Start preparing for ICD-10 now

Establishing structured timelines and plans for software upgrades, training and testing are essential elements of a good plan for transitioning to ICD-10, said Renee Richard, health insurance specialist and ICD-10 lead at the Boston regional office of the Centers for Medicare and Medicaid Services (CMS), speaking at the Massachusetts Health Data Consortium’s Dec. 13 program on the topic.

CMS granted the healthcare industry more time to prepare because of the other initiatives on providers’ plates, such as Meaningful Use, and the fact that about 25 percent of the provider population would not have been ready for a 2013 implementation, representing about $1 million a week in claims.

From October to December 2012, providers should have completed the following, Richard said:

• Create ICD-10 project team or identify ICD-10 coordination manager for your practice.
• Communicate with internal staff and physicians as well as payers and other business partners.
• Perform an assessment to determine how the transition to ICD-10 will affect your practice. “Identify the codes you use the most and how any change in those affects the everyday aspects of your business including referrals and intake forms.”  
• Evaluate vendors to determine whether your contracts are up to date.
• Develop an ICD-10 plan that identifies key tasks and estimate a timeline.
• Estimate a budget.

Software vendors will play a central role to a lot of organizations, Richard said. Providers should discuss with their vendors what they will offer their customers such as a new product or an upgrade. Find out about their schedule and whether the vendor is on target to meet deadlines, she said. Based on those conversations, some providers may want to consider establishing new vendor relationships.

The next phase, Richard said, starts in January and continues until October 1, 2013.  During this time, providers should install software, conduct testing within the organization, update forms and superbills, coordinate with payers on payment contracts, arrange staff training on software and upcoming process changes and develop a plan to minimize potential disruptions.

The go live phase goes from October 1, 2013 to October 1, 2014, Richard said, and providers should plan to achieve the following steps:

• Test with payers and other business partners.
• Provide training for staff responsible for coding (6-9 months before deadline).
• Start using ICD-10 codes for services provided on or after October 1, 2014.
• Review effects of ICD-10 on practice activities and make adjustments as needed.
• Estimate budget and timeline for software modifications, upgrades, staff time and education, contract costs, testing costs and more.

Richard urged the audience to take advantage of the resources available from CMS including teleconferences, fact sheets, handbooks, suggested timelines, email updates and more.