Even if the enforcement of the transition from ICD-9 to ICD-10 has been moved back to Oct. 1, 2014, it does not mean that organizations can become complacent. If they have not started the groundwork by now through ICD-10 analysis, they would have been hard pressed to meet the deadline. The transition does not exist in a micro-sphere. Even the smallest organization is connected to a larger healthcare ecosystem and any of its shortcomings will have an impact on patient service delivery and even the accuracy of government data.
Assessing from within
The new classification is different from what hospitals and health care providers are accredited to. The sheer number of the codes and the renewed focus on specificity can be a huge challenge. That means they all have to improve all their documentation and recording processes since vague codes will not be recognized under the new setup. Conducting an internal ICD-10 risk analysis will enable the company to evaluate its existing assets, procedures, information technology and staff in relation to the enforcement of the new codes. The results of the analysis will help identify the gaps in the whole system that will be negatively impacted as well as come up with recommendations in minimizing these impacts. It's crucial that organizations also recognize that adopting the codes will be useless without proper training of personnel and doctors who will be using the data from Oct. 14, 2014.
Purpose of Gap Analysis
Why is gap analysis important in ICD-10 codes implementation? The survey will help the organization to:
– Spot areas where changes have to be made in the documentation process, whether they have to add or clarify specific codes or whether they have to scrap a whole system in order to comply with the requirements of ICD-10.
– Identify the capacity of the codes specialists to read the codes to guarantee accurate billing and reporting.
– Determine if the ICD-10 codes implementation will impact on the current workflow of the organization (will it result in delays in patient reimbursements, or doctors' reporting of diagnosis, etc.)
– Determining how the new codes will impact the budgets of the organization.
Help within Reach
One of the critical steps in effective ICD-10 enforcement is to create a multi-sectoral steering committee that will undertake the ICD-10 risk analysis and if possible, handle the transition from the old to new codes. The good news, however, is that they are not left on an island by themselves. There are cost predictive tools available that the organizations can utilize so they will not have to create the evaluating protocols from scratch. Through these tools, they can determine how much of the financial impact the ICD-10 codes implementation will be in terms of their reimbursements and how prepared is the organization to deal with the new sets of challenges.