ICD-10 Implementation Looms: How Medical Practices Can Begin Preparing

On Oct. 1, 2014, the ICD-9 medical coding sets you’re now using to report inpatient procedures and medical diagnoses will be replaced by a new set of codes. With the failed rollout of HealthCare.gov still fresh in their minds, many medical groups have been pushing for a delay. But those pleas have fallen on deaf ears. An administrator for CMS recently told attendees at the Healthcare Information and Management Systems Society conference that it won’t budge any further on the planned implementation date, which has already been delayed one year. Private practices must now focus on preparing for the changeover.

The upcoming diagnostic code overhaul includes a jump from roughly 13,000 codes to more than 68,000 unique codes. All practices will be affected to some degree. In February, the AMA estimated that ICD-10 implementation might cost practices up to three times more than initially projected. It also warned of even higher expenses for practices that “don’t get ICD-10 right the first time.” An effective transition plan will help practices avoid additional education costs, lost billing revenue, and the need for repeat training.

So where should practices begin?

Registered providers and claims processing vendors began testing ICD-10 adjustments during the first week of March, so it’s not too soon for practices to begin testing and tweaking their own billing procedures. Begin by designating a coder or administrator who will coordinate the practice’s ICD-10 transition. This individual will be in charge of reaching out to vendors to determine which software and forms will need to be updated. In some cases, practices might need to invest in education for coders and administrators to make sure they are ready for the switchover. After completing some initial planning, your practice should be ready to set a budget for the ICD-10 switch.

While roughly 55,000 codes will be added to the medical coding set, not all will be relevant for your practice. The transition coordinator should work with your practice’s coders to begin converting the most reported codes that your practice currently uses to their ICD-10 equivalents. He should also work with claims submission system vendors to make sure practice coders will still be able to submit codes efficiently with the current system. Vendors and coders can even work together to minimize future errors by deleting from the practice’s systems those codes that will no longer be payable. The transition coordinator should then follow up with vendors to confirm that all necessary changes have been made in time.

The ICD-10 transition will require practices to spend time and money, but doing so now will keep your practice from having to commit even more time or money after October 1.