Where you'll see important ICD-10 developments in 2014

By Carl Natale
08:32 AM

I hate making predictions. Mostly because I'm not very good at it. So this is not the post full of predictions on ICD-10 deadline changes or how the ICD-10 implementation will go.

That's not going to be useful even if those guesses are accurate.

The key to 2014 will be knowledge. With only nine months left to implement ICD-10 coding, that doesn't leave a lot of room for trial and error. Healthcare organizations are going to have to make very smart decisions this year. And the best way to do that is to learn from the organizations that have completed a lot of the ICD-10 transition.

Here's what you need to pay attention to:

Centers for Medicare and Medicaid Services (CMS)

CMS will keep promising Oct. 1 is the deadline. Unless someone changes their minds.

They're not going to hint about any deadline or requirement changes until the decision is firmly made.  That's not saying they will make any decisions like that. The CMS doesn't make announcements like that until everything is figured out.

And the timetable for figuring out and implementing deadline changes is shrinking. There isn't much time to make major moves. So each day that goes by only allows minor changes.

Instead of watching CMS for deadline changes, it's going to be more productive to plan for an Oct. 1 implementation. CMS is going to be sharing a wealth of tutorials and information for procrastinating providers. If we're going to need to know something, CMS is going to be a source.

Clearinghouses

Clearinghouses exist to help healthcare providers navigate the medical billing process. ICD-10 implementation will be a major detour. Because clearinghouses deal in so much volume, they're going to see problems quickly. And each solution will be applied to many transactions.

The good ones will share information on how to file proper ICD-10 claims and preserve reimbursement revenue.

They will know where the mistakes are being made. Learn from them so you can avoid making costly mistakes.

Tests

There will be major end-to-end testing efforts this year. And you may not  be able to participate in them because of procrastination, unprepared partners or homework-eating dogs. At least you can look for takeaways and lessons learned during the tests.

This is going to help you prepare and perhaps make up for testing deficiencies.

Affordable Care Act (ACA)

I can't say this enough. The fate of ICD-10 implementation is tied to the ACA in Washington. Any problem with healthcare reform makes it harder for the CMS to persuade anyone that ICD-10 implementation will be worth doing.

So watch the debate carefully. The worse the ACA looks, the more likely ICD-10 coding will get thrown under the bus.

  • Remember, it won't depend on facts. Soundbites will rule.
  • Fear will trump intellectual reasoning.
  • Any language that mimics what was used to explain or implement HealthCare.gov will be used as evidence that ICD-10 implementation will be a disaster.

It's not hard to imagine the Obama administration using ICD-10 compliance as a bargaining chip to keep the ACA.

But don't spend too much time reading the political tea leaves. Focus on the useful knowledge, and we can survive 2014.