The Importance of Early Preparation for ICD-10

If an ounce of preparation is worth a pound of cure, then health care providers are grossly underweight when it comes to transitioning from ICD-9 to ICD-10 coding.

coding

If an ounce of preparation is worth a pound of cure, then health care providers are grossly underweight when it comes to transitioning from ICD-9 to ICD-10.

According to a recent survey by Health Revenue Assurance Holdings Inc., a provider of technology and revenue integrity solutions for health care organizations, 40% of hospitals surveyed have yet to begin ICD-10 clinical modification training for coding staff, and 55% have not begun ICD-10 procedure coding system training.

“The biggest obstacle [to successful ICD-10 transition] is not being prepared,” says Ryan Secan, MD, chief medical officer for MedAptus, a Boston-based coding/charge capture and management software company. “The more time and effort that people put into preparing for the transition now, the better off they’re going to be.”

Costly procrastination

On Oct. 1, 2014, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 codes. More specifically, the number of codes will increase from than eight-fold, from 17,000 to more than 140,000.

Neil Stanley, regional president of corporate partnerships for Harrison College, which introduced an ICD-10 medical coding training curriculum at the start of this year, says it is imperative that health care entities start training staff now.

“I was speaking with the CEO of a very large national health care network, and I told him that if you started educating 50 people a week starting now, you would never make [the deadline],” Stanley says. “You just wouldn’t have enough time.”

And in this case, time most definitely is money. Secan says he has seen estimates that only 60% of providers are going to achieve basic preparedness by the go-live date. As such, it wouldn’t surprise him to see a 10% to 20% decrease in physician productivity, and a 20% decrease in coder productivity, once ICD-10 implementation begins.

According to Secan, a 10% to 20% decrease in productivity could be the difference between a practice that succeeds and one that fails, especially if staffers don’t want to work more hours for the same pay.

Stanley agrees.

“With 144,000 new codes coming out, if the information is not being coded correctly, that creates a logjam in reimbursement,” he explains. “At the end of the day, that’s going to affect [a practice’s] revenue.”

Take steps now

Ample resources are available to help hospitals and medical practices of all sizes achieve ICD-10 compliance on schedule. The ICD-10 software package developed by MedAptus is able to handle ICD-9 and ICD-10 simultaneously. The benefit, Secan says, is that a health care institution does not have to roll out every physician or every group on the exact same date.

The program facilitates cross-walking entered codes from ICD-10 back to ICD-9 so that even though the physician or the provider is only seeing the ICD-10 code that they’re entering, the coder is able to see what ICD-9 that maps backwards onto and still be able to send out that ICD-9 code.

“We have institutions that already have our system in place, and are in the process of testing and getting ready to go live in ICD-10 now, a year ahead of the deadline,” Secan explains. “That way they can roll it out group by group by group, and they can distribute their training resources and their IT resources appropriately to be able to manage that transition. And we have products available for even the smallest groups to make this transition.”

The program at Harrison College includes more than 170 modules for non-coders — health care support staff, nurses and physician practitioners — as well as the standard fare for coders. All those modules are available at the college’s various campuses, as well as online. And all are AHIMA and AAPC approved — a critical component, Stanley says.

“What’s shocking is that some institutions started developing their own curriculum, which is not AHIMA or AAPC approved, so they’re in a world of trouble,” he explains. “They recognize that now, but they spent six months and a lot of resources thinking they could [develop their own curriculum]. But if you’re not certified, you won’t get paid.”

Training is also available through the New York University School of Continuing and Professional Studies, which has launched a new Certificate in Medical Coding, comprised of nine courses designed to prepare medical coders as well as other health care professionals for the adoption of ICD-10.

“The key thing is realizing [ICD-10 implementation] is going to happen, realizing you have to do something about it, and beginning to take steps now,” Secan says. “The people who are in denial, saying there’s going to be another extension, or it won’t happen because the AMA is going to block it, are the ones who will have the hardest time when the deadline actually hits in 2014.”