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Addressing Top ICD-10 Concerns


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Get tips for addressing top ICD-10 concerns and planning for a smooth ICD-10 implementation.

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Addressing Top ICD-10 Concerns

  1. 1. Addressing ICD-10Implementation Challenges
  2. 2. Challenge: Expense
  3. 3. • AMA estimates cost for 3-MD practice = $83,290• You can’t budget for your organization until you understand what it will involve: • Conduct an impact assessment • Budget time and resources accordingly
  4. 4. Impact Analysis • What systems / workflows does ICD-9 touch today? • Who needs training? • Coders, billers, physicians • How will EHR adoption impact practice mgmt., billing, coding, reporting, etc.?
  5. 5. • Budgeting may require you to make educated guesses on expenses that cannot be calculated • Ex: Diminished productivity for coders and providers during the transition
  6. 6. Challenge: Vendor Readiness
  7. 7. • Ask vendors about their ICD-10 prep and anticipated timelines.• Not confident your EHR vendor will smoothly transition your system to ICD-10? • Consider switching to an EHR partner that is committed to ensuring your success.
  8. 8. Challenge: Productivity Impact
  9. 9. • BCBS Association estimates coding errors will increase 10-25% in 1st year of transition• Improving clinical documentation is one of the best ways to prepare for the transition’s impact on productivity of physicians and coders.
  10. 10. • More codes means more documentation• Documentation Considerations • Linking relevant conditions • Initial Encounter → 7th Character Extension “A” for Patient under Active Treatment
  11. 11. • Documentation Considerations • Subsequent Encounter → 7th Character Extension “D” for Routine Injury Care during Healing / Recovery • Sequela → 7th Character Extension “S” for Complications / Conditions resulting from an injury (E.g., Scar resulting from a burn)
  12. 12. • Clinical Documentation Assessments • Do random samples support ICD- 10 coding?• Implement Documentation Improvement Strategies • Train → reassess → train again• Appoint an ICD-10 Implementation/ Documentation Champion
  13. 13. Challenge: Cash Flow Impact
  14. 14. • The ICD-10 transition is likely to cause disruptions in cash flow for a number of reasons. • Clean claims may take longer to be submitted due to productivity declines. • Denials may spike due to mapping or coding errors.
  15. 15. • Take steps to protect cash flow during the transition: • Budget for additional cash reserves • Ask major payers about their readiness to process claims coded in ICD-10
  16. 16. • Take steps to protect cash flow during the transition: • Improve clinical documentation to minimize denials • Plan your strategy to manage denials before, during & after ICD-10 implementation
  17. 17. Challenge: Testing
  18. 18. • Plan to conduct testing using the ICD-10 codes as a critical step in preparing your organization for the ICD-10 transition. • Internal testing • External testing
  19. 19. Want to learn more about ICD-10? Watch a free recorded webinar webinars.
  20. 20. Need a health IT partner to help you achievesuccess with ICD-10, Meaningful Use & more? SuccessEHS can help. Visit to request a demo.