Experts Urge Immediate ICD-10 Prep Work

HDM Breaking News, June 16, 2009

Although the deadline for using the new ICD-10 diagnosis and procedures codes is still more than four years away, hospitals need to take steps immediately to be adequately prepared for the transition. That was the message offered by two coding experts speaking at the Healthcare Financial Management Association's Annual National Institute June 15 in Seattle.

An important first step is to establish a multi-disciplinary planning team involving all departments, said Dan Rode, vice president of policy and government relations at the American Health Information Management Association in Chicago.

Hospitals and physician practices must move to ICD-10-CM diagnosis codes for documentation and billing by Oct. 1, 2013. Hospitals also must implement ICD-10-PCS procedure codes by that date, while clinics will continue to use CPT codes for procedures.

Rode and Sue Bowman, AHIMA's director of coding policy and compliance offered practical tips for preparing for the transition, including:

* Carefully assess whether medical records documentation is adequate to support the more detailed coding system.
* Ask all your software vendors now about how they plan to accommodate the ICD-10 codes as well as the new version 5010 of the HIPAA codes for claims and related transactions, which accommodate ICD-10.
* Begin investigating the role that computer-assisted coding can play over the long haul. "We'll see much more sophisticated coding technologies developed," Bowman predicted. That's because the current generation of computer-assisted coding systems have been limited by the relative ambiguity and broadness of the inadequate ICD-9 codes, she argued.
* Meet with payers to compare notes on how the coding transition might affect contract terms as well as transactions.
* Develop detailed plans for training staff. "It's extremely dangerous to think you can wait and don't have to start training for ICD-10 until 2012," Rode said.

Although the transition to the ICD-10 codes will be challenging, it will yield many benefits, Bowman contended. In addition to improving quality reporting and easing clinical research, the more precise codes should decrease the need to submit attachments to claims to justify them, she argued. And as more sophisticated auto-coders are developed to carry out the new codes, the coder shortage should be eased. That's because the technology should enable coders to spend more time on editing codes that are automatically selected rather than chasing them down manually, she added.

In an interview at the HFMA Conference, Keith Eggert, vice president of revenue management at Orlando Health, said the ICD-10 transition will affect 90% of the Florida provider's information systems-not just core claims systems. So implementing ICD-10 "is like a heart transplant."

Orlando Health already has formed a steering committee to oversee the transition. It's conducting an inventory to pinpoint the dozens of systems that will have to be modified to use ICD-10, Eggert said.

Expressing similar sentiments, Brent Grimes, corporate director for patient business services at Integris Health, Oklahoma City, Okla., labeled the ICD-10 transition a "monstrous task." Many legacy systems will require extensive adjustments, including changes in data flow, he noted. Plus, the transition will require broad testing as well as intensive staff education, he added.

--Howard Anderson

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