April 13, 2011

ICD-10-CM and Leadership


The director of health information management (HIM) is a title used to identify the person in charge of complex and challenging tasks associated with the management, care and storage of medical records. We all know there is a lot more to it than records, however. We are managing our departments in an era of change, and every function, task and process we organize and control can seem to be on a fast track to chaos. We all understand that we are not in control of the changes coming. So how can we ensure that the changes are made on time and that they become a part of business as usual, implemented correctly, in compliance and to benefit the populations we serve?

One of the biggest changes coming is the implementation of ICD-10-CM. When it comes to this process, the first thing we need to do is determine whether we are managers, leaders or both. These words often are used interchangeably but they are quite different, and we need both mindsets. According to John P. Kotter in What Leaders Really Do, “companies manage complexity by planning and budgeting, by organizing and staffing, and by controlling and problem solving. By contrast, leading an organization to constructive change involves setting a direction (developing a vision of the future and strategies to achieve the vision), aligning people, and motivating and inspiring them to keep moving in the right direction.”  

Leading the charge toward the adoption of ICD-10-CM should be the goal of every HIM director.  This transition has far-reaching ramifications for your organization and does not just affect the HIM department. Among staff in most healthcare delivery settings, the HIM director has the most experience with coding, documentation, record processing and storage. Stepping up to a leadership position for any big change takes some preparatory work, creativity and a true desire to control the final outcome.  

Here are some tips on being a leader with the ICD-10-CM transition:

•    Learn the subject matter. How much do you know about ICD-10?
•    Read the trade publications on ICD-10.
•    Look at the RAND and Nolan White papers on other countries’ experiences with transition.
•    Buy the ICD-10-CM code books and read them. They are quite thought-provoking and will help you communicate more effectively with your teams and others.
•    Download the CMS website documentation on ICD-10, both CM and PCS. Both systems now have official coding guidelines.
•    Review GEMS crosswalks and mapping.
•    Read the MS-DRG proposal for ICD-10-CM.

•    Once you become the most knowledgeable person in your organization when it comes to this topic, begin mapping the function and use of ICD-9-codes throughout your department and organization.
•    Start at the beginning of the revenue cycle and go to the end (payment). Include all areas that are impacted by ICD-9-CM codes directly or indirectly.

So let’s get started.  Time is going by and we need to decide; Are we leaders or managers?  It is best to be both!

About the Author

Sandra L. Draper, RHIT, CCS, is the Director of HIM Practice for Precyse Solutions and is an experienced health information professional with over 20 years of HIM management experience. She has a record of consistent success in advancing health information management department's participation in revenue cycle performance, improving accounts receivables, and DNFB reduction through project management.

Read 11 times Updated on September 23, 2013