With ICD-10, it's survival of the prepared, expert says

HIMSS task force leader says healthcare providers should use the time ahead of the Oct. 1 deadline wisely … or else

It’s Oct. 1 and the ICD-10 diagnostic coding vocabulary is in effect. Now what?

According to one expert, that answer depends on how prepared you are and how much money your organization has on hand.

“For some, the transition will be relatively seamless,” said Pam Jodock, senior director of health business solutions for HIMSS North America. “Others may experience a loss in productivity as office staff familiarizes themselves with new coding tools and processes.”

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Jodock, a member of the HIMSS ICD-10 Task Force, said it all depends on how much time healthcare providers spent getting prepared, working with their staffs and business partners and making sure their tools are up handling the new language.

“There is an expectation that the industry will experience a temporary increase in pended or rejected claims, but given the additional time we’ve had for testing and the positive results we’re seeing from that testing, this may not be as big an issue as originally thought,” she said.

Jodock and other members of the task force plan to offer more tips on preparation at the Spotlight on Operationalizing ICD-10 event in April at the HIMSS 15 exhibition in Chicago.

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When it comes to preparedness, Jodock said the industry has two concerns: Will it hurt productivity and will it cost money? But both of them can be mitigated if providers use the time ahead of the deadline wisely.

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At a minimum, that means hospitals and medical practices should be making sure their practice management and electronic health records systems are compatible with ICD-10 and that any staffers who handle coding have been trained within the next three months. Also, providers should identify the most common billing codes their organizations use and know what the ICD-10 equivalent is.

Jodock said providers should also make sure they have three to six months of operating cash on hand to cover any revenue shortfalls that may come as a result of pending or rejected claims.

“If this is not possible, reach out to those commercial payers responsible for 80 percent or more of your revenue to discuss options for mitigating revenue disruptions,” she said.

Either way, providers should stay calm and make specific plans for any disruptions that might arise after the switchover.

“They should be developing baseline measurements now for key activities, determining their risk threshold for these activities and establishing tracking mechanisms to monitor these activities beginning Oct.1st,” she said.

“Oct. 1st is not the end of the line.”

Twitter: @HenryPowderly