Please enjoy this guest post on ICD-10…and why not to wait on making this transition. Juliet A. Santos, Senior Director, HIMSS Business-Centered Systems
by Mike Hoeler, CPHIT
When the HHS-proposed ICD-10 compliance date was moved to October 1, 2014, many healthcare providers in the industry did one or both of two things: (1) breathed a sigh of relief, or (2) wanted a longer extension.
Those that breathed a sigh of relief have slowed down their ICD-10 activities quite a bit. They believe they have more time to focus their resources on concurrent initiatives, such as
- Meaningful use,
- Benefits realization, and
- Anti-fraud measures.
On the one hand, this action makes a lot of sense because there are many other pressing initiatives healthcare organizations must deal with— improving patient care quality, lowering the cost of doing business, and protecting the overall integrity of the enterprise are crucial to the post-recession “new world order.”
On the other hand, ICD-10 is a large undertaking that involves almost every aspect of a healthcare organization. Getting a head start on ICD-10 will more than likely help any healthcare entity effectively move ahead.
The following are important facts to consider when opting to begin, or delay, your ICD-10 project:
1. ICD-10 is not just about coding or information technology. ICD-10 is a true enterprise-wide initiative. What does that mean?
This means that ICD-10 touches almost every aspect of a healthcare organization —anywhere that involves diagnostic and inpatient procedural information. This affects scheduling, registration, admission, clinical documentation, charging, ordering, claims processing, payment, reimbursement, denials, appeals, reporting… You get the idea. Anything that touches this much of the organization has some very large associated risks.
2. ICD-10 impacts so many different areas of a healthcare enterprise with ample financial implications to any organization undergoing ICD-10 transition. Not meeting certain IT, process-oriented, or operational challenges head on can have a profound impact on clinical documentation integrity, information technology, and the ability to get claims reimbursed in a timely fashion. Any decrease in productivity or delay in payment is money taken straight from your bottom line.
3. ICD-10 offers increased granularity in capturing diagnostic information and allows more ways to capture it. The best way to deal with the increased complexity is to make the most of that complexity by enhancing enterprise-wide reporting capabilities. Beefing up reporting to maximize the use of ICD-10 will improve the ability for a healthcare organization to perform a variety of important tasks.
These tasks include
- performing population management analysis,
- identifying trends in patient care, or
- tracking financials per code or code set.
Any reporting enhancement or data integrity consolidation, however, is a fairly large IT project in and of itself, but it can pay off in the end if it gives your organization a strategic edge.
Staying on top of ICID-10 involves a lot of time-consuming and resource-intensive tasks. You must stay on top of everything that ICD-10 feeds into as well, whether that be executive suite reporting, operations, clinical services, or your revenue cycle. Given the risks of non-compliance as well as the benefits of getting a head start, how long can you afford to wait?
Mike Koehler, CPHIT, is Director in Health Information Management, Crowe Horwath LLP.