Four Steps to Avoiding ICD-10 Tragedy: Inform, Assign, Engage, Prepare

To many healthcare providers, ICD-10 is potential a-bomb of consequences set to explode on Oct. 1, 2014.

Roughly half to two-thirds of physicians are very concerned about cost, loss of productivity, and overall changes resulting from converting to ICD-10.

A recent survey by Medical Group Management Association (MGMA) also found that a majority of its member believe that ICD-10 will make “much more difficult” patient encounters and coding diagnoses.

The survey, one in a long line that appears to set out to prove how unprepared the healthcare industry will be, painfully demonstrates that much of the problem rests on healthcare providers.

The fact is, ICD-10 is coming on Oct. 1, 2014, and from our perspective nothing–not Congress, not the AMA, not apathy–is going to stop it. Here are four steps you can take today that will help you learn to love the code-bomb that is ICD-10:

Get informed. If the MGMA survey reveals anything it is how ill-informed its members are about their own organization’s ICD-10 migration plans. Almost half of those responding said they did not know when they would be testing their practice management system or electronic health records system for ICD-10 compliance. One possible reason for such a high “I don’t know” response is that the survey did not ask, “Have you planned your PMS or EHR testing yet?” and it is quite possible that those dates have yet to be established. More likely the members responding to the survey are not aware at even a slightly granular level what plans currently exist within their organization. At the very least, those broad milestones should have been communicated to all stakeholders. If you are one who does not know the answer, find out. Which leads us to the next tip.

Assign accountability. The large percentage of “I don’t know” responses by providers is unconscionable, primarily because if one does not know, they should at the very least know who to call within their organization to find out. Someone within your organization needs to own the project plan timeline to migrate to ICD-10. If you don’t know who that person is find out; if no one has that role, assign it or make certain it gets assigned. ICD-10 migration is too important to your organization. Someone needs to own it, and needs to own it now.

Engage your partners. The MGMA survey asked its member when its partner health plans or its claims clearinghouse would be ready to test ICD-10 claims and in both cases nearly two-thirds of respondents claimed they had yet to hear from these partners. The greatest risk to successful ICD-10 adoption is not from within an organization but from without. If partners are not ready, all your preparations will be meaningless. The survey states that a majority of providers “have not heard from” partners. This is inexcusable, if not dangerous, and requires a more proactive approach. Call your partners and find out when they plan to allow testing.

Prepare contingency plans. If the providers surveyed have been proactive and in truth do not know even the most basic milestones behind their ICD-10 conversion plans and those of their respective partners, then now is the time to begin planning for contingencies. If you are not ready or if your partners are not ready by Oct. 1, 2014, will you be prepared, for example, to not get reimbursed on claims for several weeks if not months? This is the type of potential risk that your organization may be facing. One of the best ways to identify and prioritize what you should be doing is to identify the risks of what will happen if you don’t.

These simple steps can help crystalize your ICD-10 conversion plans. Otherwise your office might have its own version of this exchange from the movie “Dr. Strangelove”:

The President: Why haven’t you radioed the plans countermanding the go-code?

Pentagon General: Well… I’m afraid we’re unable to communicate with any of the aircraft.

The President: Why?

Pentagon General: As you may recall, sir, one of the provisions of Plan ‘R’ provides that once the go-code is received, the normal SSB Radios on the aircraft are switched into a specially coded device which I believe is designated as CRM-114. Now, in order to prevent the enemy from issuing fake or confusing orders, CRM-114 is designed not to receive at all. Unless the message is the correct three-letter recall code prefix.

The President: You mean to tell me, General Turgidson, that you will be unable to recall the aircraft?

Pentagon General: That’s about the size of it. However, at this moment our men are plowing through and transmitting every possible three-letter combination of the recall code. But since there are over 17,000 permutations… it’s going to take us about two-and-a-half days to transmit them all.

The President: How soon did you say our planes will be entering Russian radar cover?

Pentagon General: About 18 minutes from now, sir.