6 Observations on Hospitals and ICD-10 Going Into 2013

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ICD10 in 2013

Hospitals and health systems are officially less than two years away from the go-live date of ICD-10. By Oct. 1, 2014, all providers must have made the transition to ICD-10.

1. Most hospitals are in a readiness assessment phase.
In February 2011, the American Hospital Association surveyed its hospital members to see where the sector stood in its ICD-10 implementation. Roughly 41.8 percent of hospital respondents said they had completed an ICD-10 implementation plan, and more hospitals are landing in the stage of readiness assessment, right before implementation can begin. Usually, this means hospitals have taken measures to train physicians and staff, and they are taking the time to make their code sets more operational from ICD-9 to ICD-10.

2. Competing priorities make the ICD-10 implementation harder.
Although HHS announced earlier this year that the ICD-10 implementation date would be delayed from Oct. 1, 2013, to Oct. 1, 2014 — giving hospitals an extra to year to prepare — the healthcare sector is still amidst a perfect storm of revenue cycle and technology projects.

Between meaningful use of electronic health records, telehealth implementation, enhanced security measures and others, hospitals are finding it difficult to juggle so many projects at once.

3. Hospitals must prepare for ICD-10’s impact on orthopedics software and cardiology codes.
As hospitals prepare for their ICD-10 transitions, they must identify codes and procedures that have high and low risks. This does not necessarily mean revenue cycle teams should be focusing solely on high-volume, high-paying codes and procedures. Instead, hospitals must conduct internal research.

The transition from ICD-9 to ICD-10 may have a lot of impact on orthopedics and cardiology codes, especially on the procedure side.

4. Clinical documentation improvement programs are a must.
Ms. Brenegan is helping a large health system with its transition to ICD-10. She says the biggest piece of advice she can give a hospital or health system is to implement a CDI program.

5. Hospitals should teach concepts, not memorization.
Training is one of the biggest components of ICD-10 preparation, but hospital executives and managers must have a grasp of the pertinent training lessons.

There’s a misconception that physicians and other providers will have to memorize tens of thousands of new codes. Hospitals must focus on the concepts behind the ICD-10 codes and train providers on how to work those concepts into their documentation and coding behaviors. For example, hospitals should train physicians how to document a hip replacement case more specifically in the notes rather than worrying about the memorization of all orthopedics codes for that case.

6. It may be too early to look at ICD-11.
The World Health Organization is set to formalize the ICD-11 structure in 2015, less than a year after ICD-10 will be live in the United States. Many have wondered if the entire U.S. healthcare industry should skip ICD-10 in favor of ICD-11, and while that macro-level debate goes on, hospitals should focus on what they can control.

Source: www.beckershospitalreview.com; Bob Herman; November 5, 2012.

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