ICD-10 Coder Training is Just the Tip of the Iceberg

In an attempt to understand how healthcare executives are preparing for the transition from ICD-9 to ICD-10, we conducted focus groups with Chief Information Officers (CIOs) throughout the country.  Our conversations were enlightening: coder training and application upgrades continue to dominate the mindshare.  While coder training and application readiness are critically important in preparing for the transition, they are only the tip of the ICD-10 iceberg.  Consider what lies beneath; an enormous undertaking requiring significant changes in the specificity of documentation by the provider. Now imagine the effort required to help providers document in this new language, ICD-10, with this new level of specificity.  A lack of appreciation for the provider role and the importance of clinical documentation will have a dire financial impact on organizations.  Leaders must recognize the importance of clinical documentation now, and align these efforts with other valuable initiatives in their organization. 

 

Planning for the ICD-10 transition is analogous to planning for a big-bang EMR Go Live happening for everyone on the same date: October 1, 2013.   Successful adoption of the new coding system requires a disciplined approach that begins long before go live and does not abruptly end on October 1, 2013. Leaders who appreciate the magnitude of change and how it will impact key stakeholders will plan, prioritize and communicate more effectively.  Their preparation and assessment of the stakeholders’ needs drives timely and relevant education and training by role.  This investment in people and process can begin now!  Improvements in clinical documentation and coding accuracy provide tangible benefits today.  The discipline of measuring these outcomes becomes a habit and serves the organization long after the transition to ICD-10.  Continuous improvement and optimization of documentation and coding requires a long-term commitment to education and measurement.  Metrics can highlight areas that require our attention and education/intervention drives improvements in those areas. 

 

Organizations who commit to the changes required for improved clinical documentation are more likely to achieve timely reimbursement for providers, improved public health surveillance and improved measures of health services quality.  Don’t underestimate what lies beneath the ice; the transition to ICD-10 is an enormous effort that will require a plan to address not just coders and applications, but also providers!