On October 1, 2015, ICD-10 will become mandatory in the United States. But we aren’t the first to make the transition—not by a long shot. In 1998, Australia adopted ICD-10, and in 2001, Canada did as well. So although the US appears to be a little behind the times, it might be for the best. After all, there are plenty of things we can learn from those that went before. Just ask Carl Natale of ICD-10 Watch. He wrote a few articles on the topic, and here, we’ll summarize his main points:


According to Natale—who cited source Debbie Abbott, the ICD-10 Implementation Officer for Queensland Health—Australians love ICD-10. However, although Australia runs on a similar healthcare system (citizens can choose to buy their own insurance or participate in government run programs), there are several distinct differences. The first is that Australians started out only using ICD-10 for inpatient coding, and the second is that their hospitals operate on a single diagnosis-related group (DRG), which is conducive to ICD-10. Despite these differences, there are still several key learnings we can take away from our friends Down Under. After all, their coders were back to their previous productivity rates within three month of implementation. Here’s why:

  • Assessment began early—consultants helped identify the processes clinicians were using with ICD-9 to determine “who needed to know what” and when.
  • Training began early—18 months before implementation.
  • Testing began early—early enough to identify the areas where more education was necessary and where workflows needed alteration.

Are you seeing a pattern here? I am: start early. Assess, train, and test—early. The more we can understand upfront, the better prepared we’ll be to make the transition. But that doesn’t mean we can iron out all the kinks ahead of time. And according to the Australians, “it’s expensive,” which is all the more reason to consider a few more tips from another country that went before.


Whereas the Australians had an easy transition, the Canadians did not. But they did do a great job of learning from their mistakes and passing along that wisdom. Natale referenced Gillian Price, Project Director Canada at QuadraMed, in an article where he cited several lessons the US can—and should—learn from our neighbors to the North. Here are four:

  1. Take control of your own learning: CMS has some great resources, but don’t leave it up to them to hand-feed you the information you need. Do your research. Teach yourself and share your knowledge.
  2. Get everyone involved: It’s not just your coders who should understand the differences; everyone in your office should know the ins and outs of ICD-10 and how the transition is going to impact your entire practice.
  3. Plan for the unexpected: Save. Save. Save. Make sure that you have enough funds available—experts recommend at least six months’ worth—to keep your clinic afloat in the face of potential loss of revenue.
  4. Collaborate: According to Natale, “Price is very proud of Canada’s very collaborative culture. She says it was a key part of learning from mistakes and making ICD-10 transitions smoother.” So let’s work together—and make the best of it.

There you have it: a handful of helpful takeaways from Australia and Canada that we can use to make the US transition that much easier. Want more details? Here are Natale’s full articles about Australia and Canada.