Creating an ICD-10 Action Plan: Training, Testing, and Ongoing Review

So you've taken a look at the possible effects of the ICD-10 and even created a budget and documentation plan for the medical coding transition. There are a few more steps your medical practice's action plan should include, according to Robert Tennant, senior policy adviser in the government affairs department for the Medical Group Management Association (MGMA).

Tennant recently presented a step-by-step implementation guide for practices at the MGMA's Annual Conference in San Diego.

One of the final components of your plan should address clinical and administrative staff training, he said. First, you need to identify your practice's education needs, including who needs training, what type (and level) of training is required, and how each person should be trained.

In terms of when to train, Tennant advised training your coders six months to nine months before the Oct. 1, 2014, implementation date and training physicians three months to six months in advance of that date.

"If you do it any sooner, you may end up needing retraining," he said.

There are a wide variety of training opportunities and materials available in the market now, he said, ranging from online courses to onsite training. For smaller medical practices, Tennant advised teaming up with other local medical practices. These practices could pool resources and collectively send one staff member to attend a "train the trainer" course, bringing back knowledge to share with the other practices; the group could hire one trainer for all the offices; or assign a "super user" to assist multiple physicians or even practices, he said.

In addition to training, a medical practice's action plan for ICD-10 should also include external system impact assessment and training, according to Tennant. Now is the time to communicate with your vendors about their readiness, timeline for installation and training, modules or interfaces, and possible upgrades.

In working with your practice's clearinghouse, Tennant urged practices to ask several questions, including:

• What ICD-10 services will you provide?

• Is my submission format appropriate?

• What will be the cost of the service?

• When can you accept test claims?

• Are you offering any training opportunities?

And don't forget about your health plans, he said. Ensure they are ready for the transition and inquire if they'll accept test claims and ask what assistance they can provide during and after the transition.

The final part of a medical practice's ICD-10 action plan should be ongoing review and maintenance, leading up to and following the transition. Tennant advised that practices should watch for any announcements regarding compliance dates and documentation policies from both federal and commercial payers, as well as announcements from vendors.

He also recommended identifying any issues or roadblocks your practice may face, as early in the process as possible. Once you evaluate those issues, assign a member of your staff to be sure each one is addressed and resolved, so that it won't end up hurting your bottom line, Tennant said.

The bottom line, he reiterated, is that ICD-10 is coming and that medical practices need to prepare sooner than later.

"Don't wait until next summer," Tennant said.

SIDEBAR

ICD-10 Resources

Robert Tennant, senior policy adviser in the government affairs department for the Medical Group Management Association, recommended the following ICD-10 resources at the group's recent annual conference in San Diego:

•MGMA Administrative Simplification webpage:

http://www.mgma.com/adminsimplify

• CMS Administrative Simplification webpage:

http://www.cms.gov/

• MGMA ICD-10 webpage:

http://www.mgma.com/5010icd10/

• CMS ICD-10 webpages:

http://www.cms.gov/ICD10/

http://www.cms.gov/TransactionCodeSetsStands/02_TransactionsandCodeSetsRegulations.asp

• CDC webpage (for general ICD-10 information)

http://www.cdc.gov/nchs/icd/icd10cm.htm

• ICD-10-CM files, information and general equivalence mapping (GEM) between ICD-10 and ICD-9

ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2010/

• ICD-10 home page (WHO)

http://www.who.int/whosis/icd10/index.html

• NCHS Basic ICD-10-CM information

http://www.cdc.gov/nchs/icd.htm

• CMS ICD-10-PCS information

http://www.cms.hhs.gov/ICD10/02_ICD-10-PCS.asp

• WEDI ICD-10 Implementation

http://www.wedi.org/topics/icd-10

This is the third of three articles on Tennant's proposed "action plan" for medical practices to prepare for ICD-10. Stay tuned to the ICD-10 Topic Resource Center for future installments.