Let’s be realistic.  In case you haven’t noticed the costs of EHR and ICD 10 implementation have are will continue to be higher than expected.  But with ICD 10 my worries is that the worst is yet to come.  In another life I was a programmer and one thing I learned was that applications that require bridges among systems and platforms have a tendency to act in undesirable ways.    In a study performed by the University of Chicago (UIC), Dr. Neeta Venepalli and Mr. Andrew Boyd, found that healthcare Providers and Organizations may experience information and financial losses during this conversion. This is nothing new as several other organizations have been writing and covering this information in releases via conferences, publications and electronic media.  My concerns have been voiced by many as these relate to what I consider to be the immediate effects of the transition; revenue cycle disruptions and weak liquidity positions. In other words, payments are going to be delayed and you may not have enough money to pay your expenses. So in preparation for this transition I recommend the following steps:

1. Contact a financial institution and make sure you have a line of credit or similar instrument with enough assets to cover at least three months of operations.
2. Identify the ICD 9 codes that you most frequently and convert them into ICD 10 codes.  You may use a conversion bridge for the initial conversion such as the free one offered by ICD10data.com on their web site.
3. Train your staff and Providers.  Remember that is not only coding but documentation as well.  Since ICD-10 has a wider range of options specificity is critical.
4. Update you documents and electronic records.  Create a test superbill and customize as needed.
5. Conduct a preliminary audit.  Compare current documents standards with those that will be required under ICD-10.
6. Identify weak areas and get assistance.  Don’t be shy as mistakes, more than ever, will be costly.

We offer different types of assistance and recommend the following web sites as potential resources for all healthcare professionals. http://www.cms.gov/Medicare/Coding/ICD10/downloads/ICD-10MythsandFacts.pdf https://www.cms.gov/Medicare/Coding/ICD10/downloads/GEMs-CrosswalksBasicFAQ.pdf