AAOS Now

Published 4/1/2014
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Jackie Griffin

5 Simple Steps to Get Your ICD-10 Plan Started

It’s less than 8 months until the ICD-10 deadline on Oct. 1, 2014, but many providers are finding it difficult to get started with their planning to make the switch. Others have started their efforts, but may be overwhelmed by a transition of this magnitude and unsure of what their next steps should be.

Whether you’re stuck in the middle of planning or still trying to get started, the following five steps can help make your ICD-10 plan more manageable.

Analyze workflow
Identify all the places where your practice uses ICD-9 in its current workflow. Some examples of areas that will be affected by ICD-10 include clinical documentation, electronic health records (EHRs), superbills, paper claims, electronic claims, and reporting for government agencies. Beginning in October, you will have to use ICD-10 wherever you currently use ICD-9, so identifying these areas now will help you establish transition plans.

Conduct a gap analysis
A gap analysis will help you understand what you’ll need to do between now and Oct. 1, 2014. The results of the analysis will help identify any gaps within workflows, documents, and technology systems that will make the transition to ICD-10 difficult. These areas will require focused preparation to avoid any negative impact to your practice, such as delays in reimbursement or inefficient use of staff time.

Prepare for the possible increase in denials with a strong analytics solution. Organizing denials by reason or remark code will assist in problem solving and help mitigate post–ICD-10 issues. Now is a great time to implement these tools, if you haven’t done so already.

Identify solutions
Identify solutions such as new coding books, new superbills, and new paper claim forms that can help your practice make the transition. Nearly every practice will need to update existing software to accommodate ICD-10 codes. Your practice management software vendor and your clearinghouse may have already notified you about how they are updating their systems for ICD-10. If you haven’t done so, contact your vendors to learn whether you need to install new upgrades for ICD-10.

In addition, training for both clinical and front-office staff will be critical. For example, the AAOS has a series of webinars, as well as cosponsors coding courses with KarenZupko & Associates. Some industry associations, such as the American Association of Professional Coders, offer training boot camps. Other organizations, including the Centers for Medicare & Medicaid Services, offer ICD-10 resources on their websites that can be used to help prepare staff.

Make a plan
Outline your ICD-10 plan. Start by listing the solutions you plan to pursue, steps needed to implement them, expected costs for each step, and a timeline for completion. This will help you budget your time and resources appropriately.

Industry research estimates that transitioning to ICD-10 will cost the average 10-physician practice more than $200,000. In addition to the costs associated with preparing for the transition, many practices will experience delayed reimbursements and decreased productivity once ICD-10 goes into effect. Practices may want to consider securing a line of credit now to enable them to stay afloat after Oct. 1.

Just do it!
Implement your ICD-10 plan. This will include training your staff, learning how to use new versions of your EHRs, installing software upgrades, adjusting internal processes, testing claims with clearinghouses or payers, and establishing a line of credit.

Planning for ICD-10 is overwhelming, but attempting the transition without a well-organized plan could be catastrophic. Take the time now to organize efforts, one step at a time, to ensure your practice is ready for the deadline.

Jackie Griffin is the associate vice president of client services at TriZetto Provider Solutions. For more information about preparing for ICD-10, visit www.gatewayedi.com/icd10