Don't Wait to Prepare for the ICD-10 Transition

Are you ready for the ICD-10 coding transition? Probably not, and although the deadline is years away, practices should be acting now to prepare.

"This is something that can [sneak] up on you in a hurry and can impact you," said Larrie Dawkins, MBA, CMPE, chief compliance officer for Wake Forest University Health Sciences Center in Winston-Salem, N.C.

The new ICD-10 coding standard, which goes into effect Oct. 1, 2013, is far more complex and granular than its predecessor, promising the need for much more documentation and preparation.

"It's totally different, so it will require retraining. It will impact virtually every part of your practice," said Robert Tennant, MA, senior policy advisor for government affairs at MGMA. Tennant and Dawkins spoke Tuesday at the MGMA 2010 annual conference.

To paint a picture of just how much more detailed ICD-10 is, Tennant compared codes for sprained or strained ankles. Under the current standard, ICD-9, there are four codes for that ailment; under ICD-10, that number skyrockets to 72. If you were to convert the average superbill into the new system, it would be 11 pages long.

Don't wait, Tennant told the audience. For starters, practices should call their practice management system vendors, and ask them if they are ready for the transition. Inquire about their plans for upgrading the software, so that you can plan for the transition, he said.
It's also a good idea to lock in an ICD-10 educator or consultant early. "The transition is going to be costly and time consuming," he said.

How costly and time consuming? MGMA's estimates put the potential cost for a small, three-person practice at $83,000, which includes education, technology, and training. It could also result in an average of four fewer patient visits per day as physicians take more time to document.

The ICD-10 transition is expected to affect everything from software to staffing to reimbursements. It could reduce productivity (at least for a few months) and potentially require more staff or support, Dawkins said.

(If you're wondering why, considering the issues involved, is healthcare making the transition, Tennant explained. The current code structure is outdated and doesn't meet healthcare's evolving needs. The new system will also allow for more robust public health reporting.)

Dawkins offered a list of action steps for practices:
• Keep up with ICD-10 developments and news.
• Create an internal change team, made up of both clinical and administrative staff, to coordinate the transition. Appoint a clinical leader, likely a physician, to champion the change.
• Set a multi-year training budget. It doesn't matter as much the amount you budget; just putting down a number will help keep staff committed and ease the planning.
• Determine who needs to be trained and at what level. Physicians will need to relearn how to write their narratives and improve their documentation.
• Talk to your vendors. Ask them if they are ready for the transition and whether it will require new software. Also talk with your health plans to see what their plans are.

Not surprisingly, several key issues are still unresolved, Tennant noted. For example, it's not entirely clear how much granularity payers will require under the new system. It's also up in the air how much vendors are prepared, and as Tennant said, "This is on the back of the vendors," and right now, they are mostly consumed with the meaningful use criteria for EHRs.

The ICD-10 transition, however, should be an opportunity for practices to take a close look at their technology systems, and make some upgrades, he said. What areas can you automate?

"Look into improving your practice at the same time you're coming into compliance," he said.

For more MGMA 2010 conference coverage, be sure to visit our MGMA Conference Insider page.

Sara Michael is senior editor at Physicians Practice. She can be reached atsara.michael@ubm.com.