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ICD-10 delay: Use extra time to ensure your practice is ready


In some ways, the implementation delay for ICD-10 is a welcome relief for practices not ready for the transition. But now practices must use the extra time to prepare. Here's how to get started.

Renee DowlingIn some ways, the implementation delay for the International Classification of Diseases-10th Revision (ICD-10) is a welcome relief for practices not ready for the transition. But now that ICD-10 has been delayed until October 1, 2015, practices must use the extra time to prepare, both by training to use ICD-10 and continued use of ICD-9 for the next year.  

The delay in implementing ICD-10 gives physician practices extra time to apply the principles to clinical documentation improvement. 

The documentation principles of ICD-10 reflect positive principles that should be applied to ICD-9 today to ensure the appropriate documentation of quality, severity, and risk. These are the key elements in incentive initiatives currently being offered by government and third-party payers when reported with diagnoses that support quality, severity, and risk.  

Improved clinical documentation of diagnoses support incentive dollars. It also supports the higher levels of Current Procedural Terminology procedure and evaluation and management coding that practices currently use.

In addition to continued ICD-10 training, here are some things you can do now to position your practice to be ready for ICD-10 and the year ahead.

Be ready for ICD-9

Oddly enough, some partners in the payment chain won’t be prepared to keep ICD-9 going after October 1, 2014.

Reconfiguration is needed for groupers and pricers, and health plans need to make sure their systems accept ICD-9 codes.  Some electronic health records (EHRs) may be hard-coded to accept only ICD-10 codes after the original implementation date, so check with your vendor.

Check your equipment

We now have time to ensure that our systems are ICD-10-compatible, without rushing to meet deadlines.

However, the previous rush may have left your system in less-than-optimal condition.  So find out whether your EHR and practice management vendors have identified bugs when beta testing your ICD-10 systems, and ask to make sure they are worked out in time for the new deadline.

Review updated LCDs

Although ICD-10 has been postponed, MACs were required to issue new local coverage determinations (LCDs) with ICD-10 codes by April 10, 2014. This means that diagnosis coding will require a higher level of diagnosis specificity.

Providers and staff should review the new LCDs to get started on the ICD-10 transition, including a review of the codes that support medical necessity in the LCD, and the guidelines for those codes in your ICD-10 code book.  This will help you identify the additional characters required for the codes and categories listed. 



Renee Dowling is a billing and coding consultant with VEI Consulting Services in Indianapolis, Indiana. Send your billing and coding questions to

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