Your Roadmap to ICD-10

By now you’ve already—hopefully—heard the news about the big ICD-10 transition that’s going down on October 1, 2015. But, if you’re like most US healthcare providers—about 75%, according to this article—you haven’t exactly stuck to the suggested preparatory timelines that CMS released a while back.

We get it; you’re busy, and the last thing you have time for is sitting down and mapping out a plan of action for your clinic’s transition to ICD-10. But putting ICD-10 prep on the backburner isn’t going to stop the deadline from coming. As Benjamin Franklin once said, “You may delay, but time will not.” It might seem like a long way off, but trust us, it’ll sneak up on you quicker than you think—kind of like the holidays. So, to aid you in prepping for the switch, we did some of the work for you. The following “roadmap” tells you exactly what you need to do and when you need to do it—assuming that you start today.

1. Accept the change (now). I’m not saying you have to embrace it, welcome it, or even like it—but you need to at least accept it. The fact of the matter is that after October 1 of next year, you’ll only receive reimbursement for claims you submit with ICD-10 diagnosis codes. 

2. Designate a lead—or a team (this week). Every office has a captain—that natural-born leader who keeps everything organized and delegates like a champ. Maybe it’s you; maybe it’s not. Either way, your clinic’s Peyton Manning will need to become well versed in all things ICD-10 so he or she can keep everyone on track as the deadline draws nearer. That includes keeping up with all the latest ICD-10 news and boiling it down to small informational chunks and action items that everyone can easily understand and execute. If you have a large clinic, you may need a whole group of ICD-10 gurus to ensure everyone stays up to snuff. Your fearless ICD-10 leaders should start compiling educational resources now; CMS, APTA, AdvancedMD, and of course, WebPT are all great places to start.

3. Make a plan (over the next several weeks). As a rehab therapist, you’ve got a wealth of experience in the goal-setting department. Put those planning skills to use as you lay out a timeline of what your clinic needs to accomplish, along with firm deadlines for each task. Remember to make your objectives specific, measurable, attainable, realistic, and timely (sound familiar?). Get the ball rolling by looking at the diagnosis code processes you have in place now and figuring out how to tweak them to accommodate the new codes. In other words, complete an ICD-10 compliance audit.

Then, turn your attention to the external partners you rely on to do business—companies like your billing software and electronic medical record. Make sure your vendors are equipped to handle the new codes as well. If they’re not ready—or worse, if they haven’t even started to think about how they’re going to prepare—it might be time to take your business elsewhere. (As a side note, WebPT will be ready for ICD-10 well in advance of the October go-live date, and we’ve committed ourselves to providing all sorts of free educational resources so you’ll be ready, too.)

And speaking of being ready—experts recommend squirreling away at least six months’ worth of cash revenue to keep your practice afloat in the wake of any transitional snags that might lead to delayed reimbursements from your payers. Can’t fill your piggy bank that fast? Then, as Heidi Jannenga suggests, you should have “a Plan B, such as a line of credit or supplemental income to ensure your clinic’s viability during the transition.” Furthermore, you absolutely should not “wait until after October 1 because you’ll have to vie for financing and pay higher interest rates.”

4. Start training (this year). You’ve got a game plan, and you’ve got a captain. Now it’s time to get out there and rally for a victory—er, start training. Get your whole team involved, even those who have jobs that the switch might not directly impact. That way, everybody can hold each other accountable for staying on top of deadlines. It’s going to take a while for everyone to unlearn 30-odd-years’ worth of coding with ICD-9, and sticking to your timeline is the key to a smooth transition. So, get started—sooner rather than later. Remember, there are five times as many ICD-10 codes as there are ICD-9 codes. Plus, the new codes are alphanumeric and contain three to seven characters, whereas the old ones are mostly numeric and have just three to five digits. That’s a pretty big difference.

Even though your deadlines should be firm, you should remain flexible with your training approach. Pay attention to your staff members’ individual learning styles and adjust accordingly. There’s info out there in a variety of formats, and as we move closer to the drop date, more resources are sure to pop up.

5. Test, test, test—breathe—and then test some more (next year). Once January 1, 2015, hits, your number-one new year’s resolution should be trial-running ICD-10 as much as you can. That way, you’ll work out all the kinks—or as many as possible—before it really counts. Think of it as an ICD-10 dress rehearsal—or, to stay in line with the sports metaphor, an ICD-10 scrimmage. Advanced MD broke the testing phase down into three distinct steps:

1. “Test that your office staff can competently work with the redesigned workflow [and new codes].  
2. “Test each redesigned process.
3. “Test integration with partners.”

There you have it—your roadmap to ICD-10. Has your practice started prepping for the big switch? If so, what advice do you have for your peers? Share your thoughts in the comments below.