What is the status on ICD-10? In this Infographic I bring you the facts you always wanted to know & 6 foundation blocks for successful ICD-10 implementation

1. Current Status on ICD-10 Implementation
Presented By
Victoria, thepracticebridge

2. We will be using ICD-10 another 19 days. Before that I will
make you to walk through the status on ICD-10
implementation.

3. I have few questions in my mind
 Does the claims errors will Increase?
 Will A/R could rise?
 Will there be a rise in claim denial rates?

4. 2015 survey was intended only for healthcare providers. 60%
responded on behalf of a hospital or health system. Hope we will get
more clarifications if we go through the survey.

5.  According to the survey, just 7% of physicians said they have started
transitioning to ICD-10 extensively.
 31% of respondents said they had not started the transition at all.
 Among solo physicians, 82% said they have not started the
transition at all or have made only limited
 42% of respondents said they are "not at all confident" that the
implementation of ICD-10 will cause no serious disruptions.
 83% of respondents expect the transition to result in delayed or
denied claims;
 36% expect to face disruptions that require them to draw from
personal funds;

6.  32% said they might reduce staff size, work hours or benefits; and
 30% said they might retire early because of anticipated cash-flow
issues related to the transition
 65% said they are capable of processing ICD-10 codes;
 52% said their practice management software was capable of
processing ICD-10 codes
 1% said they will need to completely replace their IT systems to
comply with ICD-10.

7. A recent survey of 1,100 organizations found:
#More than half of respondents were uncertain of the actual
ICD-10 deadline.
#And more than half had not yet completed end-to-end testing.
#Some providers still believe the switch to ICD-10 isn't going to
happen this year.

8. "This is an off-election year, and if I was
a politician, I would roll ICD-10 out
during an off-election year rather than
delay it," says Mr. Joshua Berman, Relay
Health ICD-10 Director.

9. Provider organizations that haven't adequately prepared for the
switch are going to have issues with the processes that ICD-10
requires. However even organizations that have prepared may still
have problems.

10. This isn't a technology change, it's a
process change
The switch to ICD-10 requires coding staff, physicians and all others
who document conditions to be properly trained to ensure billing is
done correctly.

11. All providers are likely to encounter some issues with the switch
to ICD-10, including an increase in claim denials and the amount
of time it takes payers to process claims

12. For small practices Road to 10 from CMS has primer for clinical
documentation, clinical scenarios, and other specialty-specific
resources to help with implementation.

13. Medicare claims processing systems will not
have the capability to accept ICD-9 codes for
dates of services after September 30, 2015

14. 6 foundations for ICD-10 implementation you
can’t ignore!
 ICD-10 CM/PCS Communication
 Coding Education
 Clinical Documentation Initiatives
 IT Plan
 Revenue Cycle Plan
 Post "Go Live" Health Information Management & coding activities

15. Communication
Concise Messaging
 Vision Statement
 Partners & Roles
 Timelines
 Defined Methods of Communication

16. ICD-10 CMS/PCS Vision Statement
 Clarity-steering the team in the right direction
 Inspiring and meaningful versus compliance driven
 Expected outcomes-how we will be working differently following
ICD-10 implementation

17. Partners and Roles
 Identify
 Internal groups
 External groups (Partners)
 Agreed upon communications

18. Have a timeline that outlines milestones, secondary tasks and
deadlines keep implementation teams on task.
Multiple communication methods should be used Thumb of rule
says, “seven times, seven ways”

19. Coding Education
Self assessment goals checklists
Rate your self on a scale 1(Goal not accomplished at all) to
5(Goal accomplished)
 Are you aware of your foundational knowledge strengths related
to A&P, disease processes, pharmacology, etc.?
 Are you completing tasks to improve your weaknesses related to
A&P, disease processes, pharmacology, etc.?

20.  Are you networking with a subject matter expert and peers?
 Are you practicing and applying codes to “real world” documentation?
 Are you working to understand the ICD-10-CM/PCS coding guidelines?
 Are you gaining a deeper understanding of the clinical documentation
improvement protocols?
 Do you work collaboratively with clinical documentation specialists
when a clarification or query is needed?

21. Clinical Documentation
Improvement
 The success for this includes
 #physician involvement
 #communicating documentation gaps
 #Other key data findings
 Which agree upon goals of a CDI improvement process and ongoing
focused reviews with feedback.

22.  Medical staff, CDI staff & the coding staff will need education on
the findings from documentation reviews
 Findings should include discussion of the documentation elements
needed to support ICD-10 codes through use of specific examples.
 The value of more concise data capture for high quality data
should be emphasized.

23. IT Block
For the most part, IT plans for the transition to ICD-10 are well
underway, due in part to the conversion to 5010 compliance.
Important elements of the IT building block for ICD-10 readiness to be
monitored throughout the implementation include.

24.  Communications to and from vendors
 Testing of system capabilities
 The costs associated with IT implementations
 Necessary upgrades and system maintenance.
 Decisions around how ICD-9 and ICD-10 databases will be accessed
and maintained will need to be made.

25. Revenue Cycle Block
The 9 pieces of advice from Government Health IT practices must
consider
 Practices should develop a budget and strategy to provide for
additional cash reserves should delays in payment occur.
 Practices should conduct financial modeling to understand the
impacts of moving from ICD 9 to ICD 10 – the impacts should be
looked at by provider, by facility, by service line, and by geography
if applicable.

26.  The potential for backlogs in medical Coding, billing, and claim
edits should be analyzed and a strategy developed to work the
backlogs.
 A strategy for pre and post ICD 10 denials management should be
developed.
 Assess the readiness of external vendors who support coding,
billing, follow up and denials.
 Any audits currently performed (compliance, RAC, etc.) should be
reviewed to determine ICD 10 impact.

27.  Managed care contracts should be reviewed and if necessary,
renegotiated to decrease negative impacts to the bottom line.
 The readiness of high volume payers should be assessed to
determine their ability to process claims. Many payers are now
posting readiness information on their web sites.
 Conduct CDI reviews using ICD 10 code sets to determine if
documentation contains the specificity necessary for ICD 10.

28. Post Go Live HIM/Coding Activities.
Most important block for ICD-10 implementation is to plan the
activities to undertake following the deadline. As Sir Walter Scott
said, “I can give you a six-word formula for success: Think things
through – then follow through”

29.  Practices must follow through and monitor coding accuracy and
productivity following go live.
 When problems are identified, strategies should be implemented to
address workflow problems, process problems, and resource issues.
 Determine if further education and training is needed and provide
it expeditiously to prevent future issues.

30.  Monitor for opportunities to improve data integrity through EHR
enhancements, monitoring of alerts, and communication with
physicians & clinical documentation improvement staff.
 Finally, monitor productivity to manage responding to staffing
needs.
 Go live will be a challenging time for all and retention of highly
trained, skilled coding staff will be essential.

31. Which of these building blocks needs more attention in your
organization? Which has been successful?

32. Share Your Views With Us at
www.thepracticebridge.com
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