How Facilities Are Moving Ahead With ICD-10
By Rita Genovese, CPC, PCS
At our large facility, we are making great strides toward ICD-10 implementation. To ensure a smooth transition, eight work streams were created and will be dedicated to focus on specific projects. These areas of focus are: business process redesign, clinical documentation improvement, coding, communications, education, information technology, revenue accountability, and testing. I am a member of the business process committee and have seen the changes first-hand.
Departments throughout the enterprise designated a person within each area who will be resources in the implementation of ICD-10. These roles include providing awareness about ICD-10, modifying and implementing workflows affected by ICD-10, and identifying staff for training.
The Business Processes work stream will coordinate redesign and implementation of all processes affected by ICD-10 across the Jefferson enterprises.
Clinical Documentation & Coding acts as liaison and coordinates with Coding and CDI groups to prepare for the transition to ICD-10.
The Communications work stream will concentrate on the following:
- Developing and executing ICD-10 communication/awareness plan
- Developing and maintaining stakeholder communications and readiness matrix
- Maintaining internal ICD-10 website and content updates
Education work stream will focus on:
- Developing and executing comprehensive training and education plan
- Coordinating ICD-10 training and education across Jefferson
- Content development, delivery, and tracking
- Attendance tracking and competency testing
The Revenue Accountability and Testing work streams will concentrate on key initiatives such as:
- Analysis of data and detailed financial impact
- Contact payers regarding their readiness, and partner with key payers on testing
- Develop accounts receivables (A/R) management strategies to address increases in rejections and denials
Liaisons have been assigned to each department. The role of the liaison is to assist with the ICD-10 implementation and monitor the status of each department.
A risk impact analysis is being performed on external stakeholders. An external stakeholder has a relationship with the outpatient facility and will be impacted by ICD-10 (e.g., the National Cancer Database).
All clinicians will be trained in documentation guidelines including all residents.
Physician champions have been chosen for each area. The role of the physician champion is to recommend and promote changes in the documentation practices and workflows. They will also support the education process and enhance the department’s knowledge of ICD-10 training. All providers have been trained for several months. The feedback has been positive with many providers stating that they have a better understanding of the required documentation and levels of specificity.
Employee evaluation has occurred on all levels, beginning with the front-end, through to the back-end.
Coders have been trained via boot camp and virtual coding labs. Coders will be dual-coding. Dual-coding will allow staff to become more familiar with ICD-10, help assess coders’ needs, and increase their confidence, speed and accuracy. Additionally, ICD-10 codes captured during the dual process will allow staff to perform testing for ICD-10 readiness.
The information technology department is working through the application upgrades, remediation and the phases of required ICD-10 testing: unit testing, integrated/interface testing and end-to-end testing. In addition, the team is also performing testing with payers and clearinghouses. We have our eye on the prize and are continually moving forward.