5 steps to ICD-10 success

Editor's note: The following is an excerpt from the FiercePracticeManagement eBook, ICD-10 Implementation for Physician Practices.

Yes, the compliance deadline for the conversion to the ICD-10 coding system still seems far away. In fact, many practice leaders express a feeling of hopelessness when it comes to this massive project, which will impact everything from revenue to staffing resources.

ICD-10 implementation is more complex and time consuming than most practice executives realize, says Robert Tennant (pictured right), senior policy adviser for the MGMA-ACMPE.

"This transition has a lot of uniqueness to it," he says. "This implementation involves both the administrative and clinical side of a practice, which is unusual. You can have the IT part of the practice all set to go, but if the clinicians aren't appropriately trained, it could seriously impact practice cash flow."

Every journey begins with a single step--or, in this case, six steps you can take today to start on the right path to ICD-10 compliance and the Oct. 1, 2014, goal:

1. Get your team together

An internal implementation team should include physicians, nurses, billing and IT, at a minimum. At large practices, the research and clinical-trial arms also should get a seat at the table.

Kaiser Permanente, for example, created "continuity of practice" groups that included practice managers, staff, clinicians and IT leaders to plan implementation at its 611 medical offices and other outpatient facilities, says Gloryanne Bryant (pictured left), Kaiser's ICD-10 coding education and training leader.

For smaller practices, dedicate a staff member to developing implementation timelines and plan training modules, says Fred Ralston, M.D., a primary care internist in an eight-physician practice in Fayetteville, Tenn.

2. Take stock

Inventory every IT application and program the transition will touch and identify who is responsible for each, says Bryan Matsuura, executive director of Kaiser Permanente's ICD-10 program. Develop a project plan with key milestones and timelines for each affected functional area.

3. Contact partners

Ask software vendors, payers, coders and claim clearinghouses about their plans and preparedness for the ICD-10 transition. "Early and frequent communications" are key, Bryant says.  Ask what internal resources they plan to use and determine how that affects your practice's plans. Find out when health plans will accept ICD-10-coded claims, when they will start accepting ICD-10 claims and whether they can help train staff at your practice. 

4. Assess and test

Begin a documentation assessment to see whether coders can identify appropriate ICD-10 codes based on redacted paid, real-world claims. Identify strengths and weaknesses and plan training around them, Bryant says. But don't start training too early. Administrative staff should be trained nine to 10 months before the compliance date, and clinical staff only six months before, Tennant says. Any earlier and they're likely to forget what they learned before the go-live date.

5. Practice, practice, practice

Start shopping for "crosswalks" that link ICD-9 codes with equivalent ICD-10 codes. Keep in mind, though, that few of the crosswalks will be precise, given the differential between ICD-9's 13,600 diagnostic codes and the 69,000 of ICD-10.

"It's not just assigning the code. There's a thousand moving pieces," Tennant says. "All of these pieces have to come together perfectly in order for this transition to be seamless, and we all know that [is difficult] in healthcare."

For more on these and other steps to ICD-10 success--specific to physician practices--download the FiercePracticeManagement eBook, ICD-10 Implementation for Physician Practices. It includes articles on the financial impact of ICD-10 on physician practices, as well as tips on how train staff for the transition.