Worrisome ICD-10 Fallout Seen in Smaller Hospitals

The press has published many positive overviews about the ICD-10 transitions of the country’s largest and/or most advanced hospital systems since the October 1 go-live. This post focuses on smaller community hospitals and health systems, many of which were not as well prepared. Though it is too early to measure revenue cycle impacts, the challenges that some hospitals are  having may equate to financial disruption by the end of the year.



ICD-10 Troubles? It’s Quality Improvement Time

As your hospital already may have discovered, October 1 was not the end of its ICD-10 conversion.

For many of you, the transition thus far is going relatively well. According to the Advisory Board, post-October 1 has been uneventful, because the hospitals it has worked with “have done so much preparation that they’re eager.” Their clients, some of the largest hospitals and health systems in the country, have spent millions preparing for as long as four years. But, actual claims payment trends won’t start being available for weeks, so no one should be sighing with relief quite yet.

In the meantime, as of Day 8,  we at Phoenix (and colleagues from other firms) are beginning to see smaller hospitals and healthcare providers that are in trouble.  For them,  it’s already time for the next phase of ICD-10 — quality improvement.



It’s ICD-10 Day! Now The Devil Is In the Doctor’s Details

ICD-10 is here, and you are ready. Yes.  But, what about your physicians?

Systems are tested, billing processes are updated, coders have done their homework, contingency plans are in place…I won’t bore by repeating the ICD-10 mantra that has been pushed out to you for years. But don’t stop reading quite yet, please.

This post is about clinical documentation… which could very well become some hospitals’ undoing. We know that many physicians are not ready for ICD-10. Yet they are the linchpin of your hospital’s ICD-10 transition going forward. Despite how thorough preparations have been, if your physicians do not document with sufficient detail, they will stall your transition and immediately begin threatening your cash flow. We have some last-minute thoughts and suggestions.



Post-October 1 ICD-10 Operations: Rocky First Steps

Chances are if you are reading this, you have been directly involved in your organization’s ICD-10 compliance effort —  and are both looking forward to October 1, and a bit nervous. Your team is probably working on last-minute items such as final testing, physician training reinforcement, coding “practice…practice…practice, ” and much more.

October 1 is not, however, the end of ICD-10 implementation, despite common misconceptions.  It is merely the date of an important transition, which, per the sage Merriam Webster, is the “passage from one state or stage to another.” October 1 represents the end of the first phase of ICD-10 work — focused on a single goal of implementing systems, processes, and procedures that support the generation of ICD-10 coded claims. What happens after October 1? Very possibly, a path that is slow and not automatically smooth.



Your ICD-10 War Room: It’s Time to Mobilize

Hospitals are focused on last-minute efforts needed before the monumental ICD-10 transition facing them.  As they should be.

But, critical as final pre-October 1 task requirements may be, hospitals also must have a strong, defined strategy for what to do on and after October 1. Even in the best-prepared organizations, the adage “If things can go wrong, they will go wrong.” applies. Magnify that expectation to the extreme, if your hospital is one of the many that have been playing serious ICD-10 catch-up over the last few months. It’s time to set up a War Room.



Six Superb Resources for Just-in-Time ICD-10 Success

Over the last three years, we’ve published many blog posts, articles and infographics about ICD-10 that have been warmly received — for which we thank our readers! Today, I’m turning the tables and recommending six of the best ICD-10 resources on the web. If you’ve never visited some or all of these sites, you’re in luck. Even if you think you’ve seen all that these sites offer, take a close look below at many of their hidden gems.



New CMS ICD-10 Test Results: Is the Cup 87% Full or 13% Empty?

CMS has announced successful results of its latest ICD-10 testing week in July. However, the test achieved only an 87% claims acceptance rate, similar to rates in January and April. Consider that these results, released just 35 days before the compliance deadline,  also mean that 13% of claims were not accepted. The industry should be concerned.



ICD-10: Many Hospitals At Risk of Non-Readiness on October 1

Though WEDI’s new ICD-10 Survey report tries to send a positive message about the healthcare industry’s readiness for ICD-10, the results leave much room for concern. A close look at the survey data indicates that numerous hospitals may be at great risk of not being ready to submit claims accurately in ICD-10 by October 1, the compliance deadline. Many industry professionals are worried about inadequate preparedness of a large portion of hospitals, particularly smaller facilities. Left with only weeks to prepare, it appears that their operations are at risk for major disruptions.



ICD-10: How to Minimize Coding Slowdowns [Free Guide]

With October 1 fast approaching, many providers share a concern that the transition from ICD-9 to ICD-10 coding holds the potential for dramatic reductions in coding productivity.   Inadequate and/or under-prepared staff, insufficient documentation, and unexpected issues causing coding mistakes  will cause an overall slowdown that will directly impact revenue cycle continuity. While an initial decrease in productivity may be unavoidable, the degree and duration of impact will vary depending on each provider’s preparations and resources.

We have developed a free guide intended to help you minimize these impacts — or simply serve as a double check on your ICD-10 preparations thus far.



CMS Sends a Small ICD-10 Lifeboat — But Only to Physicians

Physicians’ practices have been so slow to prepare for the ICD-10 transition that the American Medical Association (AMA) and other physician groups have warned of a healthcare industry crisis starting October 1, the ICD-10 deadline. They have strongly campaigned for a reprieve for physicians, supporting one Congressional bill that would kill the ICD-10 initiative outright, and two others that would delay penalties for up to two years. CMS has answered the call by announcing new relief measures  — for physicians and eligible professionals (EPs) only.