Six Ways to Capitalize on the ICD-10 Delay
By Dan Stewart
Most of the healthcare industry was taken by surprise when President Obama signed legislation that delayed the deadline to implement ICD-10 by at least a year. Now that there has been time to digest the new compliance date of October 1, 2015, healthcare providers may benefit by considering a more strategic approach for their transition to ICD-10.
Prior to the extension, many healthcare providers put in patches to meet the previous and quickly approaching October 1, 2014 compliance date. Process improvements and documentation training were put into high gear to meet the deadline, and in many cases, lacked strategic planning. With the additional time, providers can revisit their approach to implementation and potentially take advantage of other initiatives that directly impact the way their organization is evolving.
Here are six strategies to take advantage of the delay to be better positioned for post-transition success.
1. Increase clinical documentation and education
Providers now have an additional year to train their workforce. Nurses, physicians, coders, and even members of the C-suite need to understand the benefits for greater specificity in clinical documentation and how it applies to their role. Customized simulation training that addresses the specific educational needs of clinician groups can simplify the learning process and speed adoption. For example, customized simulation training can allow caregivers to practice documenting care in ICD-10 through their actual EHR application, which is critically important for learning workflow and gaining new knowledge about the system.
Any time and money invested in efforts like simulation training will be financially beneficial in ICD-9 and will also provide a smoother transition to ICD-10 with reduced risk of reimbursement issues. In addition, by continuing to engage staff with training, organizations can avoid losing the focus and interest that was created by the momentum leading up to the previous deadline.
2. Evaluate and improve the revenue cycle
Providers now have time to improve charge capture and billing and claims processing. Doing so will help to identify potential lost revenue and charge issues before claims are submitted and will improve compliance in anticipation of new denials and other post-transition challenges. Improved charge capture will also create a safety net to assist in identifying any potential ICD-10 process issues.
3. Implement computer-assisted coding (CAC) systems
Many hospitals have invested in CAC systems to aid coders in digesting physician documentation and determining which of the staggering 141,000 possible codes under ICD-10 is appropriate for each diagnosis and procedure. Now is the time to support the implementation of CAC and focus on coder workflow to optimize the benefits. Remote coding programs should also be evaluated. Incorporating tools like these not only reduces post-transition risk but also assists in the recruitment and retention of coders, which are in significantly increasing demand.
4. Begin dual coding
It is a reality that hospitals will need additional coders during the transition from ICD-9 to ICD-10. The extra time resulting from the delay creates an opportunity to begin dual coding sooner, providing physicians and coders additional practice before the compliance date. Prior to the transition, CAC systems can assist in the dual coding process by providing an automated crosswalk back to ICD-9 codes for submissions to payers, clearinghouses, and other third parties. The increased accuracy and efficiency of documentation and coding optimizes the post-transition period, mitigating the risk of compliance and reimbursement issues.
5. Analyze the financial impact
Hospitals should take the time to perform an in-depth financial impact analysis to determine the highest-impact codes on reimbursement to provide focus on operational remediation and training. Such analysis will additionally assist in identifying the reserves that will potentially be needed to get through post-compliance stabilization.
6. Expand the implementation plan
The ICD-10 extension presents an opportunity to strategically link its transition with other initiatives like Meaningful Use, Patient-Centered Medical Home (PCMH), and Accountable Care. Combining plans to adopt all of these programs can help ensure they each work together as efficiently as possible.
Miami Children’s Hospital, for example, is working to deploy a revenue cycle management system in addition to working toward ICD-10 compliance. Now that there is less immediate pressure to have physicians trained as soon as possible on ICD-10, their training can occur after the new system modules are implemented to better reflect the healthcare provider’s specific system and workflow. Implementing both of these programs in tandem saves time and money and strengthens the success of each.
While it would be easy for healthcare providers to decide to pause their efforts to become ICD-10 compliant as a result of the recent delay, it would benefit them much more to view the extra time as an opportunity to take a more strategic approach. Continuing the process will position the provider for a more successful, efficient transition to ICD-10.
Dan Stewart is vice president and partner of strategic consulting and advisory services with Xerox.