For many, the delay of the ICD-10 transition will require major revisions to their implementation plan. For others, the changes will be minor. Some won’t change a thing.
A recent webinar, hosted by the Weymouth, Mass.-based consulting firm, Beacon Partners, articulated this discrepancy while providing tips to providers that are undergoing ICD-10 implementation. In a survey conducted during the webinar, 43 percent of attendees said they anticipated minor revisions to their implementation timeline, 23 percent said they were staying the course, and 16 percent said they were going to undergo major revisions to the timeline.
While industry-wide opinions seem to be split on whether or not the delay was a good idea, Summer Humphreys, executive consultant at Beacon, said that most providers still have a lot of work to go on implementation, even with an extra year. Humphreys shared five tips with providers on how they can utilize the extra time.
Tip 1: Dual Coding
This can occur multiple ways, Humphreys said. It happens when one coder codes a record in ICD-10 and then performs crosswalk coding in ICD-9 when possible in a single session. It can also happen with two coders, one coding in ICD-10 and the other in ICD-9, or multiple coders coding in ICD-10. Dual coding she said can measure the impact ICD-10 will have on productivity while helping apply a standard measure of coding application. Those who wish to dual code should figure out what specific areas to focus on, she said, and also create a diagram workflow process.
Tip 2: Create a Clinical Documentation Improvement (CDI) Program
This kind of program can capture and monitor key performance indicators (KPIs) and measure them against benchmarks, Humphreys said. It also gives an organization a better idea of its coding workflows and helps it better understand where the problem areas might be. Of highest importance in this kind of program is to incorporate feedback from physician advisors and champions. In order to make a CDI program successful, she said organizations have to obtain physician participation and make them understand what's in it for them. Also it's critical to get buy-in from the hospital's leadership team, she said.
Tip 3: Optimize Revenue Cycle Workflows
In a poll conducted by Beacon during the webinar, 81 percent of participants predicted that ICD-10 would have a significant impact on their revenue cycle. No matter what an organization thinks of the ICD-10 delay, Humphreys said she is fairly certain that there will be room for improvement in its revenue cycle management (RCM) when it comes to ICD-10. Some ways to optimize the process, she said, include meeting with frontline staff, using staff interviews to map out workflow diagrams and matching workflow to IT scripts/process flow, and rebuilding RCM work flows to fit employees. She also suggested analyzing which payers, providers, and coders have the highest denial rates to try and better understand those reasons for denials. This can help an organization evaluate how much time staff is spending on claim resubmission and denials.
Tip 4: Evaluate Computer Assisted Coding (CAC) Readiness
Humphreys noted that as of last year, fewer than 10 percent of provider organizations have implemented CAC. She said that many organizations don't have the expenses for CAC and there are no standards within the systems, so it creates a lot of variations. However CAC, she said, can increase productivity, coding consistency, create an audit trail, and it can be used in conjunction with the CDI program. To evaluate readiness for CAC, she said organizations should figure out how much electronic documentation they are doing and the costs and benefits of CAC within their specific organization. Even with the delay, if CAC doesn't result in a 20 percent increase in productivity, it might not be worth it, she said.
Tip 5: Test, Test, and Re-Test
Testing was one of the big issues brought up by industry stakeholders BEFORE the delay was announced. Humphreys recommended organizations create an internal testing plan for each of the ICD-10 touch points, beginning with the most important systems first. She said organizations should test systems more than once using a varied data sample. Lastly, she said organizations should take the extra time to reach out to payers and external reporting agencies to test on that end.