ICD-10 compliance: 8 lessons from Canada that can help you plan

Canada's ICD-10-CA implementation did not go smoothly for many reasons. But healthcare professionals were able to learn from the problems and get practices and hospitals on track.

Gillian Price, currently Project Director Canada at QuadraMed, was a consultant doing operational reviews for Canadian healthcare organizations during the transition to ICD-10. She offers some takeaways that can help United States healthcare providers transition to ICD-10-CM/PCS coding.

1. Take responsibility for your professional development

Price said that the mandatory training sessions were not enough. Medical coders needed to do more, such as use informal learning resources on their own time. This naturally caused friction. But the medical coders who put in the time learned the ICD-10 coding more quickly and were more valuable to their healthcare organizations. Especially if the stress induced by the transition caused an increase in sick time and retirements.

Once comfortable with ICD-10, medical coders were more energized and professional. They used critical thinking skills instead of rote memorization.

Dive into learning ICD-10 as a system and you will become a stronger part of your healthcare organization, Price said.

2. Get your physicians involved early

Price said she learned this by her third ICD-10-CA implementation. Physicians need to understand ICD-10's scope sooner than later, she emphasizes.

Once involved, Canadian physicians were able to help choose tools and systems that worked for them. And they were able to champion the changes to their colleagues.

It's advice that gets repeated often now, but it wasn't common practice in Canada, and they paid for it.

3. Teach documentation sooner

Speaking of physicians and commonly repeated advice: They need to develop better documentation skills so medical coders can accurately assign codes.

So when should that training start? Ideally, in medical school.

Price said she visited a medical school to find out just how much education was dedicated to training in documentation. Shockingly, it was a mere four hours.

If better information is needed to treat patients, that process starts with physicians. Every bit of documentation training will help medical coders and the reporting system.

4. Plan for delays and cost overruns

Price says issues will arise that create delays. And unfortunately, it's going to cost more than you think. Price suggests that you add another 25 percent to your budget. You will need the extra time and money, she affirms.

By the way, planning for delays also means starting your ICD-10 project now.

5. You will not regain productivity

So plan for that now. Price suggests you make workflow reports that help you map out processes. Then look for inefficiencies and redundancies in your organizations. Make it as efficient as possible. "You must take advantage of every automation," says Price.

The goal is to boost productivity now so you can handle the drop in productivity that comes with ICD-10 implementation.

6. It's a whole new way to look at healthcare

Remember, Price said that ICD-10 is too different from ICD-9 for crosswalks and mapping to work. She also recommends forgetting about comparability. It's just not going to work.

7. Collaborate and share the pain

Price is justifiably proud of Canada's very collaborative culture. She says it was a key part of learning from mistakes and making the ICD-10 transition smoother.

Sharing information is going to help everyone learn what works and what doesn't. It's going to help moderate the learning curve, Price says.

8. Healthcare providers need better information

Price said that patient care did improve with the detailed information offered by ICD-10 codes. With the new information, physicians learned more about disease and treatment.

Although the road to full implementation was bumpy, Price says the process was a success. And now, on the other side of all that work, Canadian medical coders wouldn't go back to ICD-9 codes.

Carl Natale is the editor of ICD10Watch.com. He can be reached at editor@icd10watch.com.