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Countdown to ICD-10: One Health System’s Final Preparations for the Oct. 1 Transition

September 22, 2015
by Heather Landi
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The Oct. 1 ICD-10 implementation deadline is fast approaching after several years of discussions, delays and preparation. All healthcare organizations covered by the Health Insurance Portability Accountability Act (HIPAA) are required to be ICD-10 compliant beginning Oct. 1. There has been considerable angst in the healthcare industry about the impending change, as there is a great deal of complexity with the transition to the new coding set. As previously reported in Healthcare Informatics, several ICD-10 readiness surveys have in the past found levels of preparation and readiness were not high within healthcare organizations and there seems to be varying degrees of optimism for ICD-10 implementation.

However, out on the front lines, progress is being made as most healthcare organizations are moving along with their preparations. Now, it seems, the biggest concern is what happens on and after Oct. 1. The University of Missouri Health Care, based in Columbia, Mo., has been working with health information technology (HIT) vendor Cerner Corporation to prepare for the transition. As the chief medical information officer at the University of Missouri Health Care, Thomas Selva, M.D., is responsible for oversight and system-wide implementation of the health system’s ICD-10 preparation.  Dr. Selva recently spoke with Healthcare Informatics Assistant Editor Heather Landi about what to expect before, during and after the conversion and shared his insights about why ICD-10 is important to physicians.

Is your organization ready for the ICD-10 transition?

The preparation has been going well. It’s been a long journey, as you can imagine, as we actually started on this journey more than two years ago. We were preparing for the cutover for Oct. 1 last year, and then when Congress said we’re going to put it off for another year, it just gave us more time to get ready. On the flip side, it forced us to put off other projects we really needed to get started on so we’re happily looking forward to getting past Oct. 1 so we can get started on the other things we want to work on.

Thomas Selva, M.D.

Have you hit any major roadblocks while preparing for the ICD-10 transition?

Not really, as CMS [Centers for Medicare & Medicaid Services] really put out a nice roadmap as a guide, showing where you need to be along the way. We’ve benefitted from a phenomenal project manager and a wonderful team that we’ve put together, which includes information technology, the billing office, medical records office, our revenue cycle people, and we have physicians on the front lines, all in that room having discussions about what are the next best steps. And, a lot of this has been checking our back end business systems to make sure they’ve been brought up to the latest codes, that they are all ICD-10 compliant and that they are all communicating with each other and with the third-party payers. We’ve been through a lot of that validation already and, in addition, we’ve also been working very hard and early on assuring that our providers are educated on what ICD-10 means and how best to be prepared for what that’s going to imply in their specific area of practice.

Do you have any concerns about the transition on Oct. 1?

Many wonder if it’s going to be Y2K…it’s not going to be Y2K. My crystal ball isn’t perfect, but I think October 1st you’re not going to see the world grind to a halt. I think what you’re going to find is that it’s going to be several days after that when you start seeing coders looking at documentation as it relates to inpatient care and they begin calling physicians and saying “I need more specificity.” So now you’re interrupting the provider’s workflow and the coders are working harder. I think a few weeks further down the road, you’re going to start seeing denials from insurance companies for lack of specificity. I think that’s the worry that everybody has, and no matter how well prepared you are for the transition, it’s probably still going to happen. Any time you change the foundational system in the billing and coding world, you’re going to have a shake-out that has to occur.

How has MU Health used new technology to help meet the challenge of the ICD-10 transition?

We’re testing partners with Cerner, so we’ve been testing modules within our EMR. And, we’re using software on the front end to help physicians find codes quickly. We’re using Physician Transition Early, where as a physician is documenting, if they want to look up a code, they have the ability to search the ICD-9 coding catalog is a very rapid way to get down from, let’s say a 150 different ways to describe a disease, to the three that are probably applicable to where they are and what they are seeing and then from that they can get the right (ICD-10) code.