When Centers for Medicare & Medicaid Services (CMS) first proposed the one-year delay of the compliance date for the transition to the International Classification of Diseases, 10th Revision (ICD-10), it estimated savings of billions to the healthcare industry. Although covered entities have additional time to prepare for ICD-10, they still run the risk of falling behind if they don’t capitalize on this extra year to address gaps in the systems. “This is certainly not a time to be sitting back and relaxing,” explains Cheryl Robbins, RHIT, CCS, Precyse Director of Remote Coding Operations, “That time flies, and when you’re dealing with the major system restructuring required to make this transition, you can’t wait.”
For Robbins and other experts, the move from ICD-9 to ICD-10 is anything but simple. “ICD-10 is not just a simple update of the ICD-9 code set,” argues Robbins. “There are huge structural changes as well as the complexity in the composition and concepts that the coder has to know in addition to the vast number of codes that we’re going to have to deal with.” And while the deadline is two years away, it may prove insufficient for those lagging behind. “The pathways that we see are typically taking two years start to finish, and that’s being very aggressive,” adds Robbins.
In this first installment of ICD-10 Best Practices, we highlight the critical first steps covered entities should take to ensure that they are compliant with ICD-10 come October 1, 2014. In order for these entities to reach compliance, they must first recognize the work that needs to be done by assessing the abilities of their staff and their systems.
Evaluate your coders: First and foremost, ICD-10 is about coders and coding. Unlike previous iterations of ICD, the tenth revision places a premium on coders having more extensive knowledge of medical terminology. “One thing that is abundantly clear when you go through the ICD-10 training, if you do not have a solid base in anatomy, physiology, pathophysiology, you’re going to suffer. That’s where we see the knowledge deficit and that’s where we’re focusing training efforts for coding teams across the country,” Robbins asserts.
Educate your staff: Without proper education, many coders will be unable to come up to speed. For some, this may be the first training they have received. As Robbins observes, “Many coders were grandfathered into the profession and perhaps never went through formal training as many of us did.” In order to provide the right level of training, hospital leaders and project managers must suit staff education to the meet the needs of the team:
Those that are doing it right are starting off by doing internal assessments and making sure that their coding teams are thoroughly educated, meaning they’re doing preliminary assessment to see where their skill sets are strong or weak and fine-tuning their preliminary training to address those skill set.
And education must extend to the clinical side as well. ICD-10 will require physicians to document their patient encounters differently with a whole new level of detail. If they don’t adjust their workflows accordingly, clinicians could just as easily jeopardize the project.
Assess your systems: “Not every hospital has an EHR, not every hospital is going to have the software that’s going to be able to easily translate a code from the written word into an electronic number,” warns Robbins. Some providers are of the opinion that their electronic health record (EHR) or health information technology (IT) systems will make up for deficiencies in user knowledge. But because many providers use a mixture of electronic and paper records, few are likely to be able to lean so heavily on technology. “You’re not going to have a whole lot of hospitals that are one hundred percent electronic and making things much smoother,” continues Robbins, “You have to assess the functionality and ability of your current systems to integrate with and talk to each another because most of these hospitals (if we look at this seriously) are still going to be in a hybrid record situation come 2014.” If intraoperability is as big as problem as interoperability, there will be many headaches down the road.
source: EHR Intellegence
