Break the silos for successful ICD-10 transition

Despite a deadline that is roughly two years away, providers throughout the nation are in scramble mode to prepare for the change from ICD-9 to ICD-10. But providers aren't the only ones impacted by the coding switch, as both vendors and payers also are feeling the crunch. And while each has their own plan of attack, all three must learn to work together to ensure a smooth transition in October 2013.

"The three silos can't stay siloed to move this out effectively," Joanne Romasko, director of medical economics for BlueCross BlueShield of Montana, said at a session addressing the viewpoints of all three at the AHIMA 2011 Conference & Exhibit in Salt Lake City earlier this month. "We have about 120 vendors ... so vendor readiness is a major concern ... and provider readiness also is critical ... because if they're not prepared, we're worried about what a denied claim status will do to them if we're only going to accept ICD-10."

From a vendor's perspective, a lot of the focus will be on maintaining both the old ICD-9 systems while simultaneously moving into ICD-10, according to Becky DeGrosky, a product manager with TruCode.

"Between now and 2013, our focus is going to be on training and testing," DeGrosky said. "After 2013, though, our focus shifts to supporting both the old and the new encounters; we have to support payers that don't convert, as well as those that do."

Essentially, DeGrosky said, vendors have to be able to enable coding of the same record in both systems to evaluate reimbursement differences, and be able to predict the financial impact.

Providers, meanwhile, must learn to work through the silos created, not only across each division, but also within their own facilities. Keith Olenik, interim system director at Chicago-based Cook County Health and Hospitals System, specifically highlighted physician cooperation and maintaining coder productivity as his chief concerns for the ICD-10 transition.

"I have to be honest with you and say that we've got a long way to go," Olenik said. "Any physician is going to struggle with us constantly hammering them as we try to get better documentation in order to ensure that our coders and other people are going to be able to code properly. ... It's been slow to start."

Olenik also addressed his organization's struggles with trying to transition to ICD-10, while at the same time attempting to meet Meaningful Use and dealing with HIPAA 5010.

"ICD-10 has taken a backseat to all of those [Meaningful Use and HIPAA 5010] knowing that we've got, what, two years?" Olenik said. "All of that has, in turn, created quite a bit of an issue."

Ultimately, all three agreed that collaboration and communication were the best remedies for their respective issues.

"Figuring out the skill and mix and the requirements of all these people is going to be a pretty big challenge," Olenik said. "It's figuring out between now and two years from now, how are we going to accommodate all of these IT changes that are going to be required and all these systems and managing from a resource perspective. "