The Smart Medical Practice

9 Surprising Reasons Your ICD-10 Transition Will Fail


ICD-10 FailWe’ve said it before, but it bears repeating—it’s time to plan for the ICD-10 transition next fall. Many practices are focused on other projects or putting off ICD-10 training until the deadline is closer. At this point, procrastinating may lead to an ICD-10 crisis next October. Here are nine possible reasons for failure.

1. You didn’t start soon enough.

Many tasks associated with the ICD-10 transition are time consuming, including training, evaluating the effectiveness of the training, and implementing new systems. Practices that wait will have a tougher time securing training seats and may overload staffers by asking them to get up to speed on new systems and learn new documentation practices (or codes) simultaneously.

2. You thought your EHR would take care of everything.

Some physicians believe having an EHR means they’re exempt from disruption during the changeover. The truth is that even if their EHR has been updated for ICD-10, their staff still needs training, especially if billing is done in-house. Yes, many EHRs include crosswalks, but those only take you part of the way toward correct codes.

3. You didn’t stay in close contact with your vendors.

Practices relying on an EHR vendor to have an upgrade ready or a billing company to begin dual coding at a certain stage should ask for a project schedule and monitor progress. Don’t make the mistake of simply asking whether or not a vendor is preparing for the transition. Projects slip deadlines all the time, and some practice revenues will dive in October as a result. Another reason to stay in close touch with vendors is to be first on the list to receive training on new systems or upgrades.

4. You didn’t budget enough.

Some practices have underestimated the costs associated with the transition. Be sure to budget sufficiently for training and ICD-10 resources (paper or electronic guides). Realize that software upgrades to bring your systems into ICD-10 compliance may cost more than standard upgrades and that some cloud-based services will increase their monthly fees in conjunction with the transition.

5. You didn’t freeze other projects.

Because a rough ICD-10 transition will affect revenues, it’s a good idea to focus only on this project six months before the changeover. Likewise, don’t expect to start any new projects until six months afterward (spring 2015).

6. You forgot to order new forms.

Many of the forms in your practice will be obsolete after the transition, including authorization forms, pre-cert forms, patient intake, patient encounters, referrals and physician’s orders.

7. You didn’t train your entire staff.

Physicians, nurses, and other clinicians will need to revise how they document, and those involved with claims will need to master the new codes. In addition to formal training on codes, it’s a good idea to start new documentation practices now so clinicians can understand the gaps between current styles and those required by ICD-10.

8. You didn’t have a strong project manager.

There are a lot of moving parts to the changeover, and having a strong leader will ensure success. Someone must lead the training effort, line up additional staff (temporary or permanent), buy forms, order ICD-10 resources, evaluate the payer mix for potential issues (which payers are likely to falter during the changeover?), and either monitor cash flow during the transition or charge someone with doing so.

9. You did not formulate a disaster plan.

Even practices that plan far in advance and train sufficiently will experience a few panic moments. Some will run into unexpected personnel issues; some will have payers that miss the October 1 deadline. Planning now for these potential crises will help everyone stay calm if they occur, and setting up a line of credit in advance of the deadline will ensure sufficient funds to cover delayed reimbursements.

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