How should health care organizations recover from the ICD-10 delay?

When the date of the ICD-10 implementation was pushed back to Oct. 1, 2015, last March, many health care organizations felt the heavy impact of the delay. Although it was good news for smaller practices that had not yet fully prepared for the new codings of ICD-10, larger hospitals and organizations that had already spent significant amounts of time and money to code their procedures were left trying to figure out what to do with the lost time they had spent. Many hospitals and practices also underwent time-consuming efforts to audit the ICD-10 to check for accuracy.

The impact of the ICD-10 delay
Modern Healthcare stressed that areas like training require a significant amount of time and motivation to complete. Health care chief information officers will not want to lose momentum gained in the efforts spent in reaching the ICD-10 goal. At the same time, however, they will be much more hesitant to spend more money on areas like training until they can be certain of the date of ICD-10 implementation, as this was not the first time the release date has been delayed. To fully commit to new efforts, they will need a clearer understanding of where the industry is headed.

"My guess is, there are chief information officers all over the country saying, 'How do I shelve this program?'" said Andrew Smith, president of Impact Advisors consulting firm, based in Naperville, Illinois, according to Modern Healthcare.

Organizations that had taken the proper measures to prepare for ICD-10 may begin to ask for ways to put their hard work to good use before Oct. 1, as waiting for the date will only hold them back. There also may be confusion, as employees in all areas of the organization had spent time in training, learning the new codes and adapting to the new system. Learning all of this and then going back to the old coding process could be a recipe for disaster.

"It says what they can't require, but it doesn't say what they can and can't do to facilitate the work that has been done," said Chris Powell, president of health IT consulting firm Precyse, according to Modern Healthcare. "That's what everyone is waiting to hear. Some organizations will stop their ICD-10 efforts until they hear that."

However, despite the setbacks felt by many practices, the fact that ICD-10 is set to arrive in less than a year is unavoidable. Whether relieved by the news of the delay or frustrated by another false implementation date, there are steps that organizations should be taking during the delay period to both recover and prepare for Oct. 1.

Steps to take during the delay 
The first thing to make sure is that the IT systems are upgraded. According to EHR Intelligence, organizations should also consider running a test to ensure that the internal systems are operating the way the vendor said they should. However, it is important to keep in mind that the way a vendor says a system should run is not always the way an organization needs it to run, so it is crucial that everything is working as needed to enhance workflow. Therefore, adjustments or additions to the electronic health record system may be required before a successful adoption of ICD-10 can be achieved.

The other essential aspect of preparation during the delay is focusing on dual coding and getting practice for coders. This is important because with the introduction of ICD-10, productivity is expected to decline 40 to 60 percent on the inpatient side. The coders should be able to work together as they adapt to the new codes, making it important that the channels for communication are opened. However, EHR Intelligence pointed out that there is a lot that an organization must decide during the transition process – much that is open for interpretation – and decision-making has to be consistent. 

Summer Scott Humphreys, executive consultant for Beacon Partners, advised that organizations do not shelve the software they obtained for ICD-10, for some of their work will probably need to be redone. They may also end up missing something if they do not take the time to closely review their system again. A simple review of the gap analysis and project plan will confirm that all of the necessary elements have been addressed, according to the news source.

The practices that have made good use of the extra time during the delay will benefit in the end, as their bottom line is greatly improving. Working on dual coding and taking a thorough look at their CDI efforts and revenue cycle optimization are not just activities that can help them in the future, but now. Improvements in documentation while using ICD-9 can enhance an organization's case mix index long before the transition to ICD-10.