There are only days to go before the transition to ICD-10. In preparing for this big change, what types of things should an organization or HIT professional be checking as the clock winds down?

Health Data Management recently conducted a web seminar on final preparations for ICD-10. Topics covered in the seminar provide important suggestions for providers getting ready for October 1. Moderated by HDM Editor Fred Bazzoli, those participating in the seminar included:

  • Aaron Miri, CIO at Walnut Hill Medical Center.
  • Jean McCammack, Chief Quality Officer at Walnut Hill Medical Center.
  • Debbie Schrubb, Corporate Director of Health Information Management and Kettering Physician Network Coding at Kettering Health Network.
  • Stephen Stewart, Interim CIO at Schuylkill Health Systems in Pottsville, Pennsylvania.

Fred Bazzoli: In preparing for the transition to ICD-10, what types of things should an organization or HIT professional be checking over the next few days?

Stephen Stewart: From my perspective as the CIO, what I've been doing over the last few weeks is just checking and double checking test results, digging a little deeper into some of the things that didn't look quite right, and making some adjustments.

You know, if by now your systems haven't been upgraded to ICD-10, you've got to solve a problem, but I can also tell you that issues can show up at any time. We found a problem a week ago that on a particular type of billing, there was a bug in the software. And so, testing and retesting what you've done, making sure you've walked through every possible scenario that you're going to have to build is probably the best thing to do.

Jean McCammack: We have been doing extensive dual coding, just to make sure that our coders are feeling comfortable and trained. We also made sure that our coders had formal training in the ICD-10 world so that they could help the rest of us learn as we go along on this.

We've also found some glitches in software that, but because we were well on board with this process, managed to take care of.

Aaron Miri: Make sure that you have a very transparent communication channel amongst the entire C-suite and then down to the front line staff so that if the coders do find something, they can immediately escalate all the way up and get appropriate resolution.

For the CIOs or technology leaders, make sure the partnership is there with your vendor community. They need to understand that you're going to be doing extensive testing. You're going to be trying to break things, and you're going to be trying to find those gray areas, perhaps, where there is an indicator or there is a diagnosis that's not built out, or something to that effect.

Last but not least, make sure that you are testing with your payers. Speak with your commercial payers, with your government payers. If you're dealing with Tricare, if you're dealing with whomever, and test, test, and test some more. And even when you test and have a green light, test again, because you will find something.

Debbie Schrubb: I can’t stress enough what everyone else has already talked about. We have been making sure over the last several weeks that we've been validating our system readiness, and we've also been doing a lot of concentration on physician education over the past couple of months, just to make sure that the physicians have been going in and doing the education that we're providing them through a software system.

One of the things that we've been doing the last couple weeks is making sure that we have everything together for a command center that we're setting up, and a phone line for physicians to call when they need help with ICD-10 code assignments so they will hear from a person, in a personal voice. Someone will work with them immediately when they need ICD-10 code assignment assistance.

Fred Bazzoli: What's the mood of physicians at this point? Are they nervous? Feeling confident? How would you describe that?

Debbie Schrubb: Some are still not believing it's going to happen. I do feel there's some relief that they know from their side, the provider side, that they don't have to do the specificity that we are required to on the hospital side, and they have that year reprieve (worked out between the American Medical Association and the Centers for Medicare & Medicaid Services). But when they document for us, they're going to be hearing that we need that specificity.

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