4 Ways to Make the Most of the ICD-10 Delay

April 23, 2014

Having at least another 18 months until ICD-10 becomes a reality can be a good thing for your medical practice. Here are four things to start doing today.

While not ideal for medical practices that were prepared for the ICD-10 transition on Oct. 1, 2014, a congressional delay of the new coding system is not necessarily the end of the world, according to coding expert Rose T. Dunn. In fact, there are four ways medical practices can still "stay the course," she said.

Dunn was a keynote speaker at the American Health Information Management Association's (AHIMA's) ICD-10 and Computer-assisted Coding Summit, held in Washington, D.C., April 22 and 23.

A former AHIMA president and the chief operating officer of health information management consulting firm First Class Solutions, Dunn said despite uncertainty about when ICD-10 becomes a reality, there are four key things practices can do over the next 18 months to prepare.

The first is to continue ICD-10 system upgrades, as many include the Stage 2 requirements to meet meaningful use through CMS' EHR Incentive Programs. "You are going to have to put in an upgrade anyway, as you need the components of the upgrade driven by meaningful use [in Stage 2]," she said. "The delay was for ICD-10, not Stage 2 of meaningful use."

In addition to the upgrades, Dunn advises continued internal testing and following up with payers and other partners about their plans for the ICD-10 transition.

Second, Dunn advised focusing on the "ailments" at your practice discovered during your ICD-10 preparation for implementation this year. That includes everything from cross-training your practice staff to "growing your own" pool of coders to handle the transition. The latter can be done by setting up apprentice programs with students from local schools, current clinical staff (like physical therapists and registered nurses), and even medical staff.

"There are some who are saying they are just tired of all the edicts, regulations, and requirements they have to live with and there is no time to take care of patients anymore," she said. "They want something 9 to 5 with no call, so why not get them?"

As for your current physician pool, Dunn advised "getting them out of the coding business altogether."

"Let [them] take care of patients and convert your coding professionals to clinical information assistants or scribes, following the physician and getting the documentation you need," she said.

The third focus Dunn noted was to address physician documentation deficits. She advised using ICD-10 as the "gold standard" going forward, utilizing any software dashboards set up to track coding changes, and having staff and physicians continue to practice their ICD-10 coding.

"Have your coders continue practicing ICD-10," she said. "We predicted [with the original deadline] a productivity deficit … that was a six-month learning curve. We now have 18 months to get rid of that curve. Will they practice as many cases? Probably not, but they should definitely continue to practice."

The fourth way to utilize time from the ICD-10 delay, according to Dunn, is to automate where possible. From completing EHR implementation or expansion to utilizing computer-assisted coding, she advocated moving fully to digital recording.

"Throw away the quills," she said. "You need to get rid of handwritten documentation and some of the paper there. Automate it."

She also followed a page out of the HHS' Office of Inspector General in advocating an end to copy-paste operations in your software solutions. "It's bad, bad, bad," she said. "It doesn't help coder productivity and actually facilitates erroneous data."