The stakes are high for the upcoming ICD-10 conversion and the consequences for organizations that don’t properly prepare may be severe. Here are some first key steps in ICD-10 implementation planning, provided by Ann Zeisset, an author for the American Health Information Management Association.
In order to avoid future claims rejections, denials, delays in processing authorizations and reimbursement, compliance issues and improper claims payments, among other problems, healthcare providers must be working on Phase 1 of ICD-10 implementation, which includes an implementation plan and impact assessment, said Ziesset.
“We are expecting the final rule on ICD-10 on June 30. Until then, CMS tells us to continue planning and providing education,” said Ziesset. “If ICD-10 is extended another year, it’s because there are people who really need it to be extended. The more specific codes we’ll find in the new system will improve our ability to analyze and trend different issues. Also, we’ll be able to process claims for reimbursement easier and with more specific codes… The first phase is very important because it’s really a strategy and assessing the impact for your whole organization. It’s the critical planning phase. I think we have learned from other projects that if we don’t plan well, it will not be implemented well,” she said. “A one-year delay seems like a long time, but it’s not if we are already behind.”
Ziesset discussed some important steps within creating a implementation plan, including establishing an interdisciplinary steering committee, formulating transition strategies, identifying goals, developing a communication plan and developing a detailed project plan.
“One of the most important first steps is creating a steering committee – and it must be done before an impact assessment is done. The size of the committee depends on the size of your organization, and even small clinics should have one,” she said. “It’s also not too early to start talking with your system venders and payers – ask questions and discuss issues like the costs involved. Awareness education is important too. Provide education for senior management, IT personnel, department managers and medical staff.”
Ziesset said the next step for providers is having the impact assessment to study an organization’s readiness for the change.
“With this assessment, we look at all business areas,” she said. “We need to look at impact on all systems applications and databases using ICD codes, as well as an analysis of systems changes. We need to prioritize the sequence of systems changes and estimate the cost. It’s important to develop an ICD-10 budget.”
Zeisset mentioned that another important aspect of the impact assessment is figuring out which staff members need what levels of ICD-10 education, as well as how that education is delivered and what the most cost-effective method is.
Source: www.healthcarefinancenews.com; Kelsey Brimmer; May 24, 2012.