September 14, 2015

Countdown to ICD-10: Are you Ready for Oct. 1 Discharges?


The countdown continues leading up to the immovable ICD-10 implementation deadline of Oct. 1, 2015. We are down to a couple of weeks to go. Providers across the country are facing the cold reality that delaying is no longer an option. For those who have lived through this for 40 years, it is hard to believe that we are really going to witness ICD-10 compliance this year!


There is no pixie dust or a silver bullet to save the day at the last minute. The operational, clinical, and financial viability of your healthcare organization depends on the knowledge transfer inherent in relevant, role-based education.

So, where are we on this continuum of rapid change, and what is next? Hopefully, you can look in the rearview mirror and see many accomplishments. Check off each on this list and ask yourself, did your organizational ICD-10 transition include a strategy to achieve clinical documentation integrity?

  1. Ensure organizational awareness and establish executive leadership and commitment.
  2. Perform a current state impact assessment and implement recommendations.
  3. Conduct systems inventory and perform gap analysis.
  4. Evaluate entire clinical documentation integrity (CDI) program from top to bottom.
  5. Establish an internal timeline/project plan.
  6. Determine plan for training staff and medical staff.
  7. Establish multi-year budget.
  8. Manage contractual agreements with vendors.
  9. Refine strategy to prevent decreased coding productivity and accuracy.
  10.  Initiate a continuous quality improvement culture.

It is time now to assess your readiness and be sure that your contingency plans are realistic and in place. Ask yourself the following questions:

  • Did all of our vendors provide ICD-10-ready solutions?
  • Have we leveraged all of our technology investments: computer-assisted CDI, computer-assisted physician documentation, and computer-assisted coding?
  • Are the coders tested, trained, experienced in dual coding, and meeting productivity and accuracy requirements?
  • Are there any flaws in our ICD-10 testing, either internally or with our external partners and payors?
  • Are we well-positioned in our project management structure and reporting for every ICD-10 initiative?
  • Do we have metrics for monitoring all of our processes, systems, staff, technology, etc.?
  • Are we tracking to the benchmarks we established for performance/budget/timelines?
  • What are my backup plans for coding resources?
  • Do I feel good about the coding auditing process that we have set up? Is it manual or electronic? Will it see me through the next six months?
  • Do I have all of the necessary reporting tools in place so I am laser-focused on our ability to provide daily feedback to the C-suite?

Now is the time to rigorously evaluate your mitigation strategy to manage the risks associated with the conversion and minimize the impact on patient care and workflow.

There is no question that ICD-10 will provide high-quality and high-integrity information for measuring healthcare quality and safety, and we must continue to facilitate and refine the process for accurate and meaningful data collection. It is important that everyone in the healthcare industry is united in their approach to ensure the successful adoption of ICD-10 CM/PCS.

ICD-10 transition planning taught us a great deal about the critical importance of collaboration. It required the skills and talents of all of us to see that the adoption of ICD-10-CM and PCS was done right and on time. Be sure to take the time to celebrate with your healthcare team and medical staff!

Cheers to you and yours on this incredible journey!


Bonnie S. Cassidy, MPA, RHIA, FAHIMA, FHIMSS

Bonnie Cassidy is a leading HIM executive advisor, focusing her efforts on advancing clinical documentation integrity, risk-adjusted reimbursement, and health information governance. Cassidy was the 2015 chair of the Board of Directors for The Commission on Accreditation for Health Informatics and Information Management (CAHIIM) and the 2011 President /Chair of AHIMA. She is also a fellow of AHIMA, an AHIMA Academy ICD-10-CM/PCS certificate holder, and an ICD-10 ambassador, as well as a fellow of HIMSS and an advanced member of HFMA. Cassidy was honored to be the recipient of the 2014 Distinguished Member Triumph Award from AHIMA and the 2015 Distinguished Member Award from the Georgia Health Information Management Association. She is also a recipient of the Distinguished Member Award from the Ohio Health Information Management Association.

 Bonnie Cassidy has served as an executive with nThrive, Nuance, QuadraMed, the Certification Commission for Healthcare Information Technology (CCHIT), Price Waterhouse, and Ernst & Young, and was a HIM administrator at two major teaching hospitals, including the Cleveland Clinic Foundation. She is a member of the ICD10monitor editorial board and makes frequent appearances on Talk Ten Tuesdays.

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