Strategies for a successful ICD-10 transition

The president's signature on legislation that pushes back the ICD-10 compliance date until at least Oct. 1, 2015, has many practices breathing a sigh of relief. However, before practices put their ICD-10 implementation plans on the shelf, they should first consider how to use this extra time to their advantage.

While it’s tempting to put readiness efforts on hold, further delays will only leave practices underprepared when the final deadline arrives. It would also mean squandering one of the most valuable resources needed to adequately prepare for ICD-10 – time.

[See also: ICD-10: How best to proceed now]

By keeping the momentum of ICD-10 preparations alive, practices can ensure a cost-effective and timely transition. Thankfully, there are a number of strategies and tools providers can leverage to stay on course. At Regional Urology, an important first step toward achieving ICD-10 readiness was creating a detailed plan that outlined everything it would take to get our 17-provider practice ready for the new code set, including: 

Staffing. The ICD-10 transition is much more than a billing issue. It’s a broad initiative that impacts every area of the organization. With that in mind, we recruited staff across the practice to assist with our readiness plans. Our team includes approximately 25 employees who represent everyone from physicians and medical records personnel to registration and check-out staff. This team consists of formal members and members in which job specific information and processes are informally discussed.

We also decided to proactively add more billing personnel to our staff now so we could free up our veteran billers to focus on strategic, transition-related efforts. With these new resources in place to handle routine coding tasks, we’ve been able to keep productivity high and ensure everyone on staff receives adequate training. We plan to keep these extra billers on board until after the transition is complete. By doing so, we’ll be able to submit more accurate claims, which will ultimately reduce denials, speed reimbursement and minimize disruptions to cash flow.

Budget. Time is money. While IT upgrades are certainly a major aspect of our budget, a bigger concern for our practice was allocating enough funds for personnel during the transition and beyond. We also increased our available lines of credit and started to build up a war chest of funds to ensure we’re prepared for any dips in revenue that may occur as everyone gets up to speed on the new code set.

Education and training. One of the biggest assets in our ICD-10 readiness efforts has been a complimentary analytics tool that allows us to identify which ICD-9 codes our practice uses most, as well as the corresponding codes in ICD-10. Called the ICD-10 Analyzer, this tool provided by Navicure quickly identifies our most common ICD-9 codes using typical production data and all of the potential ways these codes will look using ICD-10 at both the practice and individual provider level. With this data in hand, we are able to focus our training efforts on those areas that will impact revenue the most. For example, if we find that one of our most frequently used codes has 10 or 15 different translations, we know it will require more education and training than a code with a straightforward one-to-one translation. The goal is to ensure everyone is educated and knowledgeable about the ins and outs of ICD-10.  

Testing. We are among the small minority of practices that have already started to send test files to our clearinghouse, Navicure. So far, as we anticipated, we’ve encountered some minor hiccups, but it’s much easier to address these items before they have the opportunity to impact revenue. Going forward, we plan to continue testing all of our internal processes and systems to ensure they function at the highest possible level before ICD-10 takes effect. We also intend to participate in end-to-end testing with payers. While we can’t control their readiness, we can collaborate with them to verify that all systems meet requirements and that any transactions involving ICD-10 work as expected. A variety of tools and resources are available to help practices prepare for end-to-end testing, including checklists and best practice documents from CMS. By testing the entire process from claims creation through submission and payment, we’ll all have a better sense of what the future holds.

While it would be great if practices could use the extra time to kick up their feet and relax, the reality is there’s a lot of work to do and there will be costs associated with it. Expenses related to training or extra coding staff may seem like significant investments now, but indirect costs like payment delays, productivity losses, incorrect reimbursement or overtime are much more expensive over the long-term. Getting tools in place now and taking advantage of the variety of resources available to help providers streamline tasks related to the transition allows practices to prepare for ICD-10 as easily and cost-effectively as possible.

Joel Young is CEO of Regional Urology, a 17-provider urology practice based in Shreveport, La.