ICD-10 Transition for Behavioral Health: Let’s Start at the Beginning

For any ICD-10 Transition to happen successfully by October 1, 2014, we need to start at the beginning and ensure our organizational preparedness strategies are in place.  Change is not easy and this transition will require large-scale processes and cultural changes that touch every part of our business operations. I sometimes tell people: “Think of this transition as being like your EHR selection and implementation process.” That comment emphasizes the depth and magnitude of the ICD-10 Transition. How does an organization begin this process?

Leadership: C-level and other organizational leaders need to realize this will be time-consuming, require resources, and that it will involve reviewing everything from clinical documentation practices to third-party contract language. The leadership then needs to support the time and efforts necessary to make the transition happen in a manner that is timely and minimally disruptive. Of course, anything that can threaten potentially serious revenue-cycle disruption tends to get everyone’s attention.

ICD-10 Transition Team:  Your organization needs to put together a team of interested and key stakeholders to drive the transition project and keep it on track. There is a long list of to-dos and tasks that must be accomplished well before October 1, 2014. Project management, prioritizing, communication, and dedication to the project are required skills for any member of the ICD-10 Transition Team. At a minimum, a representative from each of the following departments should be present on the team: Fiscal/Billing, Clinical, Contracting, Quality Improvement, and IT Systems should be on the Team. The Team leader should be well-respected within the organization so that when difficult news must be delivered, it can be heard.

Internal Communications:  It is imperative that every single employee understand what is about to happen, and when. It will be the job of the internal ICD-10 Transition team to communicate timelines, progress, challenges, and successes throughout the organization. This can take the form of an internal Intranet, bi-monthly email update, updates at staff/department meetings, or the posting of ICD-10 Team meeting minutes in the lunchroom.

External Assistance:  The ICD-10 transition will be bumpy. Polls from fall 2013 indicate many “smaller” healthcare entities have not even begun the transition process.  I also hear about EHR vendors who are struggling to transition themselves and about State Medicaid agencies whose teams are all over the map in terms of their ICD-10 decision-making and readiness. The transition situation in the behavioral health industry is further complicated by the need for providers to ensure that any ICD-10 transition process ensures and maintains consistency with newer DSM-5 diagnoses and criteria. Successfully navigating this maze will require significant learning, experience, and skill. If your ICD-10 team does not know where to begin, start by consulting CMS.gov for the fundamentals.  Ultimately, you’ll need your own, organization-specific transition plan to get this transition done. 

Have questions about the ICD-10 Transition in the health and human service industry? Please contact me at lwright@behavioralhealthsolutionsmn.com.