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Planning for a Successful ICD-10 Implementation

posted by SamK on September 4, 2012

Craig Adkins, Executive VP, Accel Anesthesia, LLC

September 4, 2012


On August 24, 2012, the Centers for Medicare and Medicaid Services (CMS) announced that the ICD-10 compliance date was moved from October 1, 2013, to October 1, 2014.  And while many practices breathed a huge sigh of relief, it is clear that practices can no longer delay the planning required for a successful ICD-10 implementation.  We advise anesthesiologists to plan now to avoid potential operational and financial problems.  Delays from payers could have significant impacts on your cash flow!


Here are the most important ICD-10 implementation steps for your anesthesiology practice.


Perform operational impact analysis. ICD-10 will impact almost all aspects of your practice. All personnel, systems and functions in your work flow must be evaluated from patient referral and scheduling to billing.  Identify staff, workflows, systems and business processes that currently use ICD-9.  Identify possible work flow changes needed to implement ICD-10, including changes to forms and superbills.  Assess whether it will be helpful to hire a consultant such as Accel Anesthesia to assist you in the planning and implementation process.


Train your staff.  Training is an integral piece of the implementation process.  Training on the fundamentals is essential for everyone.  Deeper training will be required for those who work more closely with coding.  Send appropriate staff to medical coding classes or boot camps.  Develop a timeline for training.


Assess the impact on payer contracts and insurance plans.  Include ICD-10 in payer contract negotiations. Understand the changes in documentation required for each plan.  Insist that ICD-9 reimbursement policies stay in effect during transition.


Estimate and approve budget required to cover ICD-10 implementation costs such as software / hardware procurement and staff training as well as productivity losses.  Establish a back-up plan and budget for possible cash flow interruptions caused by coding slow down, health plans not ready to accept ICD-10, IT / vendor issues, etc.  List factors that might alter your budget during the course of the project.


Contact your system vendors to assess their readiness for ICD-10, and their timeline for implementing ICD-10.  Billing, Practice Management and EMR systems (including interfaces) will need to be upgraded to ensure all forms are 5010 compatible and can store and transmit both ICD-10 and ICD-9 codes.  Develop a timeline for testing systems.  Be aware of system downtime.


Don’t let the CMS delay cause you to delay your ICD-10 planning and implementation. ICD-10 is going to happen and you and your practice need to be ready. With any change of this magnitude, there will be bumps along the way, but you have the power to minimize them through careful and timely planning.