5 steps to prepare for ICD-10

So, you’ve heard: ICD-10 is coming—dun, dun, dun. Just kidding about that last part. While there are several preparatory tasks we really think you should get started on now (if you haven’t already), ICD-10—contrary to what some people believe—is nothing to be afraid of. But it is something to take seriously. So what can you do to prepare? Well, here are our top five next steps and when to take them:

1. Accept the facts (today)

Sure, you could go through all five stages of Kübler-Ross’s mourning process before finally landing on acceptance, but we suggest you make it a quick trip. Beginning on October 1, 2015, you will only receive reimbursement for claims you submit with ICD-10 diagnosis codes. The sooner you accept this fact, the better. Use this as motivation—you have a deadline. And I don’t know about you, but I sure work better with a firm end date.

2. Elect a lead—or a team (this week)

There’s someone in your office who excels at this sort of thing—and that may or may not be you. This person is a born project manager with a knack for research and a love of all things organizational. This is your ICD-10 implementation lead, so go buy him or her a coffee—or maybe a personal espresso machine.

Depending on the size of your office, you may need to elect an ICD-10 team, but at the very least, every practice needs one head ICD-10 honcho who is responsible for staying up to date on the latest and greatest in the world of diagnosis codes—and translating that information into comprehensible tidbits and action items for everyone else. Looking for a place to start? Assign your lead the first task of compiling a list of great ICD-10 resources like CMS, APTA, and AdvancedMD. (Bonus points if he or she puts WebPT at the top of that list.)

3. Create a plan (next week)

Now that you’ve got your lead and a host of really helpful resources, it’s time to start laying out a plan—that is, what you want to accomplish by when. Just like you do for your patients, we recommend using the SMART goal method—setting learning objectives that are specific, measurable, attainable, realistic, and timely. You can start by taking a look at your current diagnosis code processes and determining how these will need to change in the coming months to accommodate the new codes—an ICD-10 compliance audit, if you will.

And it’s not just about your internal processes. If you outsource your billing or use an electronic medical record for documentation, make sure that your vendors are ready to handle the new codes as well. If they aren’t prepared—or don’t seem confident in their ability to transition—you may need to start looking for new partners. (In case you’re wondering, WebPT will be ready to handle the new codes well before the October go-live date, and we’ve made it our mission to provide you with a wealth of free educational resources so you’ll be prepared, too.)

You could spend every waking moment between now and October 1, 2015, preparing, and you still might hit a snag or seven when it’s time to submit—not on your end, but on your payers’. That’s why experts recommend having at least six months’ worth of cash revenue available to ensure you can weather the potential storm of delayed reimbursements. If you can’t save this much in advance, Heidi Jannenga suggests “having a plan B, such as a line of credit or supplemental income to ensure your clinic’s viability during the transition.” She cautions not to “wait until after October 1 because you’ll have to vie for financing and pay higher interest rates.”

4. Start training (next month)

You’ve got your lead, and you’ve got your plan. Now, it’s time to begin training—and that means including everyone in your office, whether it seems immediately beneficial or not. As an industry (and as a nation), we’ve been using ICD-9 codes for the past 30 years, and it’s going to take a while to unlearn what we’ve learned, so start sooner rather than later—especially because there are five times as many ICD-10 codes as there are ICD-9 codes. Whereas ICD-9 codes are mostly numeric and have three to five digits, ICD-10 codes are alphanumeric and contain three to seven characters. While that may not sound like a big difference, it is.

As you begin training, pay attention to what your trainees need in order to be successful. Are they audio, visual, or hands-on learners? Knowing this will help you and your lead train effectively. Look back at your list of resources; there is a lot of great information out there in a variety of formats. And as the year wraps up, even more resources will begin to surface.

5. Test, test, test, and test some more (next year)

  1. AdvancedMD succinctly summed up this stage in three sentences:
  2. “Test that your office staff can competently work with the redesigned workflow [and new codes].
  3. “Test each redesigned process.
  4. “Test integration with partners.”

Beginning on the first of the New Year, your clinic should be almost (you still have your patients after all) singularly focused on ensuring that come October 1, 2015, you’ve got ICD-10 on lock. That is, you and your staff know the ins and outs of the new codes and how to properly use them, as do your partners (billing, documentation, etc.). So start testing and keep testing until you are 150% confident.

Interested in seeing a few other suggested timelines? Here’s one from AdvancedMD and one for small- to medium-sized practices from CMS. Now, it’s important to note that both timelines suggest that ICD-10 preparation should have begun months ago, but not to fret. There’s still plenty you can accomplish in the time you have left. You’ll just have to step on the gas, pick up the pace, give it some gusto—you get the idea.

Have you started preparing? If so, what steps have you found most useful? Tell us your thoughts in the comments below.