The switch from coding set ICD-9 to ICD-10 has the potential to improve hospitals' revenue cycle efficiency, coding accuracy and ability to track data, but only if done right. Hospitals need to undertake a thorough impact assessment of ICD-10 and identify areas of opportunity within the organization for concurrent updates. Karen Boruff, CPC, CPHIT, senior consultant at Hubbert Systems Consulting, offers four tips for hospitals implementing ICD-10.
1. Start early. Although the deadline for implementation is not until Oct. 1, 2013, Ms. Boruff recommends hospitals start as early as possible on assessment, training and practice and have ongoing education for the next two years. "The sooner everyone in the industry becomes familiar with [ICD-10], making it part of day-to-day operations, [the easier] the Oct. 1, 2013 deadline will be," she says. Unfortunately, many providers are postponing training for ICD-10 until they update HIPAA to version 5010. "There are so many initiatives out there right now, from meaningful use and [electronic health record] adoption, to 5010, in addition to day-to-day operations, [hospitals] are stretched to the limit," Ms. Boruff says. While she recognizes the many responsibilities competing for hospital leaders' attention, she maintains that ICD-10 preparation should be made a priority. "It's not just another annual code update; it is adopting a whole new code set that is vastly different from the current one. It requires not only technical changes, but changes in the way we do business," she says.
2. Improve other areas. One way to take advantage of the major shift in coding is to use the ICD-10 transition as an opportunity to improve other areas of the organization. "Identify ways to improve business and start implementing them as early as possible," Ms. Boruff says. "This will make the transition a lot smoother and easier than just flipping the switch on ICD-10." For example, the specificity of the ICD-10 codes provides a great deal more information than codes in ICD-9.
"In some ways [ICD-10] is like learning a whole new language," Ms. Boruff says. This new language includes more specificity and more modern terms that will help increase the information a code includes, which can in turn provide more detailed trends in data. "Hopefully [we'll] see improvement because of better data. ICD-10 will help facilitate interoperability between EHR systems and information exchange because we will all be speaking the same language."
3. Involve the whole organization. The challenge of transitioning to ICD-10 is not localized to the coding or IT departments, but instead affects the whole organization. "ICD-9 codes are so deeply embedded in so many aspects of hospital operations," Ms. Boruff says. Because of the far-reaching impact of coding, Ms. Boruff believes everyone in the organization should have some form of ICD-10 training, the type and depth corresponding to the needs of the organization. She suggests hospitals involve staff and leaders from all departments, including the clinical and nursing departments in addition to the IT, HIM and billing offices.
4. Gain stakeholder support. One of the most important steps in implementing ICD-10 is gaining stakeholder support, according to Ms. Boruff. "Engage stakeholders early and often throughout the process, making sure they understand how vast the impacts are," she says. ICD-10 stakeholders come from both within and outside the organization. Leaders of various departments in the hospital as well as those throughout the industry, such as vendors and payors, are integral to successfully transitioning to the new coding set. "It is important for hospitals to work closely with vendors for all of their IT systems, but they also shouldn't rely fully on their vendors to do all the work. Review the vendor's project plan early and work that in to the hospital's own transition plan," she says.
To obtain the buy-in of stakeholders, Ms. Boruff suggests hospital leaders conduct an impact assessment, identify gaps in operations and develop a strategy for eliminating the gaps and implementing ICD-10 in a way that will benefit the whole organization. "Gaining stakeholder support is a matter of helping them understand how [ICD-10] is going to benefit the organization. It's not just that we need to [implement ICD-10] because of compliance, but because it is also going to help us move forward as an industry," she says. "Identifying some key, specific areas of improvement is a great way to gain support."
Connecting ICD-10 to other requirements can help stakeholders see how a change in coding can influence all aspects of a hospital. "I see ICD-10 as a key element in the foundation of a lot of other initiatives happening throughout the industry — meaningful use, EHR adoption, HITECH, healthcare reform. They all rely on better data,and ICD-10 is a key component of that. Successfully implementing ICD-10 and taking full advantage of the benefits of the new code set will help us with everything else that needs to be accomplished," Ms. Boruff says.
Learn more about Hubbert Systems Consulting.
Related Articles on ICD-10:
6 Tactics to Prepare a Hospital for ICD-10
AAPC Suggests 16 Steps for Successful ICD-10 Implementation
ICD-10 Code-A-Thon Presentation Says "ICD-10 Will Change Everything"
1. Start early. Although the deadline for implementation is not until Oct. 1, 2013, Ms. Boruff recommends hospitals start as early as possible on assessment, training and practice and have ongoing education for the next two years. "The sooner everyone in the industry becomes familiar with [ICD-10], making it part of day-to-day operations, [the easier] the Oct. 1, 2013 deadline will be," she says. Unfortunately, many providers are postponing training for ICD-10 until they update HIPAA to version 5010. "There are so many initiatives out there right now, from meaningful use and [electronic health record] adoption, to 5010, in addition to day-to-day operations, [hospitals] are stretched to the limit," Ms. Boruff says. While she recognizes the many responsibilities competing for hospital leaders' attention, she maintains that ICD-10 preparation should be made a priority. "It's not just another annual code update; it is adopting a whole new code set that is vastly different from the current one. It requires not only technical changes, but changes in the way we do business," she says.
2. Improve other areas. One way to take advantage of the major shift in coding is to use the ICD-10 transition as an opportunity to improve other areas of the organization. "Identify ways to improve business and start implementing them as early as possible," Ms. Boruff says. "This will make the transition a lot smoother and easier than just flipping the switch on ICD-10." For example, the specificity of the ICD-10 codes provides a great deal more information than codes in ICD-9.
"In some ways [ICD-10] is like learning a whole new language," Ms. Boruff says. This new language includes more specificity and more modern terms that will help increase the information a code includes, which can in turn provide more detailed trends in data. "Hopefully [we'll] see improvement because of better data. ICD-10 will help facilitate interoperability between EHR systems and information exchange because we will all be speaking the same language."
3. Involve the whole organization. The challenge of transitioning to ICD-10 is not localized to the coding or IT departments, but instead affects the whole organization. "ICD-9 codes are so deeply embedded in so many aspects of hospital operations," Ms. Boruff says. Because of the far-reaching impact of coding, Ms. Boruff believes everyone in the organization should have some form of ICD-10 training, the type and depth corresponding to the needs of the organization. She suggests hospitals involve staff and leaders from all departments, including the clinical and nursing departments in addition to the IT, HIM and billing offices.
4. Gain stakeholder support. One of the most important steps in implementing ICD-10 is gaining stakeholder support, according to Ms. Boruff. "Engage stakeholders early and often throughout the process, making sure they understand how vast the impacts are," she says. ICD-10 stakeholders come from both within and outside the organization. Leaders of various departments in the hospital as well as those throughout the industry, such as vendors and payors, are integral to successfully transitioning to the new coding set. "It is important for hospitals to work closely with vendors for all of their IT systems, but they also shouldn't rely fully on their vendors to do all the work. Review the vendor's project plan early and work that in to the hospital's own transition plan," she says.
To obtain the buy-in of stakeholders, Ms. Boruff suggests hospital leaders conduct an impact assessment, identify gaps in operations and develop a strategy for eliminating the gaps and implementing ICD-10 in a way that will benefit the whole organization. "Gaining stakeholder support is a matter of helping them understand how [ICD-10] is going to benefit the organization. It's not just that we need to [implement ICD-10] because of compliance, but because it is also going to help us move forward as an industry," she says. "Identifying some key, specific areas of improvement is a great way to gain support."
Connecting ICD-10 to other requirements can help stakeholders see how a change in coding can influence all aspects of a hospital. "I see ICD-10 as a key element in the foundation of a lot of other initiatives happening throughout the industry — meaningful use, EHR adoption, HITECH, healthcare reform. They all rely on better data,and ICD-10 is a key component of that. Successfully implementing ICD-10 and taking full advantage of the benefits of the new code set will help us with everything else that needs to be accomplished," Ms. Boruff says.
Learn more about Hubbert Systems Consulting.
Related Articles on ICD-10:
6 Tactics to Prepare a Hospital for ICD-10
AAPC Suggests 16 Steps for Successful ICD-10 Implementation
ICD-10 Code-A-Thon Presentation Says "ICD-10 Will Change Everything"