Are You Prepared for the ICD-10 Transition?

Will you be ready for ICD-10-CM on October 1, 2015? The current plan by governmental agencies is to implement ICD-10-CM in the United States this fall. Advocates for this change point out that ICD-9-CM went into effect in the US in 1979 and is obsolete, inadequate, and inflexible. The experts further state that the 69,000 plus codes of ICD-10-CM will provide more information and specificity on US morbidity statistics and improve data used for defining healthcare policy, providing appropriate reimbursement, researching epidemiological problems, making care decisions, and identifying quality care.

Optimus EMR has installed system tools to help in the transition.  The tools are designed to propel your team to a cost-effective, efficient transition. We have purchased a code matching/conversion module that has been incorporated into Optimus that assists your staff in mapping current ICD-9 codes to applicable ICD-10 codes. This is much more efficient and cost effective than the use of the standard (and somewhat limited) General Equivalency Mapping (GEMs) tables supplied by CMS. After the Optimus ICD-10 Webinars, Optimus EMR users will begin mapping the ICD-9 codes to ICD-10 codes well before the October 1, 2015 implementation date. Staff will review the resident ICD-9 code list in Optimus, and the system will display possible matching ICD-10 code choices in a streamlined list for user selection. Because of this matching module, hunting through spreadsheets and references for the matching code scenarios is unnecessary. System users may create custom mapping scenarios if needed. Once the ICD-9 diagnosis codes are mapped to ICD-10 codes for each resident, the updated ICD-10 codes will flow automatically to other modules of the Optimus EMR system including eChart, new Orders, eMAR/eTAR, MDS Section I, and MD Notes.  This provides your team significant time savings as they become more familiar with ICD-10.

What are the challenges with transitioning from ICD-9 to ICD-10 for Long Term/Post-Acute Care?  First, planning is critical. Benjamin Franklin said, “By failing to prepare, you are preparing to fail.” October 1 will be coming soon, and NOW is the time to develop your plan.

  • Appoint a Project Coordinator or Transition team to oversee the transition
    • Identify goals, tasks and timelines
    • Monitor the process once transition begins
  • ICD-10 Staff Education
    • Who will be doing the coding, and what general ICD-10 education have they received?
    • Remember all of the IDT team members including physicians, nurse practitioners, physician assistants, nurses, admissions, medical records, MDS, QA, Billing, and others
    • Acquire reference materials
  • Staff Education on the use of your systems for transition
    • Include all necessary staff members in the training sessions
    • Optimus EMR will begin a series of Webinars during the summer of 2015.  During these sessions we will not only demonstrate the functionality but also walk the audience through the sequencing of activity and project plan that should be followed to be successful.
    • The Webinars will be recorded and made available for download during our customer’s transition.
    • In addition to the Webinars, Optimus will provide our customers with information including training videos through Optimus University. The training videos are available 24 hours a day, can be viewed before and during the transition process as many times as needed by all users.
  • Evaluate and improve your current medical record documentation
    • Analyze current ICD-9 diagnosis codes for accuracy and completeness
    • If you have more than one system, compare the diagnosis codes and ensure that they match
    • Evaluate the documentation in the medical record. When the coder is searching the record for details in order to select the new, more specific ICD-10 code, is the information available to complete the coding? Does the record support the code selected? Examples of specificity required in ICD-10 are right/left, initial/subsequent encounters, routine/delayed healing.
    • Consider quantity, quality, and frequency of documentation by the key team members.
    • If documentation is incomplete, users should start now to improve the documentation.
  • Contingency planning
    • Plan for unforeseen events. Multiple staff members should be able to assist with coding if necessary.
    • Start early, allow extra time to complete the tasks, and do not wait until a week before the deadline
  • Budgeting and resource planning:  time is money
    • Entering the ICD-10 codes will take staff time. Plan for it.
    • Use the Optimus system for efficient, cost-effective mapping of ICD-9 to ICD-10 codes
  • Check CMS resources for the most recent information

Will you be ready for ICD-10-CM on October 1, 2015? It is coming soon. Don’t prepare to fail by failing to prepare. NOW is the time to plan for successful implementation. Contact us to learn more about how Optimus can support your team during successful implementation of ICD-10, or schedule a demo today.