For those in healthcare. By those in healthcare.

So, we reached ICD-10. Now what happens?

Few issues have dominated healthcare over the past several years more than ICD-10. The angst and gnashing of teeth that so many in our industry displayed when it became clear that ICD-9 finally would be laid to rest now seems like one part Chicken Little and one part Y2K.

In my first interview with Amy Amick, President, Revenue Cycle Management and William Davis, Vice President, Revenue Cycle Advisory Solutions at MedAssets, we learned how their teams and healthcare partners worked together to prepare their partners for the ICD-10 transition in October.

In this follow-up conversation, we discuss how healthcare organizations ought to proceed now that ICD-10 is the new normal for the industry.

Free: We are two months past the October coding transition. Are you hearing that, more or less, the sky won’t be falling now that ICD-10 is a reality? 

Amick: I hear a lot of things, but the highest consensus that I am hearing from the providers is that they have done the best they can to be ready, and that they are now spending their time and effort on making sure that they have ways to react to the problems that might arise moving forward. It seems as though many have wisely used the extra time provided by the extensions to prepare for ICD-10, but there still may be problems to follow. 

Whenever you introduce change, there’s a natural inefficiency to expect for a period of time. If a task usually takes 30 seconds, while I’m going through a change, that activity now might take me 45 seconds. If you multiply that difference due to a greater change and a greater volume like ICD-10, you could have significant inefficiency.

I hear providers talking now about this point, and they have switched their focus from “How do I train my people?” to now making sure that they have their responsive actions in place and working well. They are asking themselves, "How do I make sure that I am planning for overtime in the coming months because my people, for the first time, will be using a new set of codes and a new set of modified processes and decision making? How do I make sure that I’ve got the necessary labor support in this initial stage?"

I recently worked with an organization who created a set of "what if" scenarios. One of their scenarios centered upon how would they operate if they encounter a denial because of x, y or z. How do they make sure that they have their staff ready, not just to make the change to defend against that denial and to fix that challenge that may result from the coding error, but how do they also have a targeted readiness plan to go back and see what the root cause of that particular denial was? Also, how will they go back to train whomever might have made the coding error up front that resulted in a denial or what not? So, not just reacting to, "How do I clean up, address, resolve issues in a tactical way, but how do I actually have pre-programmed ways to go back and refresh training, modify processes, etc. to do any responsive action that may have to come post-change?" These scenarios are no longer hypothetical. They are our partners' realities today. 

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clinical documentation improvement, denials, ICD-10, MedAssets


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