Should ICD10s Affect Your EHR Strategy?

On October 1, 2014, practices will start submitting claims using the ICD10 coding system.  Any practice planning on using EHR systems to facilitate the transition to ICD10 needs to take a close look at the practicality of implementing an EHR in time to support ICD10 coding.

The move to ICD10 will be dramatic and challenging.  The ICD10 coding system uses a level of specificity beyond the ICD9 system and requires more details that match up with the CPT code.  For example, ICD10 codes may include site and severity information which will have to be consistent with your procedure codes and modifiers.

In order to use an EHR to support your ICD10 coding challenge, you cannot expect to address ICD10 coding a in the middle of your EHR effort.  Indeed, you will want to have completed the rollout of the EHR before you tackle the ICD10 challenge.  Consider the following calendar issues as you plan ahead to meet ICD10 coding with the help of an EHR:

·         Selection of PMS and EHR products can take 2 to 4 months or more before you have finalized your decision.

·         Implementation of an EHR can take 4 to 6 months depending on a variety of policy, and practice issues.

·         Once the EHR implementation is complete, your practice will need 4 to 8 months to transition individual patients to the EHR.

·         If you will be replacing your PMS system as part of your EHR project, allow an additional 4 to 6 months for your project.

A full PMS/EHR project can take anywhere from 10 to 18 months or more.  Considering that you should be ready to focus on ICD10 by the beginning of the summer of 2013, it is not too early to tackle the EHR project on your critical path to ICD10 compliance.

Note that differences between ICD9 and ICD10 coding systems will probably lead to changes to the EHR and PMS systems that you use leading up to the ICD10 start date.

Depending on the size of your practice, you need to be well along on your transition to an EHR before you focus on the transition to ICD10.  Otherwise, you could be facing overwhelming uncertainties in your clinical and billing operations that could lead to disruptions in patient service, clinical operations and cash flow.