The Role Software Vendors Must Play to Ensure a Smooth Transition to ICD-10

Sean Benson, for HealthLeaders Media , September 1, 2009

A realistic solution is for vendors to reach out to their provider clients and assume a proactive role in transition planning. Doing so allows vendors and clients to work together to determine what is needed to achieve compliance, how much it will cost and what the various deliverables will be. This, in turn, allows them to reach mutually beneficial agreements on who is responsible for executing each element of the transition plan and the timeline for that execution.

To maximize the time spent in these vendor meetings, provider organizations should first conduct a thorough evaluation of any IT applications that will potentially be impacted by the change to ICD-10, including:

  • Practice Management/Billing
  • Registration/Scheduling
  • Documentation/Coding/HIM

Hospitals and practices should also identify which systems may need to operate in a dual environment and for how long. They need to determine how long the ICD-9 system will need to be accessible and by whom, as well. For example, anyone responsible for data analysis will likely require access to the old system for longer than coding and billing personnel. The billing department may also require longer access to ICD-9 to process older claims and to manage any necessary re-billing.

Armed with this information, hospitals and software vendors will be better able to work together to hammer out a plan of action, budget and timeline for the IT aspects of the ICD-10 transition. This includes identifying which software modifications will be needed to accommodate format changes, new diagnostic codes, etc.

For the most part, modifications will include expanding field sizes, changes to alphanumeric composition, decimal use, redefining code values and interpretations, edit and logic changes, table structure modifications, etc. Reports or forms may also require modification or redesign. For example, practices that utilize superbills will need to make significant changes to accommodate the expanded number of codes contained within ICD-10.

Vendors can also assist in determining if and how the transition to ICD-10 might be leveraged to introduce additional enhancements to the IT infrastructure. One example is deployment of new applications, such as service-line specific automated procedure documentation and coding tools, which can ease the transition to ICD-10, while also delivering streamlined workflow processes and increased revenue.

The transition to ICD-10 will affect every segment of healthcare, including providers, vendors and payers. Success will depend upon how accurately and efficiently providers are able to implement the technology changes required to accommodate the new code set.

For this reason, software vendors must recognize the critical role they play in transition planning and get involved with their clients now to ensure they are building a solid foundation for a smooth transition.

Sean Benson is co-founder and vice president of consulting with ProVation® Medical, which is part of Wolters Kluwer Health. He can be reached at
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