Health Information Management

It's the final countdown

HIM-HIPAA Insider, April 6, 2015

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No joke this time. We have six months left until ICD-10 implementation.

That’s a good news/bad news proposition.
The good news is that all of the hard work we’ve put into training and implementation plans is finally going to pay off. Woo-hoo!
In other good news, CMS seems ready to process ICD-10 claims, based on the first round of end-to-end testing. I am curious to see how the second and third rounds go and I’d love to see some more details, but hey, at least CMS is successfully testing.
Now the bad news. We only have six months until ICD-10 implementation. That means we have six months to iron out all of the bugs, make sure everyone is trained and ready, and be prepared for the inevitable problems.
So, it’s time to imitate Santa by making a list and checking it twice.
Here are some thoughts for what should be on your list:
  • How well are your coders trained? Have they been practicing on actual records? Do you know what kind of productivity hit you’re facing and have you made plans to address it?
  • How’s your EHR? Do the physicians like it? (Okay, they probably don’t, so a better question is, can they use it?) Have you talked with your vendor about upgrades/updates for ICD-10? Can they add prompts or templates into the system to help capture additional documentation required for ICD-10?
  • Are your physicians on board with ICD-10? It’s easy to say all physicians hate ICD-10 because the AMA keeps trying to kill it. But don’t rely on the AMA’s stance to tell you what your physicians think. They may love ICD-10 and be ready to go October 1. At the very least, you need to make sure physicians are educated on what will change for their specialty October 1. For example, talk to your OB/GYNs about documenting weeks’ gestation. Skip that conversation with the pulmonologists. Tell them about the new asthma codes, which align more with the disease process.
  • Are your queries ready? Has your clinical documentation improvement (CDI) team reviewed their queries to make sure they are capturing ICD-10 information? Hopefully, they’ve been updating queries for a while and the physicians are getting used to documenting additional information.
  • Does your query process work? That seems like a no-brainer, but now is a good time to assess whether your process is efficient and effective. How long does it take physicians to respond to queries? What is the overall response rate? Is physician behavior changing for the better with queries? For example, several years ago, CDI specialists began querying for bacterial pneumonia. In some cases, physicians began documenting bacterial pneumonia for every patient to avoid a query.
  • And while we’re on the subject of queries, are you ready to query for surgical procedures? Coders are going to need very specific information to report procedures using ICD-10-PCS. Is that information currently in the operative report? If not, do your CDI specialists know what to look for in the record? Are your coders clinical enough to understand where to find information in the operative report?
This is not by any means an all-inclusive list of things to worry about. With six months left, we need to take stock of where we are and prioritize our remaining tasks. And it’s also a good time to start planning your post-implementation success party so we can pat ourselves on the back for getting this major upgrade up and running.
This article originally appeared on HCPro’s ICD-10 Trainer blog.


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