Breaking News: ICD-10 Transition Delay

Precyse advises clients to use this time to focus on CDI, training and process improvement
Wayne, PA and Alpharetta, GA Apr 1, 2014 — Yesterday, Congress passed the Sustainable Growth Rate (SGR) Bill that extends the proposed physician rate reduction for one year, but which also includes language that delays the compliance deadline for converting to the ICD-10 system of diagnostic and procedural coding from October 1, 2014, to not before October 1, 2015. President Obama is expected to sign the bill today.
“Like everyone in the industry, Precyse has been closely watching the developments related to the SGR Bill and its effect on the transition to ICD-10. We are disappointed with the vote as our clients have spent considerable time and resources ensuring preparedness for October 1, 2014” said Chris Powell, president of Precyse. “However, this change to the legislation cannot deter us from our goals to improve the overall level of clinical documentation that will in turn improve the quality of the data that will drive the delivery of the best health care in the world.” Consistent with our advice the last time we experienced a delay in ICD-10 implementation, we believe there is still no time to procrastinate. Providers should use this delay to continue staff education efforts, improve their clinical documentation processes and build a strong foundation for process improvement and downstream strategic initiatives embarked upon under the Affordable Care Act.
ICD-10 will provide clinical and financial benefits to help us drive better clarity about the care that is being delivered. It is critical to stay vigilant and continue to focus on training and developing coders, CDI specialists and others who will use the data and convert it into meaningful information. ICD-10 is a measure of quality. Hospitals and physicians aspire to offer world-class care. Precyse will do our part by accurately capturing, organizing and tagging the clinical data that leads to that outcome. Precyse has not stopped preparing for the implementation of the new coding rules and stands ready to support and meet the needs of our nearly 5,000 clients, many of whom already rely on our management, staffing and technology solutions, through our training and implementation process. Because Precyse not only supports, but also operates entire HIM and coding departments for some of our clients, we recommend three key areas of focus throughout the next 18 months.
Documentation
Providers should increase clinical documentation training programs for physicians and other caregivers. This includes developing processes, guidance and support for improved clinical documentation under ICD-9 to be better prepared for ICD-10. Improved documentation skills – even minor changes such as more specificity in notes – create obvious financial and non-financial rewards: fewer claims denials, reduced audit exposure, improved case mix index and improved cash flows. Most importantly, patient care is improved when downstream clinicians can review and rely upon more complete chart notes, and better data is available for analytics and comparative studies. It is essential to target high-volume specialties within each organization most impacted by ICD-10 and train these specialists in proper documentation while training the coding team on the new coding system, then move to the next specialty for training.
Build a Strong Foundation for Process Improvement
Providers should assess the flow of information across its organization and develop a plan to address gaps through process improvement and technology. Invest in automated systems that streamline the entire clinical documentation process. ICD-10 will not be just about retraining medical coders – it is about having better data about patients and their treatments, affording vast opportunities for improvement in data capture and processing. This leads to a more complete and useful set of codes, which is crucial in a fully automated electronic medical record environment. Today, inefficient, labor-intensive workflows abound, whether involving clinical information inputs such as dictation and transcription; approvals, coding, physician queries and other myriad facets involved in billing for services; or abstracting and analyzing quality indicators to improve patient care. We also recognize the promise of new innovations such as automated speech recognition, Computer Assisted Coding using Natural Language Processing (NLP) and clinical decision support tools – but know that realizing their full promise tomorrow requires that we improve how current users interact with and use their systems today. As a member of the healthcare information management/information technology community, we must use our skills to innovate for clinicians. We must develop workflow platforms and applications that allow healthcare providers to do their jobs more efficiently and effectively. We do not want to add more time and complexity to an already challenging process.
Training and Development
Continue to invest in the training of coders, auditors and those who will use the data. Improve the basic skills of your coders and auditors in ICD-9 areas that will also be required in ICD-10. The transition to ICD-10 has pushed healthcare to appropriately invest in training our coders as skilled knowledge workers. As part of our own ICD-10 preparations, Precyse assessed the coding skills of the hundreds of coders and auditors on our staff to evaluate their ICD-10 readiness. Precyse invested in and developed a comprehensive and multifaceted online training program called Precyse University, while developing individual training plans for every coder. This investment has paid off for Precyse clients handsomely, yielding a better case mix index for hospitals, improving coding compliance audit results, increasing coder retention and attracting new coder recruits who are eager to develop and perfect their skills. We recommend that you perform side-by-side dual coding in ICD-9 and ICD-10, assessing the documentation and coding gaps, and target training based on these findings.
At Precyse, our vision is a world in which meaningful information is available, whenever and wherever needed, and helps save time, money and lives. We are an innovation company that listens carefully to our clients and prospects; every day we challenge ourselves to come back to these clients with solutions that ensure a healthy organization to promote a healthy population. We pledge to our clients and prospects that we will never stop innovating in the midst of very challenging times.