Tag Archives: ICD-10

ICD-10 deadline to be pushed back a year?

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.

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Engaging providers in ICD-10

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.

Using ICD-10 for immediate quality of care and coding improvement

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.

EHR hurdles

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.

Are we ready for this?

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.

Four ways to reduce ICD-10 risk

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: