ICD-10 Implementation: What to expect from reputable vendors
With the coming transition to the ICD-10 code set, having the right electronic medical record (EMR) vendor is more important than ever before. Your vendor should be working hard right now to determine the easiest, most efficient conversion from ICD-9 to ICD-10, helping you put into place any new processes and systems. There are two ICD-10 implementation edicts every vendor should be working toward: 1) Don't slow down physicians; 2) Don't interrupt revenue flow into the practice.
To make sure the ICD-10 conversion goes smoothly, we recommend you ask your vendor these questions, as suggested by CMIO Industry News1:
- What is covered by your contract?
This is the easiest place to start determining what you can expect your HIT vendor to do ease the ICD-10 transition.
- What is your plan and timeline for the ICD-10 conversion?
Every vendor should have a comprehensive preparation plan, including an ICD-10 implementation and testing period—if you or your vendor find there's a hiccup in their process on October 1, 2015, it's way too late.
- How will systems work with both ICD-9 and ICD-10 codes?
Your vendor should send the right codes to the right payers and clearinghouses, based on their varying readiness schedules. Plans should be in place to automatically avoid medical billing errors during the transition.
- What does the ICD-10 implementation process include?
As part of ICD-10 implementation, workflows, interfaces and reporting should all be tested and refined without any disruption to your current claim submissions.
- What is the cost associated with training and support?
With the financial impact of ICD-10 being felt throughout the industry, it's vital to know exactly who much a practice or medical group may be charged for ICD-10 training and support.
- Will we need extra software or infrastructure?
Speaking of costs, ICD-10 may require vendors to implement new software updates, and possibly new hardware as well. Know what to expect, understand the potential costs, and work both into your time and financial budgets for 2014 and 2015.
It's also important for you, as a medical practice, to think about any vendors you may have: Which will be impacted by the ICD-10 conversion? What kind of technology upgrades does each require? How will new claims be tested, and what are the costs and fees associated with ICD-10 implementation that will have you ready by the October 1, 2015 deadline?
With those questions in mind, there is a list of specifics that every EMR vendor should deliver to providers, with the flexibility and technology that yields the smoothest possible conversion to the ICD-10 code set and conversion. We recommend integrating these details into your inquiry when talking with your current—or potentially future—health IT vendor:
- Support for diagnosis code selection
- Testing with payers and vendors on ICD-10 as available
- Coordination of the transition across key impacted areas
- Updates to all relevant rules (e.g., billing, coding, utilization)
- Ongoing communication on the progress of the conversion
- Dual-submission workflow during the migration
- New billing workflows to support coding staff
- Tips and reporting tools to minimize productivity loss during transition
1"HIMSS: Failing to prepare for ICD-10? Plan to fail," Kaitlyn Dmyterko, CMIO, August 11, 2011, http://www.clinical-innovation.com/topics/analytics-quality/himss-failing-prepare-icd-10-plan-fail