Set Your Sights on ICD-10-CM

Our checklist will pave the way for a smooth transition.

By Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, COBGC, CEMC, CDERC, CCS-P

Only 53 months and counting before we go live with ICD-10-CM. There are so many tasks to accomplish before Oct. 1, 2013 that you may not know where to start your journey toward implementation.

Before concentrating on specific ICD-10-CM guidelines and codes, your organization needs a plan or a “road map.” Your road map toward ICD-10-CM implementation should include communication and significant collaboration in information technology, finance, clinical areas, payers, and outcomes. Knowing where you are going will get you to where you want to go.

AAPC Has a Plan for You

AAPC’s website is a great place to find the information needed to contrive an implementation plan. Take time this week to begin reviewing the ICD-10-CM training plan on AAPC’s website, if you have not already done so.

Once you have reviewed the plan:

Log into your member area.

  1. In the ICD-10 Preparation area at the right side of the Member Area web page, select the type of organization you work for from the pull-down menu. There is guidance for health plans/payers, very small practices (1-3 physicians), small practices (4-10 providers), medium practices (11-49 providers), and large practices (50-plus providers). This is called the ICD-10 Tracker.
  2. Click the Save button once you have selected an implementation plan according to your organizations needs. The web page “My Personal ICD-10 Implementation” displays implementation plan guidance. If you chose a small practice, there are 14 steps you will need to take for a successful ICD-10 transition. If you are a medium or large practice, you may have a couple more steps to take.
  3. Click on a step under “My Personal ICD-10 Implementation,” such as “Step 1: Organize the Implementation Effort.” You are taken to a new web page, where each step hosts a detailed, numbered checklist to further explain how to achieve implementation success.

Take it One Step at a Time

Every time you complete an implementation step, check off the step and click the Save button on your online ICD-10-CM implementation plan. The yellow lines next to the track steps will turn green as the actions are checked off. This indicates that you have completed the step in the recommended time frame. Steps have end dates. If one or two of the step end dates pass without all of the actions being checked off, the progress light turns to amber, warning that you have fallen behind. If more than two of the step end dates pass without all of the actions begin checked off, the progress light will turn red—and we all know what that means.

Begin the implementation process step by step. Focusing on all elements that need addressing at one time will lead to frustration. Systematically focusing on one step at a time and creating a timeline to phase in ICD-10-CM will streamline the process and eliminate getting overwhelmed with unnecessary work. The amount of work necessary to implement ICD-10-CM and the resources required depends on the practice size. A large practice may need to recruit key persons from many different departments to assist with the transition; whereas a small practice might incorporate only one or two person(s) to assist in the transition.

Step 1: Organize the Implementation Effort

The first step to a successful transition using the online implementation plan is to “Organize the Implementation Effort.” Every practice needs to assign a project team or key person to organize and to manage the implementation effort. If you have several people in your practice involved in the ICD-10 transition, form a team and assign projects with completion dates for each step along the way. The project team or key person is responsible for the initial planning process. Each practice should include at least one physician in the implementation process. Physician “buy in” is critical for ICD-10-CM.

Physicians need to be involved so they understand the importance of preparation as ICD-10-CM implementation occurs. Get coding staff involved. Provide periodic progress reports to the implementation project team and/or physicians, so everyone is made aware of the progress, problems, and barriers to your organization’s implementation.

A small practice might benefit from hiring a consultant to either participate in the project or coordinate the overall transition plan. In a large practice, leadership staff should be involved in the transition plan development.

Once the project team is set and leadership roles are identified, it is time to get to work. Begin by preparing a project summary, including an overview description of regulations, changes to code sets, and anticipated internal and external work processes. For larger practices this could mean reading the ICD-10 final rule; for smaller practices this could mean reading materials prepared by a professional society. The project summary and an outline of project steps will serve as the roadmap for completing implementation. This summary should include the scope of work anticipated to accomplish successful implementation and it should be shared with the physicians in your medical practice.

Within the scope of “Organizing the Implementation Effort,” a preliminary impact analysis should be performed. This analysis will identify all areas that will be impacted within the practice such as the clinical areas, IT systems, documentation, etc. When you have developed the analysis, draft a simple written report to share with your physicians or project team. This information must be shared with the providers so they can understand the impact on their practice. In this planning stage, identify who in the medical practice or organization has decision-making authority.

One of the main concerns with ICD-10 implementation is the delay of claim submission resulting from the ICD-10-CM learning process. People’s short term productivity decreases when they are in training or learning a new skill. These productivity slowdowns can include charge capture and reimbursement, and can affect a practice’s financial health. The project team should anticipate a decrease in productivity by measuring and analyzing the transition prior to beginning the training process.

Take a Proactive Role

Every practice should begin this process immediately. Preparing for this change will take a great deal of time and effort. The project team is instrumental in the success of implementing ICD-10-CM and should be proactive in its preparation. All staff members should be involved in some way in the ICD-10-CM transition. Understand that the transition effort will not succeed without input and cooperation from all practice members. Personnel involved in the transition process should begin planning early to avert potential problems in the process.

In June and July of 2009, AAPC will conduct audio conferences and webinars on implementation guidance. A distance learning module will be available in September 2009 to help with implementation guidance. Watch AAPC’s website and news and updates for these important dates, and review the online ICD-10 Implementation Plan. Take advantage of the tools we have created to assist you in this important transition.

Next time … Developing the ICD-10-CM Communication Plan.

Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, COBGC, CEMC, CDERC, CCS-P is AAPC’s vice president of strategic development and the former AAPC National Advisory Board president. Deborah is currently writing the ICD-10-CM Implementation Guide.

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