The ICD-10 Delay: A Checklist to Get Back on Track

August 15, 2014

Though you may have taken a break from ICD-10 planning and prep when news of the delay first broke, it's time to get back to work.

Reactions within the healthcare community to news of the ICD-10 delay to Oct. 2015 are akin to students’ reactions to a school teacher delaying the final exam: Students who feel unprepared are ecstatic and look forward to the extra time to study and prepare, while those who studied intensively and paid for tutors and other prep tools are frustrated.


Despite the delay, however, whether you are the 11th hour all-nighter or the semester-long studier, ICD-10 implementation is still coming. And though you may have taken a break from planning and prep when news of the delay first broke, it's time to get back to work.

Here are 10 tips to help you get started:
1. Know what ICD-10 actually is and how it pertains to your specialty practice;
2. Review each compliance step and prepare a schedule timeline to meet each component;
3. Plan your budget for technology upgrades and resource investments;
4. Plan a schedule and additional budget allocation for training your staff because ICD-10 is more than just diagnosis codes;
5. Learn how the ICD-10 will integrate (or not) with payment scheduling and reimbursements to avoid claim denials;
6. Develop an internal process for ICD-10 across your workforce to simulate the process to be sure each individual understands what needs to be done
7. Know and identify all of the other regulations and changes so you don’t get behind as you approach ICD-10 implementation;
8. Make sure your EHR and practice management systems can handle the conversion.
9. Conduct external testing with your clearinghouses and payers to make sure you can send and receive transactions with the ICD-10 codes.
10. Filter out codes you use the most.

Following this checklist is important because of the very real changes in the move from ICD-9 to ICD-10. The current ICD-9-CM diagnosis codes do not provide sufficient clinical specificity to describe the severity or complexity of the various disease conditions. Hence, the current ICD-9-CM system is less effective for monitoring utilization of resources, measuring performance, and analyzing healthcare costs and outcomes.

ICD-10 will add over 65,000 new codes that describe medical conditions and treatments.

The major difference between the current ICD-9 codes and the new ICD-10 version include revisions to the structure of the codes themselves. Also, ICD-10-CM differs from ICD-9-CM in its organization and structure, code composition, and level of detail.

Since ICD-10 provides more specific data than ICD-9, it will refine and improve operational capabilities of clinics. Physician practices and healthcare organizations should be getting ready for this change using the above checklist, and clinical organizations need to move even faster to prepare.

Unlike a student pulling an all-nighter and acing a test - thoughtful ICD-10 prep and planning will be necessary for making the difference between a successful transition and missing the deadline.