The U.S. Department of Health and Human Services (HHS) will reportedly announce a proposed extension of the deadline requiring healthcare providers to implement ICD-10, moving it from October 1, 2013, to October 1, 2014. The extension follows an announcement in February that HHS was postponing (actually, “initiating a process to postpone”) the compliance date.
What does this mean for healthcare providers and other organizations with skin in the ICD game? The American Medical Association (AMA) was a major proponent of the postponement and expressed their thanks for it in an official statement:
The American Medical Association appreciates Secretary Sebelius’ swift response to address the AMA’s serious concerns with ICD-10 implementation. The timing of the ICD-10 transition could not be worse for physicians as they are spending significant financial and administrative resources implementing electronic health records in their practices and trying to comply with multiple quality and health information technology programs that include penalties for noncompliance. Burdens on physician practices need to be reduced – not created – as the nation’s health care system undertakes significant payment and delivery reforms.
However, after the delay was announced, two major industry organizations pleaded with HHS to be decisive about the new date—and not to set it too far in the future. Worried about the uncertainty and risk created by a shifting deadline, the College of Healthcare Information Management Executives (CHIME) sent a letter to HHS:
We believe a prolonged delay to ICD-10 implementation, or more specifically, prolonged uncertainty about the timing and details of a delay, will create more problems than it would solve.
Recommendation: We strongly urge HHS to move quickly and decisively in setting a new compliance date for converting to ICD-10. Every day that passes without a concrete deadline is another day that should have been spent planning and implementing this critical undertaking.
Read more…
Electronic Health Records
HHS, ICD-10, Patricia Zenner
The purpose of engaging providers in the ICD-10 transition is to create stellar physician documentation and coding, which could make ICD-10 coding beneficial to providers and patients—accurate and complete patient records can be used to facilitate care consistency and coordination, promoting evidence-based practice and appropriate reimbursement for services rendered.
Recent surveys have found, however, that most providers are not yet engaged in the ICD-10 transition. Organizations must plan and implement focused efforts to change superior documentation and coding from lofty goals to practical ones.
In this paper, we discuss the emerging best practices to engage physicians in the ICD-10 transition.
Electronic Health Records
ICD-10, Pat Zenner
The immediate focus of most HIPAA organizations and their vendors is on the conversion and mitigation of potential risks related to ICD-10 implementation. Many of those risks relate to the data fog that will ensue for at least 18 months following the October 1, 2013, implementation.
Some organizations have thought about what will happen after the data fog clears—the long-term advantages that ICD-10 will likely offer include better identification of fraud or abusive practices, improved ability to manage care and disease processes, and tracking public health and risks.
However, few have thought about the immediate opportunities that ICD-10 offers starting on the first day of implementation. Organizations do not have to wait two or more years for historical ICD-10 data to improve condition management, enhance population management, or engage in outcomes analysis. With a little foresight, organizations may even be able to use ICD-10 to improve coding. Find out more in this new white paper.
Electronic Health Records
EHR, ICD-10, Pat Zenner
We blogged already this month about ICD-10, the new clinical coding paradigm with the October 31, 2013, implementation deadline. So it’s interesting to see the reaction to an article last week suggesting this deadline be pushed to 2016.
While on the topic of hurdles to a more intelligent and integrated health system tied together by electronic health records (EHRs), here’s a different kind of challenge: The need for a human being to actually record clinical details in the system. An increase in “medical scribes” may help ensure the proper information is documented:
Scribes started working in fast-paced emergency departments in the mid-1990s, but hiring has picked up as more hospitals have switched to electronic records, say officials at several companies that hire and train scribes. Having scribes do most of the data entry allows the highest-paid people in the room to focus on patients and see more of them and ensure that information used in billing is complete, the companies say. It also allows doctors to make more eye contact with patients, and that makes patients happier.
Electronic Health Records
EHR, ICD-10
We’ve blogged before about ICD-10, the clinical coding set that all U.S. payors have to convert to by Oct. 1, 2013. Managed Healthcare Executive covers the slow move among some health plans toward ICD-10 preparedness. Here’s an excerpt:
“As much as individuals and organizations in the industry have tried to raise awareness of ICD-10, we still have organizations come to us and say they’re are not getting the attention of senior management,” says Patricia A. Zenner, healthcare management consultant with actuarial firm Milliman, Inc.
In fact, a survey of MANAGED HEALTHCARE EXECUTIVE readers published in October 2010 indicated that 33% of payers and 45% of providers had not taken any action on ICD-10 implementation. While it’s in the best interest of providers to complete the transition early, just 4% of those surveyed indicated they were nearing completion of the conversion.
Payers will have a secondary concern when the Oct. 1, 2013, conversion deadline nears, because they’ll undoubtedly receive claims in ICD-9 and ICD-10 during a prolonged transitionary period. In other words, they’ll need to have two systems operating simultaneously to handle both types of transactions. According to the MHE research, about 6% of payers were nearing completion of their conversion last October.
For more details read the full article.
Electronic Health Records
ICD-10, Pat Zenner
A new article on the blog ICD-10 Watch looks at the risks associated with ICD-10 implementations, quoting ICD-10 expert Patricia Zenner. Here is an excerpt explaining four key risks:
1 Planning
In this phase, Zenner recommends that organizations identify goals, allocate resources to making necessary changes, chart a road map for how to achieve ICD-10 compliance and communicate with external partners.
2 Preparation
“Analyze and test the portion of codes not cleanly mapped in order to assess the potential reimbursement impact, modify standardized schemes, modify contracts to provide for the uncertainty that will accompany the transition ‘data fog,’” Zenner writes.
3 Implementation
What with the clock ticking, the implementation phase is the time to actually provide those allocated resources so your organization can achieve timely and accurate coding and reimbursement, Zenner adds. “Be over-prepared to address issues as they arise.”
4 Post-implementation
Once ICD-10 is implemented and compliance day, October 1, 2013 has come and gone, healthcare organizations will need to monitor KPIs (key performance indicators) for any potential issues, actively manage reimbursement, and continue to promote open communication, Zenner explains.
For more on ICD-10, see these other resources:
Electronic Health Records
ICD-10, Pat Zenner
When it comes to peering into the future, many in healthcare are now eyeing the 2014 date when the bulk of the healthcare reform provisions take effect—which means they are already looking beyond another important deadline. Change is in the air, and the October 1, 2013, deadline for implementing ICD-10 diagnostic codes is one of many system-changing evolutions that will take place in the coming years.
Where should healthcare organizations start? Pat Zenner offers perspective in a cover story published this month in “For the Record.” Here is an excerpt:
Simply performing an ICD-10 assessment is a huge task in itself. A thorough assessment is an exercise designed to help the healthcare organization build a strategy to achieve compliance that should involve identifying all organizational components that will be impacted by the conversion and then gauging the readiness to address transition for each component, says Patricia A. Zenner, RN, healthcare management consultant at Milliman, Inc, an actuarial firm that recently released a report measuring industry perceptions and readiness for ICD-10. The report details how organizations should currently be focused on synthesizing the output of the planning phase. “We recommend that organizations use a four-phase approach to ICD-10 implementation: planning, preparation, implementation, and postimplementation,” explains Zenner. “Upon completion of the planning phase, organizations should have a strategic approach document that brings together all pieces of the assessment and integrates them into an outline of what is impacted, preferred approaches through transition, contract and vendor strategies/changes, the resources needed, recommendations on how communication of the organization’s approach should be relayed internally and externally, and how education should be rolled out through implementation.”
According to Zenner, organizations that are on track with the report’s recommended timeline should already be well into that planning phase, targeting completion in the first quarter of this year. That includes completing an assessment examining all facets of the organization. “Since ICD-10 has the potential to affect nearly every aspect of the organization, the assessment should cover every aspect as well,” Zenner says. “It’s better to err on the side of covering too much rather than risk omitting something important. Once all of the components have been identified, then the organization can develop detailed strategies and tactics for achieving compliance. Those strategies and tactics feed into the detailed implementation plan that must ultimately be developed and used.”
Electronic Health Records
ICD-10, Pat Zenner
Even with the direction of reform now in question, change continues throughout healthcare. One evolution that should be well underway is the mandated, industry-wide conversion to ICD-10. Here is a summary from GovTech:
They say it’s a bigger deal than the Y2K bug.
Not so much in terms of mass hysteria, but in scope: In 2013, the U.S. will upgrade to the latest version of the International Classification of Diseases (ICD) system — the standard diagnostic taxonomy by the World Health Organization — a move which represents “the largest health-care systems modernization effort in history,” said Bartlett Cleland, senior director of policy at TechAmerica, a technology industry association.
As hospitals switch to the latest disease diagnosis and procedure codes, industry observers say, the technical and economic impact to the U.S. government and health-care community could eclipse the much-hyped system upgrades at the turn of the century.
“It’s going to affect anybody who touches the health-care system,” Cleland said. “If not done correctly, this change has the potential to be even more painful than anything in the health-care debate that’s going on.”
ICD-10 is starting to get more press and attract a greater sense of urgency. This blog article has appeared several places. Why the increased attention? First, because 2013 no longer seems so far away; and second, because many in healthcare are not yet prepared for the conversion. The industry’s preparation was recently highlighted in this survey.
Read more…
Electronic Health Records
Andrew Naugle, ICD-10, Pat Zenner
A new study looks at how health organizations are responding to the ICD-10 deadline of Oct. 1, 2013. In many cases, they don’t seem to be responding at all—70% indicated their organization has done “little or nothing” to implement the new standard.
You can read the study here.
Electronic Health Records, Quality of Care
Andrew Naugle, ICD-10, John Kasey, Patricia Zenner
October 1, 2013, sounds like a long way off—unless you are in health IT.
That’s the day that the U.S. Dept. of Health and Human Services (HHS) has set as the deadline for conversion to ICD-10 clinical codes.
Two new Milliman white papers help clarify the issue by looking at critical factors for conversion and by isolating the characteristics that will separate the winners from the losers as the American healthcare system makes this switch.
Anyone looking for even more depth can check back with us for future publications, or join our series of Webinars, which begin tomorrow.
Electronic Health Records
ICD-10, Kathy Zaharias, Lisa Mattie, Patricia Zenner
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