despite the fact that the federal government’s October 1. with its substantial impact on documentation of clinical care. Yet healthcare organizations don’t seem like they are on track to transition from International Classification of Diseases. only 4. When questioned further about their compliance plans. Tenth Revision. “The transition to ICD-10. “Indications remain that significant numbers of industry participants have a considerable amount of work to do in a very short time.” says Stanley Nachimson. Clinical Modification (ICD-10-CM). found that a third of providers said that the compliance date extensions prompted them to shift their timeline for their ICD-10 projects by more than six months. Clinical Modification (ICD-9-CM) to the International Classification of Diseases. Ninth Revision. Englewood. Further. MGMA president and CEO. about half of surveyed providers said they weren’t sure when they would be able to begin external testing with health plans or other trading partners. AN IMMOVABLE DATE While some organizations and leaders are calling for yet another extension. their work until much later.8 percent of medical practices reported that they have made significant progress when rating their overall readiness for ICD-10 implementation. physician productivity and practice reimbursement. according to a study conducted in June of 2013 by the Medical Group Management Association (MGMA). while a quarter of vendors admitted such changed priorities.ICDIndeed. WILL ACTION FOLLOW? It’s often said that there’s no better motivation than a deadline. such as health insurance exchanges and Stage 2 of the CMS Meaningful Use EHR Incentive Program. Turney. which surveyed representatives from about 950 organizations.” An earlier study conducted in February of 2013 by the Workgroup for Electronic Data Interchange (WEDI) shows that organizations have not really taken advantages of the extra time afforded them when the deadline was pushed back from 2013 to 2014 – but instead have simply dragged their feet. Adding to the implementation challenge and clearly taxing all stakeholders. “It has become clear that many entities postponed DEADLINE LOOMS.. director of the North Carolina Healthcare Information and Communications Alliance/WEDI timeline initiative for ICD-10.” stated Susan L. ICD-10 will arrive at the same time that a number of other transformative federal policies go into effect. at this point. about 40% of providers said they didn’t have an estimated completion date for their ICD-10 impact assessment about 40% also said they were unsure of when they were going to complete ICD-10 business changes. 2014 deadline looms in the not-so-distant future.” The study. MD. it doesn’t look as if C ONTINU E D ON PAGE A5 A1 . Colo. “It is proving to be one of the most complex and expensive changes our healthcare system has faced in decades. is unprecedented.

at www. clinical documentation improvement. realized her department needed to streamline coding and CDI processes to head off the expected ICD-10 productivity impact. enabling better access to patient information for caregivers across its multi-county region. Hays Medical Center has realized a 45 percent increase in inpatient coder productivity and a 20 percent increase in outpatient coder productivity. documentation accuracy and timely billing.com/ Hays360 CONTACT 3M Health Information Systems 575 W. Hays began transitioning its records to an electronic health record (EHR) system in 2004. As changing regulations exert new demands on healthcare providers. Farthing says the process has been smooth. They listened to our pain points and always asked for our suggestions for improvement. Deloris Farthing. Hays is well on its way to achieving ICD-10 readiness. Murray Blvd. going live in December 2011. “The reality is that in the new ICD-10 environment. well ahead of many other facilities.3Mhis. 3M is the choice for organizations wanting to improve quality and financial performance. the “who” was equally as important as the “what” in choosing an integrated computerassisted coding (CAC) and clinical documentation improvement (CDI) solution. With the 3M 360 Encompass System.ICD- 3M Health Information Systems Known for market-leading coding solutions and ICD-10 expertise. Farthing says. you can either work harder or work smarter. HIM director. The advent of ICD-10 and the growing volume of data in the EHR had the potential to impact coding speed.com A2 .” After a year of success using 3M’s CAC technology. “Our coders have used 3M coding software since 2002 and 3M’s DRG Assurance program has helped us keep our documentation on track since 1998. 3M Health Information Systems delivers innovative software and consulting services that raise the bar for computerassisted coding. we didn’t even look at any other vendors. With a robust healthcare data dictionary and terminology services to support EHR expansion and accuracy and 30 years of healthcare experience. Hays Medical Center exemplifies this kind of innovation. Today. Hays has seen a marked increase in coder and CDI staff satisfaction. with limited staff and fewer resources.” she said.3Mhis.com | www. was an important factor in their selection. Having previous experience with 3M. Once we heard that 3M had released an inpatient computerassisted coding program. rural hospitals and clinics. UT 84123 800-367-2447 | 3MhisSales@mmm. A health system on the front lines of technology adoption. Hays signed on to be the first beta site for the 3M™ 360 Encompass™ System. | Murray. download the full case study. about 95 percent of Hays’ records exist as discrete data within its EHR. Hays wanted a vendor they could count on. must find new and innovative ways to prepare for regulatory mandates. We chose the second option.” True to its reputation for leading innovation. For Farthing. and natural language processing. To get more information about the positive results Hays Medical Center has received with the 3M 360 Encompass System. More than simply acquiring new software. Staff members who shied away from the automation changes now embrace the benefits. Since implementing 3M 360 Encompass. “With 3M it wasn’t an issue because we worked together. Taking on the responsibilities of being a beta site isn’t something she’d be willing to do with every company.

CEO What are the most important elements of a comprehensive approach to ICD-10? The ideal—and most effective— approach to the ICD-10 transition engages all areas of the practice. Identify all systems used to create.ICD- Vitera Healthcare Solutions Vitera Healthcare Solutions provides end-to-end clinical and financial technology solutions so physicians and medical professionals can work with patients. All of Vitera’s solutions. the practice should schedule its upgrade as far in advance of the October 2014 deadline as possible and be prepared to conduct testing with other stakeholders early in the process. implementation and ongoing support. including front office and billing staff.viterahealthcare. and work with associated vendors to understand their timing and customer support in regards to ICD-10. From the onset. not paperwork.viterahealthcare. It is key that practice staff understand the two initiatives and why each is important to the practice’s future. but ensure their system is robust and scalable to serve the practice’s future HIT needs. testing and training that engages both staff and all vendor partners. of course. Prior to conversion. Collaboration and coordination between the practice and software vendor is crucial. financial and care perspective. in addition to ensuring the technology they provide comply with all upcoming regulations. Develop a training program for all staff members who will be affected. To ensure users are as comfortable as possible with the new system. HAWKINS. A checklist for successful ICD-10 adoption should include: • Comprehensive planning. including those at www. Vitera Stat and Vitera Medical Manager. rather it represents a significant IT project. Physicianfocused and patient-centric. for both staff and leadership. Ongoing efforts to comply with the next stages of Meaningful Use will only compound the challenge. The IT strategy must not look only at the current challenges. Forward-looking vendors like Vitera are actively helping providers prepare by offering regulatory readiness resources. Both projects. • Technology preparation. and includes both a high-level and in-depth analysis of operations. CONTACT Vitera Healthcare Solutions 4301 West Boy Scout Boulevard | Suite 800 | Tampa. cardiology and orthopedics. cash flow and staff productivity. BY MATTHEW J. Upfront training and ongoing education will help engage staff and empower them to make necessary adjustments to their work processes. store and transmit ICD-10 codes. An intentional and well-planned ICD-10 implementation strategy includes planning. Practices that adopt a “change management” attitude toward these transitions and create a comprehensive roadmap will be able to minimize disruption. require that staff managing IT efforts adopt a plan that considers whether existing PM and EHR software can be updated or if a new solution is needed. including Vitera Intergy. Ensure staff understands the rationale behind the migration from ICD-9 to ICD-10 and how important a smooth transition is for the practice—from an operational.000 physicians and several specialties such as primary care. How can healthcare organizations best manage the transition to ICD10 while also addressing other IT projects such as Meaningful Use? There is little question that ICD10 adoption will impact practice operations. maintain their revenue stream and achieve their goals more efficiently. How can healthcare organizations best work with various software vendors to ensure a smooth transition to ICD-10? Without a doubt. FL 33607 (877) 932-6301 | www. communication.com A3 . OB/GYN. • Testing. practices must understand that this transition is not a coding or billing challenge. will be ICD-10-enabled by the end of 2013.000 healthcare professionals including 85. pediatrics. medical practices must have assurances that their practice management (PM) and electronic health record (EHR) systems are ready for ICD-10.com/ regulatoryreadiness. Vitera Healthcare Solutions provides electronic health records and practice management systems serving more than 415. • Education and training. practices will look to their technology partners for assistance with preparation.

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burdensome. 2014 deadline. hospitals and hospital systems. “Halting this progress midstream would be costly. MD. there is the increased volume. Md. while many industry stakeholders are worried that the ICD-10 transition is just too much of a burden considering other regulatory imperatives such as meaningful use. A HUGE JOB Providers. as organizations that are using certified EHRs for clinical documentation could have an easier transition to ICD-10. C ONTINU E D ON PAGE A7 . the government is holding strong to the October 2014 date. Mostashari has contended that there is potential synergy between the two initiatives. Tavenner again stated that the federal government plans to stick to the October 1. and severity (see chart on page A8). with ICD-10 including about 68.” Tavenner wrote.000 codes. and large physician practices are far along in their ICD-10 implementation and have devoted significant funds. And. “Many in the health industry are under way with the necessary system changes to transition from ICD-9 to ICD10. resources and staff to the effort.. and would eliminate the impending benefits of these investments.000 in ICD-9. She emphasized that delaying the move to ICD-10 would mean that the healthcare industry would have to continue relying on outdated ICD-9 codes that soon will be incompatible with general health care needs and new technologies. once again stated that there would be no ICD10 extensions. on June 17. the national coordinator of Health IT. Indeed. In a letter sent to the AMA in February of 2013.ICDCON T IN U E D F R O M PAG E A1 the federal government will cave in. anatomic site. The new codes are also more complex and provide greater specificity to identify disease etiology. CMS Administrator Marilyn Tavenner clearly supported moving forward with ICD10 to modernize the health care system. might perceive the job as an overwhelming one.” During the HIMSS annual conference in March. prompting many organizations to stay in procrastination mode. compared to just 13. Farzad Mostashari. however. While delivering the keynote address at the HIMSS Media ICD-10 Forum in National Harbor. To start. Many private and public sector health plans.

an instructor-led training and web-based learning center for ICD-10. including interfaces. billing and cash) any current workflow process or procedure that is functioning poorly in ICD-9. Identify. will create even more dysfunction and negative financial impact. and strategies to prepare people. and correcting all the workarounds staff have been forced to adopt due to lack of automation. cooperation or training. Organizations are traditionally rich in data and poor in information. Since ICD-10 impacts so many areas in your organization (from preauthorization.com A6 . BY MARY BETH HAUGEN. Identify all areas in the organization that will need to be trained and determine a strategy and timeline so the right training occurs at the right time to the right staff. HCG also offers The Haugen Academy. Prioritize report needs based on patient care. The Academy provides training and education to ensure learners become confident and proficient with ICD-10. and technology for the upcoming conversion from ICD-9 to ICD10. remembering such things as series patients. The translation of a one-page superbill in ICD-9 could result in a 20 page superbill in ICD-10. It will take a variety of staff with expertise and knowledge of the current state and a comprehensive understanding of the vast impact of ICD-10 to be successful. documentation. CDI. coding. Assessments include identification of risks.ICDHaugen Consulting Group. Backup coding services. ABN. Workgroups should report back up through the Steering Committee so that ownership is guaranteed. Inc. what can be done to pick up the pace and meet the Oct. the first step is to quickly compile a team of your strongest “go getters” and surround them with a supportive executive team. regulatory and financial impact. scheduling. Inc. | Suite 620 | Denver. Executives should also eliminate as many barriers as possible so that your project can move swiftly ahead. straddle patients (patient’s that are preauthorized prior to implementation for services after 10/1/14) and nonHIPAA covered entities. and budget needs on a structured and regular basis. or training rotations will be required to ensure adequate coding coverage during training time. The day-to-day work must continue and cash must continue to flow. roadblocks. registries and databases. Identify all superbills in the organization and determine a plan for implementation and training of a new structure to ensure proper coding and charging in the offices and clinics. Inc 1873 S. Focus on aggressively fixing processes that do not work in ICD-9. processes. Bellaire St. Haugen Consulting Group. Attack the areas that are most vulnerable. Communicate with the organization’s most common payers on their plans related to ICD-10. select and implement a training plan and consider how non-productive time spent in training will be managed. (HCG) offers custom readiness assessments. The next step is to establish a Steering Committee and individual focused workgroups. implementation. The role of the executive team is to create a sense of urgency and ensure participation of project staff. education and documentation reviews for ICD-10-CM/PCS.thehaugengroup. Communicate progress. MS. CO 80222 720-502-7690 | www. Ensure that the organization has a strategy to manage data during and after implementation. If training has not started for your coding and CDI team. ■ CONTACT The Haugen Consulting Group. The implementation of ICD-10 cannot be accomplished by a few individuals. upgrade and thoroughly test all impacted IT systems. RHIA | PRESIDENT & CEO With so many organizations behind in their ICD-10 preparations. recommendations for organizational readiness. 2014 deadline? If preparation for ICD-10 has not gotten started at your organization. overtime. Do not lose sight that many organizations are still using a superbill or fee ticket.

000 codes First character may be alpha (E or V) or numeric. business process analysis of health plan contracts. billing services. • Budget time and money for software updates. and reimbursements. to meet the ICD-10 transition deadline. healthcare organizations need to start preparing sooner. and training.000 available codes Character 1 is alpha. codes identifying right vs. • Evaluate staff training needs. characters 2–5 are numeric Limited space for adding new codes Lacks detail Lacks laterality ICD-10 3 to 7 characters in length Approximately 68. ICD-9 TO ICD-10 ICD-9 3 to 5 characters in length Approximately 13.ICDCON T IN U E D F R O M PAG E A5 COMPARISONS OF DIAGNOSIS CODES. • Ask payers how ICD-10 changes may affect your contracts. • Test transactions using the new codes with your payers. and information technology system changes. left) Source: What You Need to Know for the Upcoming Transition to ICD-10. • Discuss implementation plans with clearinghouses. characters 4–7 are alpha or numeric Flexible for adding new codes Very specific Has laterality (i. The following steps could help health care organizations get on track: • Identify your current systems and work processes that use ICD-9 codes. system changes. . • Talk with your practice management system vendor about accommodations for ICD-10 codes. change to superbills. characters 2 and 3 are numeric. More specifically. and clearinghouses. coverage determination and documentation. rather than later. billing services. • Identify needed changes to your business processes and documentation. payment schedules.e.. and all payers. providers need to address a variety of issues such as staff education and training. American Medical Association Clearly.

Natural language processing (NLP) and other advanced technologies can help providers automate many traditional tasks. GA 30309 888-99-STREAM | www. clinical documentation improvement (CDI). Advanced analytics will provide the data and the information that is needed and will be used to improve health. The hospital can use this information to enforce standard protocols for how the patient is managed financially and clinically. In a healthcare world that is moving toward risk-sharing. in which they can work in both ICD-9 and ICD-10 at the same time without toggling back and forth. By using NLP and analytics. and healthcare is no different. not the least of which are improving quality and reducing cost.net A8 . Inc. the prescription for a lot of the goals we care about in our industry. What are the most important elements of a comprehensive approach to ICD-10? Providers may want to consider rethinking the traditional flow of information through their organizations by initiating health information management (HIM) and coding processes at the time of service. ICD-10 is not just a coding issue. CONTACT Streamline Health Solutions. Dual coding can help maintain productivity levels after the transition because it will help improve familiarity with the new code set and speed up chart completion. The company’s comprehensive suite of solutions includes: enterprise content management (ECM). is a leading provider of knowledge management solutions for healthcare providers. By aggressively monitoring and managing these metrics. We envision the management of these metrics as key. utilization and quality. Major changes in reimbursement models.streamlinehealth. and enable them to take place much earlier in the patient lifecycle. Streamline Health Solutions. hospitals will be forced to implement financial and clinical protocols that are much more standard and consistent across the enterprise. The data can be leveraged to understand the impact code changes have to a company’s bottom line through predictive modeling. Inc. so we recommend using a dual coding approach. One of the solutions that is a core component in ICD-10 preparation is a computer-assisted coding system (CAC) that can handle both ICD-9 and ICD-10 codes. Preparation is key to success and should include securing the appropriate tools to aid in the transition. but to the success of our healthcare system in years to come. integrated workflow systems. a hospital could determine admitting diagnosis or admitting procedures assignment more accurately than they are today. Attesting for Meaningful Use and completing the transition to ICD-10 is not the end of the road but opening the door to the next level of analytics. not only to a successful transition to ICD-10. rather than post discharge. or outsourcing to a third party.ICDStreamline Health Solutions. BY ROBERT E. Meaningful Use is not so much about getting stimulus payments in exchange for using an EMR. This unique combination of solutions is designed to help healthcare organizations navigate the business challenges of healthcare now and prepare them for the future. How can healthcare organizations best manage the transition to ICD10 while also addressing other IT projects such as Meaningful Use? The short answer is: analytics. business analytics. such as ICD-10 as well as Meaningful Use are creating a scenario that makes a new generation of advanced analytics a must-have for all healthcare organizations. but there is still a lot at stake and much of it is unknown. which will be especially important in the first few months after the transition. How can organizations manage the transition to ICD-10 while avoiding disruption or decline in reimbursements? One of the keys to success is to support the automation mentioned above with powerful analytics to measure and predict specific areas of concern including reimbursement. or prior to service. Analytics has become critical to all industries. Inc. and computer assisted coding (CAC). PRESIDENT AND CHIEF EXECUTIVE OFFICER How important is adequate planning when considering a large project such as ICD-10? A lot of money has been invested in technology to help mitigate the risks associated with ICD-10. WATSON. further ensuring that the business process is aligned to the most effective metric. 1230 Peachtree Street NE |Suite 1000 | Atlanta. It is about setting the stage and changing behavior for value-based purchasing and healthcare reform. healthcare organizations can use the information to adjust the necessary processes. Many providers are naturally worried about productivity losses.