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ICD-10 change: It's real this time... again

Though a systemic switch to ICD-10 has been delayed twice, healthcare providers, healthcare plans and clearinghouses around the country are finally saying they expect the October 2015 deadline to be the one that — finally — sticks.

Thankfully with the deadline's rapid approach, there are more testing, tools, timelines and resources available than ever before to ensure a smooth transition from ICD-9 to ICD-10, says Kelly Bryan, revenue cycle project manager for Surgical Care Affiliates, adding that SCA's more than 180 facilities will be well prepared for the change.

"There are many entities offering planning tools and checklists with timelines," says Ms. Bryan. "CMS offers planning tools based on provider type."

The key to a successful change is also one of the biggest challenges, she adds: making time for all of that planning, testing and implementation.

"By now, ASCs should have their patient accounting systems upgraded, ICD-10 codes downloaded and claims tested with payers. By June, coders should be trained and prepared to implement a dual coding program," she says.

The resources that SCA has looked to for planning advice include:

  • CMS Contingency Planning Tools
  • Industry webcasts
  • American Health Information Management Association
  • Clearinghouse vendors

But nothing beats a dry run.

"After completing our research, we followed a patient from scheduling to remittance to understand how the ICD-10 code is used by individuals and systems. End-to-end testing is key to revealing any flaws in the execution," Ms. Bryan explains.

April Sackos, vice president of revenue cycle at Meridian Surgical Partners, which owns and operates 10 centers in nine states, says they've been using a similar approach.

"We have a coding education plan in place through Optum for staff as well as specialty-specific plans for the physicians to ensure that our clinical documentation is compliant," Ms. Sackos says. "We are also working with each facility to ensure that internal processes — like forms, templates, policies and procedures — are updated, and practice management systems and payers are ICD-10 ready. Additionally, we continue to conduct internal and external testing."

Surgical Care Affiliates has conducted quite a bit of internal testing with the new CMS 02/12 form, Ms. Bryan says, "It made sense to tie the two together to save time."

Meridian is making certain "all systems function properly where ICD-10 codes are used," says Ms. Sackos. "This includes any system that stores, processes, sends or receives ICD-10 codes. We are also engaging in dual coding and evaluating the results."

Externally, SCA is participating in Medicare end-to-end testing and Meridian is similarly engaging with vendors and payers.

But even with those tools, there still are hardships, Ms. Bryan explains. "Like many other companies, we have been challenged with finding time and allocating proper resources to this huge undertaking," she says. "Our ICD-10 implementation team has full-time job duties to fulfill outside of ICD-10 but planning carefully and adhering to strict timelines have enabled us to stay on task."

"The overall process has been time-consuming," Ms. Sackos says. "Once we established a budget, we then implemented the process improvement plan, systems changes and upgrades, testing and training."

Currently, Ms. Sackos says her biggest challenge is keeping staff and physicians engaged in the ICD-10 transition process.

"Due to the delay, there is no longer a sense of urgency," Ms. Sackos says. "The overall perception is that it will continue to be delayed."

Both Ms. Bryan and Ms. Sackos say that, ultimately, their respective ASCs are prepared for the switchover.

"At this point, we are ready and have invested in the resources to make the switch to ICD-10," Ms. Sackos says.

"We are fully prepared to implement this year and have embraced the changes that are coming. We looked at this as an opportunity for continuous improvement," Ms. Bryan says.

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