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The Oct. 14, 2014 deadline for the ICD-10 conversion is fast approaching and hopefully by now, organizations would have already started the difficult process of evaluating, monitoring, assessing, identifying risks and determining the financial impact of the transition. No matter how difficult it is to comply with the HIPAA regulations, there’s no way around for organizations to remove themselves from the process. In the path to enforcing the new classifications, however, there are critical paths that organizations must bear in mind. Internal and External Evaluation The main reason for the internal impact evaluation is to determine the organization’s existing personnel, technology system and business procedures that are directly using ICD-10 codes and how they will be affected by the new classification. In the same vein, the external impact evaluation will help identify which of the organization’s partners and providers that are outside the scope of its control will be affected and what type of coordination needed to make sure that nothing gets lost in the transition by implementing different coding languages. One of the main focuses of both the internal and external assessments is to determine the ICD-10 revenue cycle of the organization. By the way, training and education for the staff and physicians could not be overemphasized to ensure the successful ICD-10 conversion. Determining Budget The budget here is two-fold. First is the practical requirements of the HIMSS ICD-10 conversion process and the second is the theoretical revenue impact when the organization goes ahead with the implementation of the new codes. Hopefully, the organization should have already appointed a task force or steering committee that will handle this issue. The budget here will cover the four key areas such as revenue cycle, coding, IT resources and non-IT management. The organization is expected to spend a significant cost in encoding the new codes, clinical documentation, investing in new technologies and software applications as well as training the staff and physicians, all the while without disrupting the current workflow. Testing and Validation The organization will also subject its new processes and technology to a battery of tests. This should be done prior to full enforcement of the HIMSS ICD-10 codes. The testing will be done in two phases: Internal testing – subjecting individual structure such as reporting, documentation, encoding, human resource, billing will help the organization understand the gaps and risks in the ICD-10 revenue cycle. The transition from one task to another must be smooth to ensure no delays. External testing – The processes that link organization to the outside like the healthcare vendors should also be evaluated. It would be helpful if the organization can sit down with the healthcare plan provider, for example, to come up with a uniform protocol in ICD-10 conversion.
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ICD-10 conversion, ICD-10 revenue cycle, HIMSS ICD-10,
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