During Lyndon B. Johnson’s presidency, the administration was under a lot of pressure to fix everything from the Vietnam War to inflation. Naturally, the LBJ team started using the word “crunch” as a noun describing a stressful, crisis-type situation. Handling a crunch required longer hours and laser-focus—hence, “crunch time”—which is precisely what the healthcare industry is in now. Sure, it’s no Vietnam, but with only nine months until the switch—i.e., the day everyone must use ICD-10 codes to be reimbursed for their services—ICD-10 has definitely catapulted many a practitioner into battle mode. If, in this analogy, a seamless transition to the new code set signifies victory, then proper planning can help you not only triumph, but also come out of these next seven months unscathed. Here’s your ICD-10 crunch time plan:
February: Knowledge—and Money—are in the Air
February typically calls for romance, chocolates, and flowers. This year, though, it calls for ICD-10 educational resources—like websites, webinars, and videos. This month, amass as much educational content as you can find on the topic of ICD-10. Then, pinpoint an ICD-10 champion—or champions—at your clinic. It may be yourself, another natural leader, or a dynamic duo (or trio, quartet, etc.); just make sure this person—or team—gives a hoot about ICD-10 and wants to triumph in this transition. Give these champions all your resources, because they’ll need to learn everything inside and out, and then bequeath that knowledge to the rest of the team through your upcoming training program.
As your practice prepares for the best outcome, you’ll want to get your finances in order to prepare for the worst. Come October, your practice might be ready, but if your payers aren’t, then you could experience reimbursement delays. Thus, experts recommend saving three to six months’ worth of cash revenue to keep your practice afloat. If that’s not feasible, there are other options. Check out this blog post to learn how your bank can help you financially prepare for the ICD-10 transition. Whatever route you choose, decide—and act—ASAP, because if you wait, you’ll have to vie for financing and pay higher interest rates.
March: Head-to-Toe Assessment
Hope you’re ready to get down to brass tacks, because March is quite tacky (and I’m not just talking about these silly leprechaun get-ups). While your champions are learning their stuff, you’re going to assess the mess outta your practice.
- Examine current diagnosis coding processes, and complete an ICD-10 compliance audit.
- What process do you have in place currently, and does it accommodate the new codes?
- Determine how ICD-10 will affect your practice.
- How and where are your staff currently seeing and using ICD-9 codes?
- What are your practice’s most frequently used codes? Once you figure this out, find and learn their ICD-10 equivalents.
- Do you need to hire a coder?
- Verify that your external partners and payers are ready.
- What softwares and outsourced services does your practice rely on? Contact all of them—from EMRs to billing services to payers—and ensure they’re ready to receive, process, and remit for ICD-10 codes.
- Are you currently shopping for any software? If so, ensure you factor ICD-10 into your buying decision.
- Establish a budget that accounts for:
- Technological and software-related upgrades
- Staff training
- New coding guides and superbills
Once you’ve assessed, it’s time to create a game plan. Partner with your newly educated ICD-10 champions to develop a timeline for your clinic—complete with to-dos, milestones, assigned individuals, and deadlines. Then, meet with your entire staff to review the plan.
April–September: No Train, No Gain
You, your champions, and your team know the plan. Now it’s time to follow through on it. Get everyone involved, even those who aren’t directly impacted by the new code set. To ensure a triumphant transition, everyone must hold each other accountable and have each other’s backs. A couple of pro training tips:
- Mix up your training. Everyone learns differently, so ensure your ICD-10 training offers educational approaches that suit different styles.
- Remain flexible and be patient. It might take some effort to unlearn 30-odd-years’ worth of ICD-9 coding, which differs significantly from the new code set.
- Remember that every day can hold a learning opportunity. Turn your practice into an ICD-10 teaching clinic, and keep your staff on their toes with pop-quiz questions and practice exercises.
- Reward jobs well done.
May–September: Testing, Testing. Saving, Saving.
Even with all the delays, no area has caused as much brow-furrowing as testing—not just for providers, but for payers and vendors as well. How do you test? Who’s testing? Should I even test? These are the questions on most minds. Here are the answers:
- How you test depends on how you document and bill. Check with your vendors to determine their testing processes. (FYI, WebPT already released an ICD-10 testing module, which you can find and use now within our current ICD-9 code selector.)
- All vendors and practitioners should be testing. Over the next seven months, you’ll hear from payers and clearinghouses regarding testing opportunities. Take advantage of these to ensure your—and their—readiness.
- In short, you absolutely should test. Conduct tests internally as part of your training plan and externally to ensure your practice will truly triumph come October.
LBJ once said, “Yesterday is not ours to recover, but tomorrow is ours to win or lose.” Pretty fitting words for ICD-10. We can’t do anything about the past delays and their consequences, but we can make darn sure that come October 1, 2015, we’re on the winning side of history. That means a smooth transition to ICD-10—no kicking and screaming, no snafus, just well-prepared providers, payers, and vendors ready to show the world that we are (finally) hip to the medical times. Crunch time means go time. Go out there and claim victory.