ICD-10 Delay: 7 Things Practices Can Do With the Extra Time

The Department of Health and Human Services recently confirmed its intent to push back the Oct. 1, 2013, ICD-10 compliance deadline for certain health care entities. However, HHS has not yet specified a new deadline or defined which entities will be covered by the change, and many physician practices are wondering if they should delay their transition or continue on as planned.


The Department of Health and Human Services recently confirmed its intent to push back the Oct. 1, 2013, ICD-10 compliance deadline for certain health care entities. However, HHS has not yet specified a new deadline or defined which entities will be covered by the change, and many physician practices are wondering if they should delay their transition or continue on as planned.

Regardless of when the deadline is or who it impacts, we recommend continuing to move forward on your ICD-10 preparation. As the industry learned from recent 5010 transition challenges, it’s never too early to prepare. Here are seven ways to take advantage of any extra time the delay provides:  

1. Conduct more thorough in-office analysis to identify each of the day-to-day processes and areas of the practice that will be impacted. For example, both clinical documentation and office superbills will need to be converted to include ICD-10 codes.

2. Ensure there is a strong plan in place to train your billing and clinical staff in ICD-10 coding changes. At a recent AAPC Boot Camp on ICD-10, it took participants four hours to code 20 cases--and that was with the help of a teacher. Having the right type of training will help reduce coding times.

3. Conduct time studies to identify how much extra time coding will take with ICD-10. The American Health Information Management Association estimates that, initially, it will take roughly twice as long for a coder to code under ICD-10. In addition, medical practices should expect a permanent 10 percent to 25 percent permanent loss of coding productivity. Questions that need to be answered are how to keep up with your increased coding needs, and how will that financially impact the practice? Will the practice pay overtime, hire more coders or outsource some of the work?

4. Check with business partners, vendors and software applications to see how they plan to handle the transition.

5. Almost every policy and written office procedures that medical offices have mention coding. To maintain compliance requirements, these documents will need to be updated to reflect ICD-10 changes. The Office of Inspector General has developed guidelines to help practices develop internal controls and processes to assist with these changes.

6. Review payer contracts, which may be based on older codes, and work with payers to update them for ICD-10. Don’t assume payers will do it for you.

7. Establish a line of credit. The industry encouraged providers to do so with the 5010 transition, but many didn’t take this step and were caught off-guard by the revenue impact. The ICD-10 switch certainly will affect cash flow, and most lines of credit need to be in place for six months to a full year before funds become available.

In light of the proposed delay, many practices are tempted to take a break from ICD-10, but the items mentioned above take a long time to complete. Doing as much as possible to prepare a practice for ICD-10 now will save headaches as the deadline nears, and will ensure that practices continue to operate efficiently throughout the transition.

Shelly Guffey is the manager of premier accounts and vendor partners, and Dawn Duchek is the industry initiatives coordinator for Gateway EDI, a claims clearinghouse.

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