Get Prepared

Care providers (includes physicians, physician offices, hospitals, laboratories)

  • Identify your current systems and work processes that use ICD-9 codes
  • Talk with your practice management system vendor about accommodations for both Version 5010 and ICD-10 codes
  • Discuss implementation plans with all your clearinghouses, billing services, and payers to ensure a smooth transition
  • Talk with your payers about how ICD-10 implementation might affect your contracts
  • Identify potential changes to work flow and business processes
  • Assess staff training needs. Identify the staff in your office who code, or have a need to know the new codes
  • Budget for time and costs related to ICD-10 implementation
  • Conduct test transactions using Version 5010/ICD-10 codes with your payers and clearinghouses
  • Factor in any abnormal cash flow disparity post implementation from a contingent situation

Payers (includes insurance carriers, fiscal intermediaries, clearing houses)

  • Incorporate a team to handle ICD-10 implementation
  • Start an intranet resource for ICD-10 implementation team to share/update information
  • Assess and identify processes/systems using ICD-9-CM
  • Allocate adequate financial and human resources for smooth transition to ICD-10
  • Provision a system to look up archived ICD-9-CM data post ICD-10 implementation
  • Assess staff training needs and provide them with adequate online training, as to minimize their absence from work while at training
  • Prepare for implement of Version 5010, the transaction precursor of ICD-10
  • Review vendor readiness and assess their game plans for smooth ICD-10 implementation
  • Conduct adequate test transactions using Version 5010/ICD-10 codes

Vendors (includes EMR vendors, coding and billing software developing companies):

  • Start a team of core staff with goal of successful migration of all clients to ICD-10 implementation
  • Assess client requirements and SOPs at various levels
  • Provide emphasis to hire/train adequate human IT resources
  • Identify/train human IT resources to include general equivalency mappers (GEMs) offered by CMS to discern the divergence between ICD-9 and ICD-10 and use the reimbursement mapping
  • Engage clients to provide them regular updates, upgrades, any changed deadlines until smooth transition of each of your clients to ICD-10