The first steps that a practice should take are assessing the impact on the practice including a system inventory. Switching to ICD-10-CM will affect the practice management system and electronic health record and/or any other billing systems.
Physician practices should not have to implement new technology to use ICD-10-CM, however new encoding software may be needed to meet the requirements of the new code set to improve accuracy of coding.
Early preparation is vital to survival in rheumatology practices. Using a phased approach with a preparation checklist has proven to be the key to success in countries where ICD-10 is currently in use as it allows for resource allocation over a number of years, rather than all at once. Listed below are key areas that should be taken into consideration:
- organize an implementation effort
- develop a communication plan
- conduct an impact analysis
- estimate a budget cost analysis
- contact system vendors
- education and training for staff
System Changes
The first challenge in implementation for physician practices will be upgrading the systems. Physicians will need to begin the process of identifying what systems will need to be upgraded and making contact with vendors to coordinate the work.
Tips for implementing system changes:
- Verify with your vendor early to determine the timeline to have systems upgrade.
- Confirm when the vendor will be available to install the system upgrades.
- Coordinate the timing of the electronic and manual system changes.
- Keep staff up-to-date with changes, timeline for completion and expected times for training.
Staff Training
Staff training is a key area for physician practices – it is a good time to identify specific individuals to be the main contact for development and training of ICD-10. Coding supervisors or lead coders can be assigned to training and information on the code sets while practice managers and/or managing physicians can be involved in the impact assessment and transition planning.
The key staff members that will need the majority of training are those involved with coding and documentation. The list below identifies practice staff and the level of training needed:
- Administrative staff (e.g., schedulers, receptionist, etc.) will only need an overview to give a general understanding of the new structure of ICD-10 codes
- Clinical staff (e.g., physician assistant, nurses, nurse practitioner, etc.) needs training on the clinical concepts and level of detail in ICD-10 to promote better documentation.
- Physicians and coders will require the most training on the new code set. It is essential for this group to clearly understand the new code structure, coding guidelines and conventions to deliver the highest level of specificity in coding for ICD-10.
Tips for staff training
- categorize which staff members should receive what level of training
- coordinate the timeline for training and work with staff for completion of training
- identify the training format that will work best for your staff (e.g., classroom, web-based, conference, etc.)
- decide the amount of “downtime” for the office during training
- identify what additional resources staff will need after training
Note: Coders and billers will need to be trained and take a proficiency test in diagnosis coding – this is a good time to have your staff educated on human anatomy and physiology to prepare them for the new code set. For more information on the proficiency test visit www.aapc.com.
The College will provide education and updates for ICD-10 through webinars and the annual meetings in an effort to prepare members and their staff. For more information, contact the ACR practice management director Antanya Chung, CPC, CPC-I, CRHC, CCP at or (404) 633-3777 ext. 818.
Additional information on ICD-10 implementation can be reviewed in The Rheumatologist 2011 ICD-10 series (January, May, and October).
