Steps to Assess How the ICD-10 Transition Will Affect Your Physician Practice

Although the final rule on the proposed ICD-10 deadline change has yet to be published, it is important to continue planning for the transition to ICD-10. The switch to the new code set will affect every aspect of how your medical practice provides care, from registration and referrals to software/hardware upgrades and clinical documentation.

A critical step in planning for the transition is to conduct an impact assessment of how the new code sets will affect your organization. Your impact assessment should include the following:

Documentation Changes: You will need to consider the increased specificity of ICD-10 codes compared to ICD-9-CM codes and ensure that patient encounters are documented with appropriately comprehensive clinical descriptions. You should:

• Train staff to accommodate the substantial increase and specificity in code sets.
• Consider physician workflow and patient volume changes.
• Revise forms, documents and encounter forms to reflect ICD-10 codes.
• Evaluate processes for ordering and reporting lab/diagnostic services to health plans.

Reimbursement Structures: You should coordinate with payers on contract negotiations and new policies that reflect the expanded code sets since they can affect reimbursement schedules.

Systems and Vendor Contracts: Ensure your vendors can accommodate your ICD-10 needs. Find out how and when your vendor plans to update your existing systems. You will need to review existing and new vendor contracts and evaluate vendor offerings and capabilities against your organization's expectations. Work with your vendors to draft a schedule for needed tasks.

Business Practices: Once you have implemented ICD-10, you will need to determine how the new codes affect your processes for referrals, authorizations/precertifications, patient intake, physician orders and patient encounters.

Testing: Work with your vendors to determine the amount of time needed for testing and schedule accordingly.

ICD-10 will affect nearly all areas of your practice, but with a thorough impact assessment, you can keep your day-to-day activities running smoothly while you transition to ICD-10.

Keep Up to Date on ICD-10

Please visit the ICD-10 Web site  for the latest news and resources to help you prepare:

http://www.cms.gov/Medicare/Coding/ICD10/index.html