When Katie Carolan asks an audience of 75 to 100 health information management professionals how many of their organizations have started ICD-10 preparations, about three hands go up.

That's obviously not a good sign that the industry will be ready for the Oct. 1, 2013, compliance date, says the director of operations at Baltimore-based Health Record Services, which provides outsourced coding and auditing services as well as consulting.

Some HIM professionals may not be aware of ICD-10 work being done elsewhere in their organization, she notes, but most should be. On this issue, "They need to assert themselves," she contends. "A lot of HIM people aren't used to doing that."

It's important, Carolan adds, that the HIM department not let the information technology department go off on its own and modify affected information systems without understanding how the changes affect various workflows, processes and policies. And it's a good idea to tie ICD-10 compliance work into an organization's EHR meaningful use initiative "as you already are changing many information systems," she adds. "It's silly to do both of these in a vacuum."

Some organizations believe continuing to use ICD-9 codes and mapping them to ICD-10 without upgrading systems, processes and training is a fallback, Carolan says. But that's only a Band-Aid that won't last long, will adversely affect reimbursement rates and using data analytics in a more meaningful manner. "You'll lose control of your revenue stream because your coders won't have the knowledge," she adds. "And coders coming out of school now know ICD-10."

Organizations in late 2010 should take a look at the readiness of their software vendors and be concerned if they don't yet have ICD-10 compatible systems, Carolan advises. Providers need to know very soon whether their current software versions will be updated or they have to buy new systems. HIM professionals need to tell vendors--immediately--that their next department budget is going in now, and ask what the initial and ongoing costs will be.

Other information needed from vendors includes their test schedules, and interfaces with other in-house information systems, insurers and clearinghouses, and the specific vendor employee in charge of the organization's account for ICD-10 work, Carolan says. She spoke to Health Data Management during the AHIMA Annual Convention & Exhibit in Orlando.

--Joseph Goedert


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