Looking beyond ICD-10 deadline: Setting goals for after the transition

The Healthcare Information and Management Systems Society ICD-10 Task Force recently released a guide at the HIMSS conference for health care professionals to use after they implement the new ICD-10 codes. Although most organizations are busy training their staff for the transition, the HIMSS is trying to focus the industry on preparing for the implementation process after the Oct. 1 deadline comes and goes. 

A guide to staying focused on efficiency after ICD-10 deadline
Providers should do their best to continue their efforts to ensure that their practices are comfortable with the new coding system well after implementation. Three ICD-10 Task Force members, Jon Melling, Betty Gomez and F. Phil Cartagena Jr., pointed out that working toward establishing a more efficient practice through the use of the new codes is essential for months after the transition date. This is the only way health organizations will continue to perform effectively in an industry centered on the ICD-10 coding system. 

To assist providers in securing a smooth implementation process, the task force listed a few concerns that organizations should consider up to six months following the transition process.

These recommendations focused on the staff's familiarity and understanding of denied claims and how to handle them if they occur. The task force also listed whether a practice's claims status is properly comprehended through the attainment of the correct reports as another important concern that should be attended to.

Providers should keep their sights set on the future of their practices, considering how the transition to the new coding system will affect internal reporting, such as pay-for-performance, and the revenue process. Similarly, the task force suggested determining the most effective method or system for monitoring a staff's progress after the ICD-10 implementation.

HIMSS answers essential questions at HIMSS15 conference
To enhance efficiency before the ICD-10 deadline, there are several steps that practices should take, including decreasing the number of payment backlogs, such as denials and claims. They can also take feedback seriously, finding the best process for monitoring it as well as their staff's performance. 

Potential problems that have clinical, operational and financial effects on a health facility should be assessed between three to six months after ICD-10 implementation. Providers should prepare solutions for these to prevent further issues from arising. While many aspects of a practice should be altered to ensure a problem-free transition, safety and quality reporting should remain the same after the deadline. 

According to EHR Intelligence, one of the many questions asked by health professionals at the HIMSS15 conference included what patients should do if they receive authorization before the ICD-10 deadline for a procedure after the transition date. 

"The authorization should be coded using ICD-10 given the procedure will take place after October 1. Payers should be able to accept that as such," responded a member of the HIMSS ICD-10 Task Force. "It doesn't hurt to make this a scenario that is tested, or at least confirmed, with your payers as implementations may vary and you want to be aware of potential variations."

In response to another question regarding the proper course of action to take when providers cannot get payers to test with them, the task force recommended that, because getting essential scenarios tested is crucial, it may be worth it to be ruthless about getting the payer to perform the testing. If that does not work, using a clearinghouse to do the testing is also effective. Testing allows health professionals to ensure that their systems are producing sufficient output.

The main message of the task force's suggestions is that, while preparing now for the ICD-10 deadline is important, health professionals should not forget that staying up to date on progress and performance in the months following the implementation is just as essential.