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Published 6/1/2014
Howard Mevis

Rethink Your ICD-10 Implementation Strategy

On March 31, 2014, Congress passed H.R. 4302, the “Protecting Access to Medicare Act of 2014.” In addition to establishing a 1-year patch under the sustainable growth rate Medicare physician payment, the bill also delayed the implementation date for converting to the International Classification of Diseases, 10th edition (ICD-10) for 1 year, to Oct. 1, 2015.

The postponement creates some breathing room for orthopaedic practices to continue planning for implementation, communicating with vendors and payers, and conducting physician and staff education and training. It also provides additional time for payers to ready their systems for accepting ICD-10–coded patient files, although many are already reporting their readiness for the transition.

If your practice was in the final stages of ICD-10 implementation, now is the time to rethink your implementation strategy and create a new timeline leading up to Oct. 1, 2015. If your practice was behind in implementation planning, now is the time to catch up by preparing a plan and getting started.

Vendor and payer management will be key factors in a new implementation strategy. Use this time to contact all vendors and payers who are affected by the delay. Ask about their ongoing plans toward implementation, especially by the payers. Find out whether they are continuing their testing periods and consider when you might be able to conduct testing.

Smart practices will also use the delay to continue physician education and staff training. Your practice might conduct staff training sessions comparing ICD-9 coding practices with ICD-10 requirements. Staff training might include creating an ongoing program of patient scenarios for coding in both ICD-9 and ICD-10.

The AAOS offers multiple resources to support the transition from ICD-9 to ICD-10, including an ICD-10 training manual (2014 ICD-10-CM Coding Workbook for Orthopaedics). This training approach enables staff to see the key differences between the two code sets while physicians can use this time to identify the ICD-10 patient documentation requirements for their top 25 or 30 diagnoses.

The implementation delay is not a signal to stop, but an opportunity to rethink your implementation plan, conduct testing, and continue education and training. The more prepared your practice is, the fewer problems—and the less financial disruption—your practice will face when ICD-10 goes into effect.

Howard Mevis is the director of the AAOS department of electronic media, evaluation programs, course operations, and practice management. He can be reached at mevis@aaos.org