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Countdown to the Deadline: A Guide for Making the ICD-10 Transition

Despite several postponements, CMS says the October 2014 ICD-10 deadline will not change.

Implementing a system that adds tens of thousands more codes can be overwhelming but it is doable. The key is to keep ICD-10 a priority and to devote the resources necessary to getting the job done right.

According to the American Health Information Management Association (AHIMA), the ICD-10 implementation process should take five years including post-implementation.  Here are some tips to keep facilities on track:

Audit Your Software and Processes

Review all the software and databases currently being used.  Depending on how many vendors the facility is working with, it could be a lot. This includes electronic medical records (EMR) database as well as additional programs for adverse event reporting, pre-registration, physician credentialing, coverage determination or other front desk tasks. Make a list of all of these programs and contact each vendor. They should all have a plan to convert software for ICD-10 compatibility.

Software programs are not the only things that may need to be updated in the facility. Staff roles may need to be adjusted and standing operating procedures revised. Specializing and clearly defining staff responsibilities so fewer employees are required to have advanced knowledge of coding systems could reduce training costs. Physician notes and patient history and physicals will need to be more detailed so coders have the information required for the more in-depth coding in ICD-10.

Set Up Training


CMS states that once staff understands the system behind ICD-10, the coding will prove easier than ICD-9. Either way, intensive training is necessary. The American Health Information Management Association (AHIMA) estimates each coder or biller will need approximately 40 hours of ICD-10 training.

During physician training sessions, conduct the training by specialty so the focus is on documentation needs for their top performing procedures. Pull the ICD-9 codes used on regular basis for each specialty in your practice and determine their corresponding ICD-10 codes.

As outpatient facilities, CMS does require ASCs to use the ICD-10-CM codes but is allowing continued use of the CPT procedural codes, unlike inpatient facilities which must switch to ICD-10-PSC. However some experts have raised concerns that payors not covered by HIPAA will require PSC codes for outpatient procedures.

What’s Ahead

Starting now, there is approximately a year-a-and-half to finalize preparations and implement ICD-10. Below is a recommended timeline to ensure facilities meet the deadline as efficiently and cost-effectively as possible.


Review how ICD-10 will affect your facility and start crafting your plan to adapt. Time is running short. Get your budget squared away and your transition leaders in place. Create a training schedule on how to train staff in the new procedural codes. Consult the steps above and start doing each.

Between Now and October 2013

Start the initial ICD-10 training. Begin internally implementing the ICD-10 coding across your staff. Designate staff to act as quality control monitors, randomly pulling coded documents and testing their adherence to the new system. Check reported data against patient records to ensure accuracy.

October 2013 till October 2014

Establish relationships with each payor to ensure their ICD-10 readiness is meeting your organizational timeline.  Once the payor is updated for ICD-10, begin testing the new codes in documentation immediately. Increase the intensity of staff training and quality control oversight. Finish updating your software and databases.

October 2014

It’s go time. All coding must now be reported in ICD-10.

This day is coming up sooner than it may seem. ICD-9 has been in place for 30 years and obviously a lot has changed since then. Planning everything out right now and practicing for a year leading up to this day will give just enough time to work through obstacles.

The most important thing is that facilities immediately start planning for the ICD-10 transition. In addition to the above steps, CMS has created a website with a suggested timelines and checklists based on practice size and type. You can access those here.


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