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COMMENTARY


ICD-10 conversion Now is not the time to implement, now is the time to learn


BY DENNY FLINT We had just finished a statewide swing talking to physicians about ICD-10 for a large hospital system when we had an epiphany. I’m not talking about your run-of- the-mill light bulb going off. No, indeed, this was a real game changer in terms of completely shifting our philosophy toward educating physicians about ICD-10. In the midst of running through our seminar content about


creating project charters and communication processes, as- sessing current readiness, con- ducting impact and gap analysis, and developing the implementa- tion plan, we realized the doctors, though politely listening, were completely not engaged. Our seminar leaders compared notes, and that’s when we had our epiphany. We realized it wasn’t push-back against ICD-10 that was causing this lack of “connec- tion.” It was that most physicians don’t know the first thing about ICD-10. How can we talk to them about impact analyses, imple- mentation planning, and budget- ing for staff training when they don’t know what ICD-10 really is? As a result, we changed our physician education strategy and initial focus. What is immediate- ly necessary is a sane, measured approach that first and foremost engages and motivates physicians by talking about ICD-10 in terms of the basic realities of what ICD-10 is and what it means for them. We must explain both the pros and the cons. The main concept physicians must understand and be pre-


pared to embrace is that the new documentation required to meet the code specificity is their primary responsibility and the key to ICD-10 success. Once understood, it is completely achievable. We gently let physicians know ICD-10 presents op- portunities for those who proactively prepare, and there are


valid long-term benefits: fewer medical necessity denials, less wasted time and resources on additional information requests, and the ability to create accurate acuity level databases with which to demonstrate their need for better reimbursement. When physicians understand it is really important to know


After conducting more than 50


we realize that nobody really


knows how ICD-10 will shake out.


ICD-10 readiness assessments,


their role as the cornerstone of ICD-10 transition success in terms of providing adequate documentation to code, we can clear the obstacles to the implementation pathway. Moreover, for many specialties, the number of new documenta- tion elements that physicians and their staff must learn number in the dozens and should be their main focus, instead of fixating on the increase to “ALMOST 70,000 ICD-10 CODES!” After conducting more than 50


ICD-10 readiness assessments, we realize that nobody really knows how ICD-10 will shake out. What we do know is that it doesn’t seem to be as daunting a task for physicians as most (ourselves included) seem to be making it out to be when the correct pro- cess is followed and ample time is given. Thanks to the delay in implementing ICD-10 until 2014, we now have that time. Teach- ing physicians about the new code set specificity and requisite documentation applicable to their practice is what is important right


now. The technology available today, combined with the speci- ficity of ICD-10, makes accurate code selection based upon complete documentation even easier than with ICD-9 and its 14,000 codes. ICD-10 implementation needs to be a phased approach with one phase as a prerequisite for the next. The good news about the delay is that we have time to roll out these phases to physician practices in a cost-effective and reasonable way that


September 2012 TEXAS MEDICINE 41


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