ICD-10 Goes live October 1st 2015

Finally! After all these years, one announced delay by CMS and hundreds of thousands of hours of work effort, we are on the doorstep of ICD-10! I had the privilege of working on this project from planning to execution at my healthcare provider and it was something like the equivalent of the Y2K project. We reviewed the application inventory, reached out to the vendors to understand their plans, worked with our EMR vendor to understand the way in which we needed to see which records in the system that we need to update and then reviewed those to understand what the work effort would be. We identified our team members, put together a project charter, a master test plan for our pre-test, unit test integrated testing rounds 1,2, 3 with the payers and finally User Acceptance Testing with the providers. We built our project management protocol and work breakdown structure and kicked off the project.

With all of the testing that has hopefully happened within healthcare provider and payer organizations this year, ICD-10 codes should be good to go when you go to the doctor and they then file a claim to get your ambulatory visit or inpatient treatment paid for by insurance, but nevertheless, you may want to wait a while if your visit isn’t of an urgent nature; just in case the physician has forgotten how to use that new tool in the EMR system that helps them with putting in the right specificity for the diagnosis that they used to remember the old ICD-9 code for the last 40 or so years.

Hopefully by now, healthcare provider organizations have kept about 6 months of reserves on hand or have worked with their financial institution to have those funds available to them in case they are required due to claim backlogs. Time will tell through financial reports whether their is truly concern about whether ICD-10 codes are revenue neutral for the organization or not.


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