Want to Prevent Backlogs Caused by ICD-10? Better Start Preparing Now

Based on experiences other countries have had transitioning to ICD-10, experts are predicting that productivity will drop by 20–40 percent when ICD-10 hits. Unless certain precautions are taken now, practices could find themselves in deep financial waters a year from now.

Some health organizations, like Sutter Health, plan to go live with ICD-10 early. They want to give their staff extra time to familiarize themselves with the new code set so the backlog won’t be as heavy when ICD-10 is required.

At first glance, the goal to go live in May rather than October may seem overly ambitious. But healthcare is hurtling toward one of the biggest changes it’s ever seen—ambitious goals may be the only thing that will ensure a practice’s financial survival.

Preparing coders is one of the first steps to take to ensure a smooth (or at least, smoother) ICD-10 transition.

• Training. Most coders will need about 50 hours of training prior to ICD-10 implementation. Several types of training are available, such as translation software and platform-based education. Translation software automates the mapping of ICD-9 to ICD-10 codes, but does not help coders learn when to appropriately use ICD-10 codes. Platform-based ICD-10 training, on the other hand, allows coders to practice using ICD-10 codes in their charting software. The more training done beforehand, the better your practice will be able to prepare for the unique challenges it will face later.
• Measure/project productivity loss. Billing backlog is no small thing. The only way to survive it is to project beforehand how your productivity will be affected. After a few months of training, you should have a rough idea of what your productivity level will be like and how much backlog to expect. From there you can bring on additional staff, conduct extra training, or whatever you need to do to prevent unmanageable financial strain.

In addition to preparing coders, keep a close eye on your current cash flow and look for ways you can improve it before the ICD-10 compliance deadline.

• Cut down A/R days. Your current A/R cycle may have worked just fine for the last 10 years, but creating some breathing room now will make a big difference later on.
• Improve billing efficiency. Your denial rates will likely never be eliminated, but taking the time to improve them now will improve cash flow a year from now.

In short, determine now what is normal as far as financial performance goes. At the very least, this will alert you of your current financial problems so you can work on diminishing them before they add to the pile of revenue issues caused by ICD-10.

Despite being on the radar for many years, most medical organizations do not feel ready for the ICD-10 switchover. But if there is anything to be learned from other countries who have already faced the ICD-10 change, it is that preparation is key. The earlier you know what your needs will be, the earlier you can prepare for them, and the better off you’ll be come October 2014.