How to Survive the ICD-10 Transition

Healthcare is going through some significant growing pains at the moment, but no change is going to hurt as much as ICD-10. A change of this magnitude hasn’t occurred for many years, and doctors and administrators are right to be worried.

Regardless, the green-light date is October 1, 2014, just one year away. There is no magic bullet to ensure a seamless transition to ICD-10, but there is one thing practices can (and must) do if they plan to survive the ICD-10 transition.

Prepare now.

And that means everyone—from the front office intern to the most experienced physician.

Preparation for ICD-10 involves three key components, the first two being familiarizing oneself with the new codes and testing/using the new software. Most physicians only use a handful of ICD-9 codes, but they’ll be dealing with at least 10 times more than what they’re used to before they know it. It goes without saying that understanding the structure of the ICD-10 coding system is imperative before going live with ICD-10.

As for testing the new codes, this can get complicated as it involves coordination with multiple vendors. What’s even more concerning is that CMS will not be conducting end-to-end testing with external trading partners (including physicians) before going live with ICD-10. According to a statement on its website, “The Centers for Medicare and Medicaid Services (CMS) feels confident that the current level of testing that is done each quarter for any changes to the Medicare claims processing systems is effective to ensure that claims will be processed properly and that ICD-10 diagnosis codes will be accepted and claims will be processed correctly.”

Physician organizations like the MGMA aren’t so sure. This puts more pressure on doctors and vendors to make sure they are testing the new codes on their own, and increases the possibility that claims will be backlogged.

Which leads me to the third key component to preparing for ICD-10: start storing up credit now. Even under the best of circumstances, there is no guarantee that practices will be paid during the transition. But employees will need to be paid somehow. Industry experts are advising practice administrators to save at least six months of credit because it is highly unlikely that they will be paid for the first few months.

ICD-10 will prove beneficial in the long run, but the first few bumps in the implementation road are going to be rough. However, with smart preparation the healthcare industry will survive the ICD-10 transition without any major casualties.