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Planning for ICD-10 – Part Two

by Phil Sullivan

THE STEPS TO ICD-10

In our last installment, we discussed the merits of using dbtech tools to mitigate ICD-10 report discovery. Here, we will go deeper into the project plan to analyze the benefits of chart analysis, financial contingency planning, and forms inventory.

While ICD-10 project plans may differ slightly based on size, infrastructure and services, all projects will include the following major task categories:

ICD-10

  • INTERFACE INVENTORY –

    In this step, you will catalogue every interface transaction between internal systems, as well as data being forwarded to external government agencies and registries.

    TIP: All these interfaces may need to be updated if you are not using standard HL7 messaging. Rasi users using HL7 will not have to update their interface.


  • AWARENESS CAMPAIGN –

    This step involves contacting your marketing department to help spread ICD-10 awareness throughout your facility. Employees need to know what to expect, and that your project team is doing everything to ensure a seamless ICD-10 implementation. Physicians and Coders need to know that they will be trained.

    TIP: Informed employees will be motivated to help uncover those hidden ICD-10 workflows if they understand the consequences.


  • CONTRACT RENEGOTIATION –

    Contracts containing references to ICD-9 codes must be renegotiated with your payers. This is no small task and analysis of your payer contracts should begin as soon as possible.


  • EDUCATION –

    ICD-10 educational needs are wide – from physicians, advance practice nurses and hospitalists to radiologists, registration clerks, IT system analysts and more. In this part of the process, you will uncover those who require education during your high level impact assessment.

    TIP: This is likely an area where you will benefit from bringing in some outside help.


  • CHART ANALYSIS –

    A proper educational plan relies on an analysis of your existing documentation practices. Any vendor vying for your ICD-10 educational dollars will need to include a complete chart analysis of your existing medical records.

    TIP: An ad-hoc report containing ICD-9 data and the Ras Data Extraction Module will give you insight into your most frequently used and highest reimbursed encounters. Include diagnosis codes, sequences, responsible physicians and final DRGs to pinpoint educational opportunities. When you combine this data with the General Equivalency Mappings (GEMs) database, you will understand the complexity of your educational efforts. Download a copy of the GEMs database on the CMS website.


  • FINANCIAL CONTINGENCY PLANNING –

    Consider the fact that your Discharged Not Final Billed (DNFB) list will grow as coder productivity slows post October 1, 2013. Experts believe the slow-down will impact 20% – 40% of coder productivity. Also expect increases in payer denials due to lack of familiarity on both sides of the transaction.

    What are your contingency plans for this financial delay?
    Solutions may include additional coding staff, but demand for coders is expected to sky-rocket in mid-2013. Onsite coders will be in short supply and naturally, fees will increase.

    TIP: Use Rasi to drive your ability to hire remote coders. With remote coders your resources expand exponentially. Rasi and remote coding can have a tremendous impact on your facility and staff satisfaction.


  • FORMS INVENTORY –

    It is very common for clinicians to check off ICD-9 code from a pre-printed form. However; this may not be possible with ICD-10. One ICD-9 code can easily expand to twenty or more ICD-10 codes. Many paper-driven workflows will simply not exist in the ICD-10 world – and those that do will need to be extensively modified.

    How do you modify your forms today? Manual effort? Forms Vendor?
    Either way, this process is going to cost you time and money. In fact, a dbtech client reported that their incumbent forms vendor quoted $85,000 for the modification of just 60 forms.

    TIP: Consider using eForms. Let dbtech assist your hospital in converting these documents into a format that can be easily updated in the future. And, with Interactive eForms, you’ll collect new, actionable data while eliminating the inefficiencies and expense of paper workflows. Would it be more efficient to have a drop down list of ICD-10 codes? With Interactive eForms, it’s as simple as creating a PDF.


Here at dbtech, we wish your organization all the luck in the world as you complete your 5010 project plans and move forward with ICD-10 projects. It’s a formidable task, but with dbtech’s solutions, you can help ease the implementation.

For more information about ICD-10 planning, please contact us.

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