Obstacle or Opportunity? Make ICD-10 Work for Your Organization

The optimist sees the opportunity in every difficulty.Winston Churchill

Because the processes for coding health care diagnoses and treatments touch nearly every aspect of the health care system, replacing the outdated ICD-9 system carries certain risks. And while some continue to debate whether and how to implement the change, others recognize the reality of a CMS deadline looming less than 14 months away. They are concentrating their energy on ensuring their organizations can fully capitalize on their investments in ICD-10.

With that in mind, Optum kicked off this series in April to provide practical information health care leaders can use to make their journey to the new coding standard successful. This month, we’re focusing on best practices for seizing the opportunity of ICD-10.

One key to making our health system work better will be enhancing our understanding of the types, severity and causes of injuries and illnesses. That’s where ICD-10 comes in. Considering the pace of innovation in treatments and our growing understanding of, among other things, chronic illnesses, the old system had simply run out of room.

So how can you get the most out of your ICD-10 readiness efforts? Organize your strategies around five key areas:

  • Communication and Awareness: Implement programs that inform your staff about ICD-10 and how it affects their roles, convince them to incorporate needed process changes into their everyday work, and involve them in driving the change.
  • Education and Training: Tailor training efforts to the unique needs of physicians, nurses, coders, clinical documentation improvement specialists and other staff. Orient them to ICD-10, develop their skills and support practical on-the-job training.
  • Revenue Mitigation: Determine measures and benchmarks for areas likely to be affected by ICD-10, including Case Mix Index, productivity, claims denials, revenue by service line and time between patient discharge and final billing. Develop contingency plans to address any deficiencies.
  • Coder Productivity and Retention: Help coding staff transition to using new computer-assisted coding technologies, and offer career development opportunities that enhance their productivity and enable them to grow professionally or transition to new opportunities within your organization.
  • Report Remediation: Develop a complete inventory of the various internal and third-party forms, reports, order sets, templates and cheat sheets used across your organization, in addition to developing  a consistent process and strategy for mapping them to ICD-10 compliance.

We will discuss each of these areas in more detail in a free Webinar on July 17. You can register to attend live here.

Other Resources:

–Emily Rafferty, Vice President, ICD-10 Provider Consulting at Optum

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