One of the best ways to avoid increased denials and the strain on your bottom line is preparation. Preparation is vital to a successful transition from ICD-9 to ICD-10.
Eight Simple Steps to Prepare for ICD-10
1. Establish a project team or steering committee
This team should include managers and/or directors, at least one physician, billers/coders, and any other key staff members. This team will develop, plan, coordinate, implement, and test all strategies, actions, and deadlines in the transition plan.
2. Develop a communication plan
Successful implementation will require strategic goals that will need to be communicated accordingly. Therefore a well-defined and effective communication plan will be a tremendous help in order to provide sufficient information to all staff during the transition.
3. Perform an Impact Analysis of your practice
An Impact Analysis is a review of all areas in your practice/organization that ICD-10 will impact. It is important to examine all operations within the organization in order to identify the potential ramifications of the transition to ICD-10.
4. Develop an ICD-10 action plan
Once the Impact Analysis is completed, the next step in the ICD-10 implementation process is to build an ICD-10 Action Plan. An Action Plan should include three major elements (1) Specific tasks: what will be done and by whom? (2) Time horizon: when will it be done? (3) Resource allocation: specific funds required to accomplish a task.
5. Create a budget
An implementation budget must be created to address the costs associated with upgrading technology and training as well as the potential loss of productivity.
6. Education and training
It is recommended that physicians, non-physician practitioners, and coders participate in a full course, or have an instructor plan a curriculum over several months to cover all avenues of ICD-10 coding. Education is a critical piece in the successful implementation of ICD-10. A comprehensive education and training program is necessary to meet the needs of the practice in its effort to implement ICD-10.
7. Perform a Gap Analysis
A Gap Analysis is the implementation plan and road map. It is a method by which the road map is developed from “As Is” to “To Be.”
8. Conduct post-implementation assessments
The transition period following October 2015 is estimated to range from the first 6 to 12 months. During this time, it will be crucial to conduct post implementation assessments in order to identify claim errors, changes to health plan policies due to ICD-10, and maintain documentation compliance.
As you can see, there is more to think about than just how ICD-10 implementation will impact your IT systems. Providers must prepare for productivity reduction, increased denials, and new medical necessity requirements. By the way, we haven’t even begun to talk about the documentation challenges!