Healthcare Law Blog

The ICD-10 switchover: It’s here – are you prepared?

The day of reckoning is upon us – October 1^st has now come and gone, and there was no other delay of ICD-10 implementation (the earliest proposed date of implementation was October 1, 2011, which was pushed back to October 1, 2013, then October 1, 2014, then the final deadline of October 1^st of 2015 – there are only so many times one can press the “Snooze” button on ICD-10 implementation, apparently). The implementation of ICD-10 is in full swing, and healthcare entities that were unprepared will be feeling a significant impact if they have not begun the process. The importance of ICD-10 readiness cannot be understated, and healthcare entities that have yet to work on Phase 1 of implantation should understand that it isn’t too late to get ready for the change.

The switchover to ICD-10 is far more than a mere change in coding. This switch will affect nearly every part of a healthcare practice, and the Centers for Medicare and Medicaid Services will not grant tardy providers an extension on this deadline. A practice that is not ready to submit claims under the new coding will likely see claims rejected, so preparation is paramount.

So, where to begin? There are plenty of paths to ICD-10 readiness, but the majority of them break down into a few simple areas. First, have you confirmed that all of your vendors and vendor systems are ready to make the switch? If the vendors and systems are not ready, implementation of ICD-10 may require replacing noncompliant systems, which will have even more impact on the entity’s bottom line.

After that, are all of your billing personnel and staff responsible for coding trained and prepared for the change? Have you identified all the clinicians who will be affected by the change and trained them to make the switch? Training on the new system may be the most crucial piece of the switchover puzzle, and every level of the organization, from senior management down, must become aware of how the switchover will affect them and learn to adapt to the new system.

The final question is whether you reserved the funds to carry over your entity through any issues with the revenue cycle that occur as a result. While larger hospitals and healthcare systems may be ready for the rollout, the most vulnerable entities are smaller practices such as physicians groups which may not have the cash reserves on hand to weather a break in cash flow due to the ICD-10 switch.

The switchover to ICD-10 may be complex and will likely cause headaches, but it should bring with it more efficiency in submitting claims with added specificity in diagnosis. It’s never too late to prepare for the change, and the Healthcare Practice Group at McBrayer can help your organization assess and implement changes under ICD-10. Hurry, though – time is running out…

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This article does not constitute legal advice.