October 1, 2015. Why is this date extremely vital for your specialty-specific medical practice? One word: ICD-10-CM. ICD-10-CM has to be fully implemented in your practice by this date – or else all of your insurance claims for clinical treatment after this deadline will be denied. Therefore, some major preparations are necessary to continue receiving insurance reimbursements for your medical services. To assist you in your ICD-10 journey, we would like to give you 6 tips on how to execute a smooth and successful transition with the least number of road bumps along the way. Naturally, the earlier you and your personnel begin to actively get ready, the easier it will be to monitor your revenue cycle after October 1, 2015. Therefore, don’t procrastinate on ICD-10 until the last minute.

The disruptive nature of the transition to ICD-10 poses serious questions for specialty practices; and while we’ve worked to address many questions in this blog, including how ICD-10 works, key differences between it and ICD-9, steps for preparing your clinical functions and readying your overall practice, and how an EMR can minimize ICD-10 disruption, there still is one lingering question: Do we really need it?

Have you implemented certified EMR/EHR technology in your specialty practice? The 2009 American Recovery and Reinvestment Act (ARRA) required reimbursement penalties for all Medicare eligible healthcare providers who do not comply with Meaningful Use.

Most specialty practices set aside ample time for software systems training when implementing new technologies. It’s typically all-hands-on-deck for vendor training during EMR implementation, and many host topic-specific training sessions to support meeting Stage 2 requirements for practices that pursue meaningful use. In addition, most practices that bill any insurance companies are currently focused on training in preparation for the ICD-10 transition. But what about the long stretches in between milestones?

ICD stands for International Classification of Diseases. This international standard is used to document all different types of diseases and other health-related conditions in many official medical records. Most member states of the World Health Organization (WHO) started using ICD-10 (the most up-to-date version) since 1994. The United States is one of the few WHO members that still uses ICD-9 and has not yet transitioned to ICD-10.

For specialty practices large and small, optimizing functionality is a common concern, especially when taking into account future changes beyond Meaningful Use, the transition to ICD-10, and other heathcare mandates.

The most recent delay in the ICD-10 transition was due, in part, to issues with vendor readiness. Another delay is extremely unlikely, yet readiness remains a potential issue with some suppliers. In fact, a recent survey from The Workgroup for Electronic Data Interchange (WEDI) revealed that only 40 percent of healthcare providers have “complete” solutions for ICD-10, an improvement of just 15 points compared to 12 months earlier, despite the extra development time. Specialty practices that rely on the remaining 60 percent of vendors whose solutions are not complete for ICD-10 should consider two key questions: How can I gauge whether my vendor will be ready in time? What represents sufficiently “complete” vendor software and services?

While most discussion of the October 1, 2015, transition to ICD-10 focuses on the billing function, ICD-10’s impact will extend significantly to the clinical side of practices as well. Documentation captured in electronic medical records (EMRs) must give coders information that supports the new coding standard if claims are to be accurate and complete. Fortunately, providers have less learning ahead than coders do. And unlike coders, they don’t have to wait until the transition date to begin actually performing in ICD-10 terms. They can, and should, start soon. Clinicians who are not yet familiar with the impact of ICD-10 on their function can read a two-page summary titled “Effects on Clinical Documentation” in the CMS ICD-10 Implementation Guide for Small and Medium Practices. In addition, each practice will want to form a game plan for readying clinicians for the effect the transition will have on its particular specialty.