How to Move Forward from the ICD-10 Delay

In our second post in our HIMSS14 Industry Outlook Survey series, we discuss the highly buzzed about topic- ICD-10. Conducted back at the HIMSS14 Annual Conference, our survey found that a majority (47%) of respondents felt that ICD-10 is the biggest topic of 2014. Knowing this, we fast-forward to today with the recent U.S. Senate vote to delay the ICD-10 compliance date by one year.

So, what do we do from here? While the start date has been pushed back, your preparations for this big change should continue.  Take advantage of the added time to adequately prepare your organization and to protect its financial health.  Below are a few consideration points to assist you in your planning:

  • Risk Assessment Matrix – continue your efforts to maintain and update and this important tool.  It can be used to highlight the different aspects of an item’s impact.  Within the matrix include each entry’s normal and unexpected duration, the possible negative outcomes and at least one strategy to lessen each undesirable outcome, the responsible party for mitigation steps, possible mitigation alternatives and interdependencies between entries.
  • Contact your clearinghouse and inquire if they will sign up to formally test with CMS.  This one point could greatly reduce your risk by ensuring your clearinghouses’ state of readiness.
  • With your newly added time, begin to think of and explore strategies that would allow your organization increased flexibility to remain fluid.  Think of alternative means other than increasing your Days Cash on Hand.  You now have additional months to prepare over the next fiscal year.
  • Auto insurance, property casualty and liability, and workers compensation payers were not required to move to the new code set.  Determine the percentage of claims these groups represent to accurately reflect them within your test script numbers.  Also consider if any COB considerations are present with these particular health plans.
  • Four medical specialties will be affected to a higher degree than others by the new code set.  Orthopedics, ObGyn, Neurosurgery and Internal Medicine deal more frequently with clinical areas that have the most dramatic increases in code expansion.  Refer to the CMS chart below to identify scenarios your test script basis should include.  Consider increasing the number of test scripts which correlate to these areas.


Stay tuned for more Industry Outlook Survey follow-up!

Thank you,

Jonce’ Smith
Soarian Financials Practice Director

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