Navigating uncharted waters: the importance of creating an ICD-10 contingency strategy

With ICD-10 around the corner, having a back-up plan is essential. Here are some strategies to proactively avoid some of these challenges.

The old saying, “The only constant thing is change,” has withstood the test of time for a reason: it’s true.  Federal regulations and policies are forever in flux, and whether you’re steering a small physician practice or a large health organization through the upcoming ICD-10 transition, the smallest modifications can create a ripple effect that really rocks the boat.

Those institutions that have built extra time and/or resources into their roadmaps and transition strategies are better positioned to ride the waves.  With the one-year mark for the ICD-10 deadline quickly approaching, now is the time for executives and health information management (HIM) professionals, in particular, to evaluate how their organization is doing on implementation and, if necessary, course-correct.  A thorough program evaluation will not only reveal opportunities for improvement, but enable healthcare providers to create a contingency plan, which is key to ensuring there will be enough time to meet the ICD-10 deadline in the case of an unforeseen challenge.

Although it’s impossible to know what the future of healthcare brings, having a contingency plan built into ICD-10 transition strategies can help organizations better navigate potential changes.  Additionally, budgeting extra time over the next 13 months will allow provider organizations and practices to address several avoidable challenges by proactively:

Evaluating and testing IT systems.  Consider all the databases and systems that need to be compatible with the new ICD-10 codes.  Think inputs and outputs: every channel of communication holding an ICD-9 code today, coming in or going out, will need to be tested for ICD-10 compatibility.  That is, of course, after an organizational decision has been made regarding the design, for instance ICD-9 and ICD-10, ICD-10 only, or any other unique configuration.  Testing is essential to ensuring all systems are fully integrated and able to process the data properly.

Training coders to dual-code.  Although it takes more time and effort upfront, dual coding in ICD-9 and ICD-10 today can improve accuracy and save organizations both time and money.

Examining end-to-end clinical documentation integrity programs.  Analyzing the data, determining top diagnosis-related groups (DRGs), and performing gap analyses will help organizations pinpoint their patient populations and ensure that education programs are properly preparing coders for the transition.

Creating an employee retention plan.  Working with HR to create an employee retention program will help prevent attrition and assist organizations in retaining their most valuable assets— employees.

Although the months ahead may bring challenges, it is possible to navigate the constant ebb and flow of healthcare reimbursement and the ICD-10 transition.  Providing a clear map to leadership, physicians and staff, along with the right tools, will help keep all stakeholders on the same course, and budgeting extra time to evaluate, test and prepare will help the next 13 months be smooth sailing.  Remember, the true test is really not the next 13 months, but what tsunami effect may be on October 2, 2014.  That is when the real fun begins!


Bonnie Cassidy

About Bonnie Cassidy

This was a contributed post by Bonnie Cassidy. Bonnie serves as the 2015 Chair of the Commission on Accreditation for Health Informatics and Information Management (CAHIIM) Board of Directors, is a Fellow of AHIMA, an AHIMA Academy ICD-10-CM/PCS Certificate Holder and ICD-10 Ambassador, and a Fellow of HIMSS. Bonnie also served as the vice president of HIM product management & innovation at QuadraMed, and served as an executive with the Certification Commission for Healthcare Information Technology (CCHIT), Ernst & Young and the Cleveland Clinic Foundation. Bonnie was the 2011 President/Chair of AHIMA, recipient of the 2014 AHIMA Distinguished Member Triumph Award and the 2015 (Georgia) GHIMA Distinguished Member Award. Bonnie received her graduate degree from Cleveland State University and her Bachelor’s Degree in HIM from Daemen College. Bonnie grew up in Buffalo, NY, lived in Cleveland, OH and has been a resident of Atlanta, GA for 17 years. She considers the Bills, the Browns and the Falcons her hometown teams.