ICD-10: 28 Days Later

Mike Mast

The October 1st ICD-10 deadline had the potential to be a real-life horror movie.  Not a movie that featured zombie-like creatures terrorizing civilization, rather a movie that consisted of denied claims, late or incorrect payments and revenue operations in massive disarray. However, as we make our way towards the end of October, we are seeing that ICD-10 largely hasn’t had a material negative impact to the overall healthcare financial landscape.  In fact, some have openly wondered whether or not the industry has overstated the risk of ICD-10 interrupting operations and even equated ICD-10 to the Y2K situation from more than a decade and a half ago.  The reality is that the challenges related to ICD-10 were not science fiction.

To ensure readiness, GE Healthcare has been helping provider customers prepare for ICD-10 for years, yes, for years.  I’d like to highlight a couple of things that helped ease the ICD-10 changeover:

  1. Customer Community – The online ICD-10 Customer Community launched April 2013 and presented customers with the opportunity to access training, collaborate with other customers and receive timely communications from GE Healthcare ICD-10 Readiness staff. An interactive community was created via the GE Healthcare IT Service Portal to enable customers to engage with GE ICD-10 experts in discussions and to access ICD-10 readiness resources in one location
  1. Analytics & monitoring – Analytics plays a major role in monitoring ICD-10 performance. As described in Health Data Management, GE can enable customers to identify reasons for denials and find patterns that establish root causes for denials, information that will help identify any “hidden” ICD-10 denials. The Centricity™ EDI Services team also built an analytics tool designed to enable staff to monitor front-end claim rejections, adjudication denials and reimbursement rates (% paid and % allowed) where ICD-10 issues may manifest with electronic claims and remit. By comparing ICD-10 rates and trends versus ICD-9 rates and trends we can identify outliers on a payer, provider group and organization level and take proactive action.
  1. ICD-10 ready software – GE began delivering ICD-10 ready software for revenue cycle in 2011, giving customers ample time to upgrade to an ICD-10 ready version. This early availability enabled healthcare organizations to put IT infrastructure in place and then focus on process and training.
  1. ICD-10 Readiness Training – A comprehensive complimentary education plan was created to drive awareness to preparation resources, provide important product notices, and drive a cross customer dialogue on overall ICD-10 readiness

The above are just a few examples of how GE Healthcare collaborated with revenue cycle management clients to make ICD-10 a non-event.

At GE Healthcare, customers determine our success and, at the end of the day, we must measure the effectiveness of our ICD-10 preparations through the eyes of our customers. While attending the annual MGMA conference, Cindy Nyberg, CFO of Raleigh Neurology Associates, PA shared her ICD-10 experience with me:

“We worked closely with GE Healthcare, who provided both guidance and ICD-10 ready software in order to help us prepare for the ICD-10 transition. We have experienced excellent results that exceeded all expectations!”  Cindy continued by saying “On October 2nd while I listened to the keynote speakers at the Centricity Healthcare User Group (CHUG), I watched our first ICD-10 claims process on the Centricity EDI Services dashboard and our first payer accepted our ICD-10 claims in less than one hour from filing.  The total results of our first day were 591 claims with only 8 non ICD-10 rejections.  On October 12th we received our first ICD-10 reimbursements.  To date we are making adjustments and providing training as necessary to address normal denials only and all services are being paid.  Plus, our providers are have maintained full schedules with little to no complaints! I’d like to congratulate the team at GE Healthcare who helped prepare us for ICD-10.”

ICD-10 had the potential to be a horror movie.  And, while the movie is not quite over, twenty-eight days into ICD-10 it looks more like a documentary on how the healthcare industry can successfully prepare for and execute a massive industry-wide initiative.

 


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