ICD-10 D-Day

D-Day was the beginning of a major turning point in World War II; for the healthcare industry, ICD-10 represents a major turning point for medical providers. No, the transition to ICD-10 isn’t a military operation—far from it, in fact—but both take a great deal of preparation and coordination to execute. Just like you wouldn’t attack your enemy without trained troops, skilled leaders, and a strategic plan of action, you wouldn’t make the transition to ICD-10 without preparation and coordination.

But despite best efforts, things don’t always go according to plan. Thanks to ICD-10’s increased demand for specificity, it seems there’s no avoiding a dip in productivity come October 1, 2015. As this AHIMA article explains, “Productivity loss, or an increased amount of time to code a patient encounter, due to the transition to ICD-10-CM/PCS is expected to reflect a bell curve, with the peak productivity loss surrounding the go-live date.”

But how will that slow-down actually manifest? According to this article from ICD10Watch, unfamiliarity with the new code set will cause decreased productivity in a few different ways:

  • Taking more time to find the correct code.
  • Spending more time communicating with physicians due to nonspecific referral diagnoses.
  • Claim rejections due to coding errors.
  • Delayed claim reimbursements due to payer unpreparedness.

While some factors are out of your control, the degree of productivity loss your clinic will suffer is mostly up to you. Here’s what you should focus on to combat productivity loss (as adapted from this resource):

  • Practice, practice, practice. If you use an EMR, take advantage of your vendor’s ICD-10 testing tool.
  • Make time for training (you’ll thank me later).
  • If it’s in the budget, consider hiring a coder (or two)—and make sure he or she knows how to code for your speciality.
  • Finalize all notes for dates of service on or before September 30—and submit any outstanding claims.
  • Examine—and refine—your systems and processes to maximize efficiency going into the transition.

Interested in figuring out how much productivity your clinic actually loses post-transition? You’re going to need to know your productivity levels as they currently stand. You should be tracking this already through key metrics, such as these metrics recommended by ICD10Watch:

  • Time to correctly code a medical claim
  • Time it takes to process a medical claim from patient encounter to healthcare payer
  • How long it takes for healthcare payers to answer coding questions
  • How long medical claims are in accounts receivable
  • Denial rates and how much money is denied
  • Difference between reimbursements and contracted rates

Once you have these figures, you can use them to compare productivity levels as time marches on. If you don’t have these metrics, it’s going to be a lot tougher to track and manage your decrease in productivity, but the war’s not over yet. You won’t have a baseline for your pre-transition productivity, but if you start keeping track now, you’ll at least be able to tell how your clinic is doing in the thick of the transition and, eventually, you’ll have data to demonstrate when your clinic begins to improve.

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ICD-10 is upon us, but if you attack it with all you’ve got, you’ll give your clinic a fighting chance. The transition won’t be easy, but if you keep your wits about you, you’ll come out the other side.