I’ve had terrible ICD-10 transition nightmares! “Night sweats!” I’ve been waking up in the middle of the night horrified that my world – my ambulatory medical practice – came crashing down when ICD-10 started on October 1.

In one dream, on the morning of October 1, I put my key in the front door of my practice and it doesn’t work. Locked out! In another dream, I get in the office OK but don’t recognize my staff… because they’re all new! And they’re all walking around the office chanting ICD-10 codes, refusing to let me see patients, telling me I’m not documenting patient encounters with the specificity needed to submit ICD-10 claims that will get paid.

But: Good news! I did get into my practice today. My office staff does recognize me. And I am seeing a full patient load. But I’m still worried! Now that ICD-10 is real, I don’t know if I’ve done everything?! And I don’t know what else I need to do, or think about, in these critical days right after October 1.

Can you help?
Still Sweating




Dear SS:

Calm down my friend! Don’t sweat the small stuff.

OK, I know ICD-10 isn’t “small stuff.” And that you and your staff DO have to “get ICD-10 right” sooner than later. But remember: The transition to ICD-10 is a process. It’s not going to happen perfectly… for any of us… and it’s not going to happen overnight.

For example, this CMS Q&A provides clarification around the July 6, 2015 CMS/AMA joint announcement and guidance regarding ICD-10 flexibilities. While diagnosis coding to the correct level of specificity is the goal for all ICD-10 claims, for 12 months after October 1, 2015, if you submit a valid ICD-10 code from the right family of codes, Medicare fee-for-service will process and not audit that claim.

That’s just one example. Everyone’s in the same boat… struggling to make ICD-10 work. “Sweat the right stuff” not “the small stuff.”

Sweat the right stuff

For you, “the right stuff to sweat” is improved documentation – more specific documentation – of each patient encounter. If you (and your provider colleagues) document each patient encounter with rigor – using more comprehensive and descriptive clinical/medical terminology throughout your documentation – you’ll be “sweating the right stuff.”

And if your medical billing and coding staff focus on best practice ICD-10 code look-ups and assignation processes – based on the accurate interpretation of your improved patient encounter documentation – they’ll “sweat the right stuff” for a better, smoother ICD-10 transition.

Don’t sweat the rest… let others sweat it for you!

The rest of my advice, for you and the hundreds of thousands of your provider colleagues, is to not sweat the rest of this knotted mess we know as ICD-10. Let someone else, or some other partner(s), share the burden. This nation has miles to go and myriad details to resolve before our healthcare ecosystem can create and process ICD-10 claims with acceptable denial levels and payment cycles.

Your EHR vendor is your best ally and partner through this painful ICD-10 transition. It’s their job to sweat the small stuff (and the big stuff too)! In addition to providing you with a robust, continually improving, ICD-10 compliant EHR solution, your HIT vendor should be front and center with proactive ICD-10 support and resources for you and your practice, every day – even 24/7 when needed!

That’s the right way to “do” the ICD-10 transition. With a tremendously experienced driver… helping drive your ICD-10 transition bus. They’ll sweat the details with you, and for you, if they’re the true ICD-10 transition partner they should be.

What makes a good EHR ICD-10 transition partner?

Here’s a snapshot of the ICD-10 support available to QSI NextGen Healthcare clients in the critical days before and after October 1:

  • Replay of “Prepare for Impact” webinar on final steps prior to October 1, 2015
  • “ICD-10 File Maintenance Set-up” webinar with billing workflows and test claims
  • “How to Apply ICD-10 Hot Fix” training
  • Weekly “ICD-10 Forum” webinar series
  • “Friendly Friday ICD-10” two-hour Q&A about configurations and workflows
  • “ICD-10 eLearning Resources” with constantly updated curriculum/content
  • “ICD-10 workflow videos”
  • NextGen Healthcare “Just in Time ICD-10 Training for Providers”
  • “ICD-10 Product Readiness Updates”
  • “ICD-10 Implementation Checklist”
  • “24/7 ICD-10 Support” for uninterrupted escalations of urgent issues requiring resolution

So don’t sweat it! We’ll do that for you.

I’m glad to hear your practice office door opened on October 1 and that your staff recognized you! Yes, things are different post-October 1. Yes, you and your staff do have to do things differently now. The ICD-10 way.

But focus on the right stuff and you’ll be fine. And it’s much, much easier to focus on the right stuff when you’ve got an EHR vendor that’s a true ICD-10 transition partner, willing to “focus on everything else” you can’t or won’t get to.

Willing to sweat the small stuff. And knowing when to make a big deal out of ICD-10 transition issues that still lurk after October 1.

No Sweat.

Dr. “Icydee Tens”
Your EHR ICD-10 Problem Solver

PS…If you are a QSI NextGen Healthcare client and require ICD-10 transition support, go to the NextGen Healthcare Client Support Center on the NextGen Healthcare Knowledge Exchange.  There are resources available to help you get your questions answered.

If you are not a QSI NextGen Healthcare client or you want a better way to track the impact of ICD-10 on your revenue cycles and cash flow, register for our complimentary revenue cycle management (RCM) webinar on October 20 from 2:30 pm to 3:15 pm ET. (You’ll be glad you did! And you’ll discover why NextGen RCM Services is #1 in overall performance by KLAS®).