ICD-10 Implementation Strategies

Cradle Solution, Inc. believes it is imperative that all providers stay informed of requirements that must be implemented for the October 1st, 2013 changeover to ICD-10-CM and ICD-10-PCS. The operational modifications required to prepare for this transition may be extensive, and our clients need to be aware of the steps they should be taking now, in order to prepare for the upcoming deadlines. While the Centers for Medicare and Medicaid services initiated a freeze on coding updates, standard changes will still be made in 2011, though updates for 2012 and 2013 will be limited, to allow providers time to prepare for ICD-10 adoption.

Your organization”s budget will be your primary tool in readying your company for this switch. Most importantly, you need to consider factors such as hardware requirements, software upgrades, and training costs. The addition, or conversion, of ICD-10 compliant software may demand that workstations, servers, and other hardware be replaced or improved. Ideally, your business should consider these expenses as part of your 2011 budget. Costs associated with integrating a new application or upgrading to a compliant one will likely be incurred during the 2012 period. It is for this reason that you should plan to make any hardware improvements within the next year.

ICD-10-CM and ICD-10-PCS training will be major factor in your budget as well. Admissions, coding, billing, and collections staff will need to be educated about the ICD-10 switch long before the October 1st 2013 target date. HIPAA 5010 adoption is required by January 1st, 2012 in anticipation of, and as a prerequisite to, the implementation of ICD-10, so your employees must be familiar with new features and statutes well in advance. We suggest developing departmental training plans to organize and implement new policies and procedures.

It is expected that most payers will be fully prepared for this transition and begin using the new coding system immediately, as fines for non-compliance are steep. However, new methodologies may result in delayed processing of claims. It may take your organization some time after the effective date to reconcile all outstanding ICD-9 claims due to new coding and reimbursement issues and guidelines. It is anticipated that there will also be a reduction in productivity immediately following the changeover, as providers begin to use the new coding system. Your business may want to consider setting aside an emergency or reserve fund to supplement your budget, in the event that you have difficulty billing and receiving reimbursement for services rendered.

While the preparation may seem intimidating, you will receive several benefits by preparing and adhering to the new ICD-10 structure. Claims payment accuracy will be improved, coding will be more organized and specific, and your company will have a competitive advantage.

Cradle Solution, Inc. will continue to provide information and news regarding the upcoming changes to ICD-10 as the compliance date approaches.

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