Initiation and Planning
Note: The references and links below may not have been edited to include the proposed implementation date change.
Preparing now can help you avoid potential reimbursement issues. A well-organized strategic plan and management approach is critical. Your transition will require a coordinated effort that is aligned across your organization involving all disciplines.
This section includes a selection of resources for reference:
- Gain perspective on the scope of the implementation
- Assess resource needs and identify any gaps
- Develop a solid work plan
Each section below includes links to materials published by national health care industry leaders. If you have questions or need assistance, email our ICD-10 support team.
The American Health Information Management Association (AHIMA) divided the ICD-10 implementation into phases and highlighted 10 essential steps in each phase. Phase 1 concluded in early 2011. AHIMA has urged stakeholders to start working on Phase 2 immediately after completing the conversion to ANSI Version 5010. Reviewing the steps in each of the phases may be helpful in planning ahead for ICD-10-CM/PCS implementation.
- Top Ten List: Phase I – ICD-10-CM/PCS Implementation Plan Development and Impact Assessment ( April 2011)
- Top 10 List: Phase 2 – ICD-10-CM/PCS Implementation Preparation (July 2011)
Communication, Staffing and Education Strategy
Have you assembled your ICD-10 implementation team? In addition to a technical lead or project manager, you should consider a physician “champion” to provide clinical expertise and guidance. You will also need to:
- Implement an internal communications strategy
- Define measures to track your success
- Develop fully integrated organizational training and awareness programs
- Identify and prepare your staff to execute the work plan
Systems / Software Tools / Selecting Vendors / Consulting Partners
ICD-10 will impact many system applications and software tools that may have been purchased or leased from multiple health information technology vendors. It is important that the related vendors provide ICD-10 functionalities for their applications in a timely fashion. These ICD-10 capabilities must be available to support internal and external testing.
In many cases, you may need to select new software vendors to replace systems that are not being upgraded. You may also need to find a consulting resource to assist you in your implementation efforts.
Budget Development and Business Preparation
A large component of planning an organizational shift to ICD-10 is modeling your expected implementation costs, both direct and indirect, and developing a comprehensive budget.
To help quantify risks and related costs, the ICD-10 Cost Predictive Modeling Tool is a cost prediction tool developed by the HIMSS ICD-10 Task Force. This tool allows users to customize assumptions and requirements based on organizational needs.
The Journal of AHIMA cites a survey suggesting that ICD-10 training costs are being underestimated until the detailed analysis is completed in the budgeting process. Organizations should avoid adopting low preliminary estimates as their final budget figures. This type of discrepancy could lead to an unpleasant surprise which could identify a large gap in a facility's budget.
It is important to consider how organizational cash flow may be impacted by the ICD-10 transition.
- The ICD-10 cash flow tips comprises an interview with the Senior Vice President and Healthcare Product Manager at Wells Fargo, who is also the chair of the HIMSS/Medical Banking and Financial Systems Committee. This article includes claims payment solutions developed for commercial and government insurance payment markets. It also emphasizes planning for disruptions, such as rejected claims, and developing strategies to help minimize impact on your organization.
- As a sample, view the HIMSS Budget Planning presentation for ANSI v5010 and ICD-10.
Key Reference Information
HIMSS collaborated with more than 30 health care and IT organizations to create the HIMSS - ICD-10 Playbook as a tool to assist providers in their transition to ICD-10.
CMS offers a wealth of information related to the activities required to support the implementation of ICD-10. The CMS website provides an overview of the implementation, with many materials developed by CMS to help providers, payers and vendors prepare for the implementation of ICD-10. Look for the official CMS ICD-10 logo, which identifies those materials which were developed by CMS and are intended for industry use.