Twelve Steps for ICD-10 Implementation at Physician Practices

The Doctor's Office , November 12, 2009

On June 23, CMS sponsored an ICD-10 conference call for physician specialty group representatives. The CMS presentation included the following 12 steps for group practice ICD-10 implementation:

1. Organize the implementation effort. This includes establishing a point person to oversee the conversion. Choose someone who is familiar with the departments that the code changes will most heavily affect. Include coders, information systems, billing, managed care contracting, and physicians in the development of your implementation plan.

2. Establish a communication plan to keep everyone up to date on the progress. Communicate with stakeholders on a monthly basis until six months prior to implementation, at which point you should communicate biweekly, according to the CMS presentation. Determine which method of communication is most appropriate for each team player. For example, some staff members may not respond to e-mails or memos and may benefit instead from short meetings with verbal updates.

3. Conduct an impact analysis, which includes a budget for system updates, staff member training, and coding resources. Don't forget to include the additional staff member time needed for the conversion.

4. Contact system vendors to ensure that they are ready for implementation well in advance of October 1, 2013. Physician practices should already be talking with vendors about compliance with the new HIPAA 5010 transaction standard. All covered entities must comply with this new standard by January 1, 2012. Ask your vendor when it will be ready to test the systems. One vendor explained that it cannot test its systems until the Medicare administrative contractors (MAC) are fully compliant. CMS recommended that providers forward information from their MACs to their vendor because CMS and MACs correspond with providers, not vendors.

5. Estimate the budget for transitioning to the 5010 transaction standard, taking into account costs for hardware, software, licensing, and training. The budget will vary depending on the practice size and the tools that your practice currently uses for coding and billing.

6. Plan the implementation beginning in early 2010. Review superbills at this time by crosswalking current codes to equivalent ICD-10-CM codes.

7. Develop a training plan. Focus on who needs training and how many hours will be required. Find out what resources are available and make a schedule.

8. Analyze business processes that are currently tied to ICD-9-CM. This could include medical policies and contracts with health plans.

9. Begin the education and training at least six months prior to the October 1, 2013, implementation deadline (for small practices). Large practices may need more time.

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