If there’s an October surprise, it may be that the transition to ICD-10 went off without a hitch. For many organizations, however, the surprises will be less welcome and may take weeks or months to reveal themselves.
No matter how smoothly the switch to ICD-10 may have transpired, after 36 years of using ICD-9-CM as the backbone for payment data, reports, and diagnosis and inpatient procedure coding, healthcare there are bound to be a few problems, experts say.
“Depending on how prepared the organization or facility is, they could see different issues,” says Melanie Endicott, senior director of HIM practice excellence at the American Health Information Management Association (AHIMA). “There are facilities out there that have been doing dual coding for a year or six months or longer. They’ve had lots of practice, and will be able to jump right in.”
She cautions against overconfidence, however. “Some issues that weren’t identified will come to light. That’s why it’s important to get onboard and get everything ready.”
ICD-10: Five Things Payers Want Providers to Know
Lynne Thomas Gordon, CEO at AHIMA, agrees, and compares the adoption of the new coding system to having a baby. “As any parent would know, the real work begins after you have the baby. Similarly, we need to make sure the correct metrics are in place, see how we’re doing with quality, and stay on top of productivity.”
Lynne Thomas Gordon
Here are a few post-implementation ICD-10 problems providers may encounter:
Incorrect Code Mapping
“The ‘gotchas’ will be [associated with] legacy systems people were attached to because they got the job done,” says Thomas Selva, MD, chief medical information officer for University of Missouri Health Care. He recently oversaw his organization’s ICD-10 implementation. For example, the EHR/EMR system may still be mapping to ICD-9-CM codes. “I can guarantee that will crop up.” The trick will be to quickly identify whether this is happening and to be able to fix it promptly.
Another problem: Not all reports will generate the same data as before, and may need to be re-built. “It will take at least a year until people have enough data to compare apples to apples,” says Gordon.