another piece of paper to keep everyone guessing? Either way, it is a document that will help you get on the right track if you haven't started to make the effort and move forward with your own preparations.

The document states to continue preparing your organization for the switch from ICD-9 to ICD-10, and gives a few key steps on how to "conduct an impact assessment of how the new code sets will affect your organization."

1. The documentation changes will have to be monitored carefully due to the increased specificity from ICD-9 to ICD-10. CMS recommends four things to do right now in regards to the paper process.

• Train staff to accommodate the substantial increase and specificity in code sets,
• Consider physician workflow and patient volume changes,
• Revise forms, documents, and encounter forms  to reflect ICD-10 codes,
• Evaluate processes for ordering and reporting lab/diagnostic services to health plans.    

2. Get in touch with payers regarding contract negotiations and new policies on the expanded codes as they can affect reimbursement schedules.

3. Make sure that the vendors you are in  a business relationship with can accommodate all the ICD-10 needs. Question them on the how's and when's of their plan updates and review new and old vendor contracts to make sure the "vendor offerings and capabilities against your organization's expectations." Draft a schedule with your vendor to prevent any misunderstanding.

4. When you have ICD-10 ready to go, figure out "how the new codes will affect your processes for referrals, authorizations/pre-certifications, patient intake, physician orders and patient encounters.

5. Finally, work with the vender to make sure you have enough time to test everything out. Schedule accordingly.

The changes are, or are not coming. Whether it happen with ICD-10 or skip right onto ICD-11, staying updated and on track is important. If you don't you will be sorry for procrastinating and making your life and your staffs a nightmare.

To keep track of the current ICD-10 situation visit the website.