February 9, 2015

Why (and How) to Spend Quality Time with ICD-10 During the Home Stretch

By Ken Bradley

The age of multitasking, overscheduling, and 24-7 technology connectivity has given way to increased use of the phrase “quality time.” As in, “my family and I are turning off our phones tonight and spending some quality time together.” Or “this weekend, we’re going camping for some quality time with friends to get away from it all.”

The phrase connotes focused time without distractions or any outside influences. So, what does it have to do with ICD-10? For providers entering the final countdown to Oct. 1, everything! While most organizations have made progress in their ICD-10 transition plans, many are lagging in certain critical areas. Accomplishing everything in the ICD-10 readiness plan may seem daunting. It’s not impossible, though, if providers leverage their internal knowledge, develop laser focus, and devote one of their most precious resources – time.

Analysis without Interruption to Conquer Four Key Components

Most of the critical transition components to be accomplished between now and Oct. 1 can happen within your organization’s walls. The key ingredients are focused mindshare and dedicated, prioritized time on the calendar – in other words, analysis without interruption. Even if you’ve been distracted by other priorities such as meaningful use and your ICD-10 plan has suffered, this quality time can expedite efforts and get your plan back on track. An in-depth analysis can focus your transition efforts while also helping you anticipate what can potentially go wrong this October – and it can help you work through the optimal solutions.

In particular, these four steps can help you stay on target and streamline your organization’s efforts:

  1. Identify where, how, and by whom the most frequent diagnosis codes are used. A thorough understanding of how diagnosis codes are used will jump-start lagging ICD-10 efforts by giving your organization focus. It can help prioritize every effort, from documentation updates to training, and potentially save your organization a great deal of time and resources during the months leading to the ICD-10 transition and beyond. Beyond knowing what common codes are, understanding the common clinical scenarios surrounding them can yield important information. For instance, you’ll be able to determine where to change processes and which technology updates should be of the highest priority. There are many online tools available that can help you identify the most frequently used codes in your organization.

  2. Improve clinical documentation. With meaningful use, value-based purchasing, and a bevy of other initiatives demanding physicians’ time, you can’t blame them if they haven’t yet prepared for ICD-10. Whether you’re a small practice with physicians performing their own coding or a multi-hospital health system with myriad coders on staff, you’re asking for time that physicians often simply can’t spare. However, clinical documentation is the foundation of ICD-10 preparation. How can you get physicians on track? By getting them to devote their own quality time toward learning clinical documentation; implementing updates can be as simple as narrowing their task lists. Let your physicians know that you’ve determined the diagnosis codes that are of greatest importance to your organization. You’re setting them up for success and saving them time – a fact they’ll most likely appreciate. While you can’t eliminate the work they’ll need to put in for ICD-10 preparation, you can reduce it. In addition, you can remind physicians – and for that matter, everyone in your organization – about the value of ICD-10. Being a physician is a vocation, not just a job; therefore, reminding physicians of ICD-10’s role in documenting each patient's condition with greater detail and clarity, thereby enabling better patient care and revenue cycle accuracy and speed, will help them prioritize it.

  3. Create a coding compliance program. When you’re devoting time to ICD-10, you can tackle coding compliance documentation and review – another strategic initiative requiring in-depth analysis. Between the Centers for Medicare & Medicaid Services (CMS) and commercial payors, organizations must operate as if they are under a microscope at all times, proving medical necessity, proper utilization, and compliance with medical policies. Even without ICD-10, having a coding compliance program in place is crucial. Now, however, it is becoming exponentially important. Devoting time to a coding compliance program can ensure ICD-10 preparedness as well as audit readiness.

  4. Initiate contingency planning. A lesson from the HIPAA 5010 transition: regardless of the depth and strength of your readiness plan, the go-live date always brings an element of the unknown. It’s like dress rehearsals for theatre or practice sessions leading up to for game day — preparation is invaluable, but it doesn’t allow you to anticipate every possible scenario. A number of factors can contribute to a reduction in cash flow during the early stages of ICD-10. Consider these factors – and where your organization is most likely to experience challenges in October. For example, practices should continue working with their clearinghouses to maximize automated eligibility and denial management tools in order to make sure that cash isn’t negatively affected. Knowing how to effectively use these tools before the transition will provide more time to focus on the transition. In the end, these tools and effective use of them could be the difference between lost or captured revenue, and if the actual transition goes as well as the dress rehearsal, great!

Unfortunately, there’s no silver bullet that will guarantee that the ICD-10 transition will be easy and successful. Fortunately, though, there is still time to ensure that the proper team within your organization has the mindset necessary to prioritize changes, evaluate and revamp processes, determine contingency plans, and maintain the right focus. For a healthcare provider, quality time is perhaps the most difficult resource to secure. However, it’s also a necessity as we enter the final stretch of ICD-10 preparation.

Ultimately, it will pay off. In addition to sustaining cash flow and enabling a smooth transition, it will also allow our industry to provide better care, improve population health, and make our revenue cycle more efficient and effective.

And that’s worth a little quality time. 

About the Author

Ken Bradley, vice president of strategic planning and regulatory compliance and one of Navicure's founding members, is responsible for assessing markets, monitoring government regulatory requirements and providing competitive analyses to develop strategies and solutions that ensure Navicure and its clients continued success in an increasingly complicated business environment.

He is responsible for all Navicure industry transitions, including ICD-10 and 5010. He has given educational presentations and written several articles on 5010 and ICD-10.

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