How to Build the Right ICD-10 Team

September 1, 2015
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Multiple opportunities for further delaying the implementation deadline have come and gone, and each passing chance makes the October deadline for ICD-10 implementation look more definitive.

In all honesty, it’s probably long past due. The current ICD-9 code set isn’t well suited for the type of granular data analysis that’s becoming standard across the healthcare industry. However, switching to ICD-10 won’t be simple, and adequate planning is required.

Multiple opportunities for further delaying the implementation deadline have come and gone, and each passing chance makes the October deadline for ICD-10 implementation look more definitive.

In all honesty, it’s probably long past due. The current ICD-9 code set isn’t well suited for the type of granular data analysis that’s becoming standard across the healthcare industry. However, switching to ICD-10 won’t be simple, and adequate planning is required.

For providers both large and small, this means forming a multidisciplinary team to plan and execute ICD-10 implementation. Finding the correct balance of power among these stakeholders is critical to ensuring the project stays on course and has the flexibility to negotiate obstacles.

So, who should be on the team?

1. Someone from Coding and Billing

The increase in the sheer number of procedure and diagnosis codes between ICD-9 and ICD-10 is incredible: ICD-10 will feature a 19 fold increase in the amount of procedure codes as well as five times more diagnosis codes.

Simply put, it would be impossible to manage an ICD-10 transition without significant input from your coders. These specialists can help physicians understand the importance of ICD-10, and supply insight about technological needs for the rest of their department.

Training and preparation will likely play a large part in any discussion with coders about ICD-10, but they’ll also have insight into the workflow process, such as how to improve documentation at the point of care that results in more specific codes and claims being submitted to payers.

2. A Physician and Clinical Staff Member

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Although coders will perform most of the heavy lifting, clinical documentation and coding begins with the clinical team, specifically physicians or other providers entering diagnosis codes at the point of care.

Try to identify which physicians are open to ICD-10 early on. Many doctors have their coding habits set, and changing these well-established behaviors won’t come naturally. Transitioning to ICD-10 will require physicians to divert some of their attention away from treating patients, which can lead to tension and competing priorities.

That’s why it’s critical to enlist your physician champion(s) early on; once they’re committed, it will be easier to sway the opinion of other physicians by leaning on their influence.

A member of the clinical staff should also be present in order to disseminate information, organize training, and generally represent the interests of their colleagues during ICD-10 discussions.

3. Business Administration and Finance

Although ICD-10 will likely affect this department the least from the perspective of day-to-day tasks, it’s important that the business side of any hospital or practice is consulted about the feasibility of each action item the team creates. This division can also help project and manage resource consumption during the transition.

Business administration may not see a great deal of change in terms of job function, but the perspective of this department can supplement that of coding and billing, especially when presenting the plan to the rest of the organization. Perhaps more than any other department, business administration knows that if ICD-10 isn’t being used effectively by the October deadline, their facility will lose significant amounts of money.

4. Health Information Management and IT

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There’s been a lot of hyperbole about ICD-10 spelling disaster for the healthcare industry, but using the proper medical software can be a huge advantage for providers of all sizes who are looking to transition to the new code set.

Naturally, this requires that a member of the HIM or IT department hold a prominent position on the implementation team. The easiest method of information flow for procedure and diagnosis codes is pushing the data directly from the EHR to the practice management and billing system. This interaction may require a substantial amount of work on the part of the IT department, so they need to be able to plan appropriately if this becomes part of your strategy.

Additionally, using computer automated coding software at the point of care can help physicians and other providers create accurate codes before they input the information into the EHR, which can improve the downstream results of the entire information chain.

ICD-10 represents a number of challenges for an entire healthcare organization, so devising effective solutions for each obstacle requires a team approach. Let these individuals make up the core of your ICD-10 implementation team and you’ll be much better prepared for the transition.

Author Bio

Zach Watson is the content manager at TechnologyAdvice. He covers gamification, healthcare IT, business intelligence, and other emerging technology. Connect with him onLinkedIn.