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Is Your Medical Business Ready for ICD-10?

Jeff Hough on Apr 23, 2015 7:00:00 AM

icd 10 codes

In the hit TV show “The Walking Dead” the Zombies just keep coming despite the survivors best efforts to keep them at bay. 

This scenario is a lot like the rapidly approaching deadline for ICD-10 implementation. 

Despite the best lobbying efforts of groups like the American Medical Association and the Medical Group Management Association, the October first implementation date looms ominously, marching ever closer.

ICD-10 is an update to the ICD-9 system which the medical community uses to code diagnoses, symptoms and procedures completed by physicians and hospitals. 

The current ICD-9 system has 13,000 diagnostic codes while the ICD-10 revision contains over 68,000 codes.  The purpose of the additional codes is to provide specific information about the diagnosis and treatment of patients.

icd 10

The International Classification of Diseases (ICD) has been around for over 100 years.  The World Health Organization (WHO) took over the revising and publishing of updates in 1948. 

Since that time there have been five revisions to the codes, with the most recent update coming in 1994 and is known as ICD-10.  Most of the world has been quick to adopt the ICD-10 codes, but the United States has lagged behind, but that is set to change on October 1, 2015.

Transitioning to ICD-10

In 2014, the Workgroup for Electronic Data Interchange (WEDI) published the findings of their ICD-10 Readiness Survey

“Based on the survey results, all industry segments appear to have made some progress since October 2013, but the lack of progress by providers, in particular smaller ones, remains a cause for concern as we move toward the compliance deadline,” said Jim Daley, WEDI chairman and ICD-10 Workgroup co-chair.

For practices that are using ICD-9 the transition to the new system does not have to be a difficult one.  The obvious key is to being preparations now so you won’t be forced to rush implementation of the new system. 

With only 35% of providers saying they have tested an ICD-10 complaint system, there is a lot of work to be done the remaining months.icd 9 codes

ICD-10-CM/PCS is composed of two parts.  The first part is the ICD-10-CM is used in all U.S. health care settings.  A big change in this part is using 3 to 7 digits for coding instead of the 3 to 5 digits used currently. 

The second part is the ICD-10-PCS, which is used in hospital settings only and uses 7 digits rather than the existing 3 to 4 digits.

The Path to Transition

To minimize potential negative impacts on business, healthcare provides need to being putting into place a plan for the transition.  The Center for Medical Services website created a checklist to help practices begin their preparations.  Their suggestions include:

Identify current processes and systems that use ICD-9 Codes. For each area that utilizes the ICD-9 codes there will need to be a transition to the new codes. 

The main purpose for the new codes is to provide greater accuracy and information into the diagnosis and procedures, so the majority of the old codes will not work in the new system.  A careful review will allow the identification of critical areas and prevent future billing areas.

icd 10

Confirm with your practice management software is ICD-10 capable.  Your practice management software is the backbone of your practice and if your vendor doesn’t have upgrades available, you will need to start shopping for a new system right away.

Reviewing with your vendor your needs and usage patterns will help identify the correct upgrades and services you will need to accommodate the coding changes.

Begin staff training and appoint a lead person.  For small practices this will be a key step in the process.  Getting a point person trained will help that individual identify potential bottlenecks and problem areas with your current processes. 

Larger groups will likely want to create small teams to take the lead in training and implementation.  These point teams will work closely with vendors and training providers to create a transition schedule that works for your office.

The Cost of Transition

As with everything there are costs associated with the transition.  Individual office costs will vary, but Nachimson Advisors has created the following chart to identify potential costs based on practice size.

The Cost of Implementation

Some of the estimated costs associated with preparing an office for the conversion are: purchase of coding book(s), coding training for staff involved in code entry, physician training and the time costs associated with the transition process.

Online training for documentation and coding can be found for less than $300, and customized training classes for staff can be found at prices less than $1000.  Additionally, ICD-10 Diagnosis and Procedure codes can be accessed at CMS.gov.

Conclusion

Despite the delays and the opposition, ICD-10 conversion will happen and offices that are prepared won’t suffer any loss of production time or income.

Most software vendors will have created valuable updates that address common issues and provide solutions to many of the questions that people have.  

By following the simple steps listed above, identifying critical processes, checking with software vendors and naming a point person you will be primed and ready to make the change and you won’t have to worry about the oncoming zombie apocalypse. 

ICD-10 CTA

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