Healthcare providers have just over a year until the implementation deadline for ICD-10. While that may seem like a long way out, that time is sure to fly by, particularly for those clinics or hospitals still struggling to incorporate new chiropractic EHR software that will help bring their recordkeeping needs fully up-to-date. 

One of the key elements about ICD-10 readiness is knowing just what exactly you're getting with this new system. With tens of thousands of new codes available, ICD-10 will not be especially quick or easy to master, and those complications have ended up creating a number of misconceptions around what ICD-10 does and doesn't entail.

To help clear the air and better prepare providers for next year's deadline, Sue Bowman, senior director of coding policy and compliance for the American Health Information Management Association (AHIMA), has identified and debunked two of the most common misconceptions surrounding ICD-10:

There's no need to replace ICD-9: 

ICD-9 has been around for 30 years, so naturally many in the industry have become comfortable with it. However, this familiarity has led some to believe that ICD-9 doesn't need to be replaced at all, and that clinics would operate just fine without the new system. As Bowman notes, though, ICD-9 is becoming increasingly obsolete, incapable of keeping up with current and future medical practices, knowledge or terminology. Health IT programs are always improving, and clinging to the decades-old ICD-9 would keep providers not only out of the loop, but also unable to coordinate and interface with new advances in EHR technology. 

We should just wait for ICD-11:

One of the chief concerns behind the latest ICD-10 delay is that it places the deadline right up against the World Health Organization's (WHO) planned start date for ICD-11, which is slated for implementation just two years later in 2017. So then why bother with ICD-10 at all? Wouldn't it make more sense to stick it out with ICD-9 for a couple more years then skip over to ICD-11?

While that may make sense on paper — after all, why go through the logistical difficulties of ICD-10 if it'll only be replaced two years later? — the fact is that WHO's release of ICD-11 does not mean that the system will be immediately ready for use in the U.S. There are a number of steps that need to be taken by both Congress and stakeholders to create a version of ICD-11 tailored to use in the U.S., all of which could take up to a decade, if not longer. Staying with ICD-9 during that interim would mean several years of increasingly outdated coding for the healthcare industry.

New EHR chiropractic software can help bring a practice further into the 21st century, with more flexible codes, improved patient care and streamlined recordkeeping.

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In its latest provider survey, EHR review group Software Advice found that 40 percent of respondents were looking to replace and update their practice's EHR software.

Industry news source Health IT Outcomes reports that the most commonly-cited reasons by providers aiming to upgrade their EHR needs were their system being "too cumbersome" and slow to use, or that they were lacking in integration for billing and scheduling applications. According to the survey, Meaningful Use certification, mobile support, lab integration and e-Prescribing functionality were the most sought-after features in a new EHR package. Additionally, 39 percent reported wanting an EHR system that they could use with their smartphones or tablets.

"Buyers purchasing an EHR system for the first time were primarily concerned with improving their practices' organization and efficiency, with many mentions of wanting to 'streamline' operations," wrote Software Advice in its official report. "Another major factor for first-time buyers was the general desire to go electronic. This included references to the practice need to reduce or eliminate paper (there were several references to 'mountains of paperwork'), as well as the higher-level desire to 'join the 21st century' or modernize the practice."

According to the hospital publication Becker's Hospital Review, the number of providers looking to upgrade their EHR software grew by a whopping 30 percent over the past year, since Q1 of 2013.

With new compliance standards like Meaningful Use Stage 2 and ICD-10 sweeping across the industry in the coming months, it's more important than ever for a practice or clinic to ensure that their chiropractic EHR system is brought up-to-date. By adopting the best chiropractic EHR software, providers can streamline administrative and recordkeeping duties, improve patient care and even reduce related costs.

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Despite facing its third, and perhaps most frustrating, delay yet, ICD-10 still has plenty of positive changes to offer the healthcare industry — as long as clinics and practices are ready for the transition.

This is according to the American Health Information Management Association (AHIMA), which convened an ICD-10 Summit last April where stakeholders expressed both concerns and optimism for the new coding system. Although the meeting is three months old, the reactions among its attendees were just recently published by EHR Intelligence, which noted that mixed feelings surrounding the latest ICD-10 delay have bred a higher degree of skepticism that the system's proponents will have to overcome by shedding light on the promised positive repercussions. These include added benefits for billing purposes and improved patient care experiences.

At the same time, these benefits can only really be achieved if vendors and healthcare groups work together to ensure that clinical documentation, staff education and software testing have all been thoroughly completed in time for the October 1, 2015, deadline.

"There is a risk that an extension in the ICD-10 compliance date will not ensure widespread industry readiness," writes Meryl Bloomrosen, Anne Zender and Sue Bowman of the AHIMA. "As has been observed with previous delays in ICD-10 implementation, extra time does not necessarily guarantee that all entities will achieve readiness by the new compliance date. There are concerns that rather than using extra time to their advantage, entities that have been consistently been behind in preparedness may continue to lag behind."

Ensuring that your practice's chiropractic EHR software is up-to-date can help alleviate these worries and offer a smooth transition, yielding all of the benefits of ICD-10 without any disruptions to daily workflow.

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The World Health Organization (WHO) endorsed ICD-10 as a replacement for ICD-9 back in 1990. In just three years from now, that coding system will be phased out for its successor, ICD-11. Over this nearly 25-year period, 117 countries around the world have adopted ICD-10 as part of their healthcare coding practices — but the United States isn't one of them.

So this begs the question: Why exactly has the American healthcare industry been dragging its feet on implementing ICD-10 when every other developed country has already been using it for years, if not decades? According to EHR Intelligence, the problem ultimately boils down to the primary difference between how the US and the rest of the developed world approaches healthcare, specifically in regards to billing.

"Whereas much of the rest of the world has already moved to ICD-10, the reason behind all these all delays that we have seen from the government over the last several years is the fact that these other countries do no use ICD-10 for billing purposes," Nalin Jain, CTG Health Solutions' Delivery Director of Advisory Services, told the source. "Much of the rest of the world has socialized medicine and the United States is perhaps the only Western developed country that has so much reliance on for its financial health, for its billing; hence, the delays and justifiably so — it's a very complicated move."

ICD-10 was initially set for a deadline of October 1, 2011, but three subsequent delays have pushed this start date to October 2015. According to Jain, the complexities in not just learning ICD-10 but bucking any incorrect coding practices from ICD-9 and incorporating the system into a practice's revenue cycle have made adoption progressively more difficult.

With the proper chiropractic billing software, clinics can make the jump to ICD-10 with minimal impact to their regular workflow.

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Despite a newly announced year-long delay, the Centers for Medicare & Medicaid (CMS) ICD-10 implementation preparations are continuing to move full-speed ahead, and the latest batch of results makes for a welcome positive development. Back in March, CMS ran a week-long testing period for providers to gauge success with or problems related to adopting the new coding language. The test was conducted under the initial plan of an October 2014 deadline, and while that date has been extended to 2015, the results have come in and paint a more optimistic picture of ICD-10 than some may have initially believed.

According to EHR Intelligence, a whopping 89 percent of ICD-10 claims made during the March 3-7 test week were accepted successfully by CMS. While this acceptance rate may fall short of the average 95 to 98 percent seen by ICD-9, it's a "generally successful" step forward, particularly as the federal agency did not see any glaring problems with the system.

"Approximately 2,600 participating providers, suppliers, billing companies and clearinghouses participated in the testing week, representing about 5 percent of all submitters," said Niall Brenna, Acting Director for the CMS Offices of Enterprise Management, in an official statement. "Testers submitted more than 127,000 claims with ICD-10 codes to the Medicare Fee-for-service (FFS) claims systems and received electronic acknowledgements confirming that their claims were accepted."

While the deadline for ICD-10 implementation is still over a year away, these preliminary results point to a strong start, one that the healthcare industry can continue to build on in the months ahead.

Clinics are encouraged to invest in new chiropractic EHR systems in order to ensure that their recordkeeping practices are brought up-to-date and within ICD-10 compliance. The best chiropractic EHR software can help ensure this transition is performed as smoothly as possible, without interruption to the practice's typical administrative workflow.

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It was only until a few short weeks ago that October 2014 was viewed as a major turning point for the healthcare industry, set as the original implementation deadline for not only ICD-10 but Stage 2 of Meaningful Use as well. Last month, Congress and the Centers for Medicare & Medicaid Services (CMS) surprised everyone by delaying ICD-10 for another year.

While this created some consternation among many providers and payers, it took some of the pressure off for those worried about rushing through both ICD-10 and Meaningful Use adoption by October. But CMS may now be taking the urgency out of that schedule completely, with new reports suggesting that the federal agency is looking into revising its Meaningful Use timetable as well.

According to the online news source iHealthBeat, CMS recently proposed a new rule that would delay Stage 2 for chiropractic EHR by another year. The decision was made in response to industry criticisms of needing more flexibility and more time in incorporating Stage 2 upgrades and certifications into clinic EHR systems. 

"By extending Stage 2, we are being receptive to stakeholder feedback to ensure providers can continue to meet meaningful use and keep momentum moving forward," said Marilyn Tavenner, CMS Administrator, in an official statement.

The new rule revision would provide the option of using either 2011 chiropractic EHR software or a mix of 2011 and 2014 editions for this year's reporting period.

While the CMS' latest proposal may grant practices some additional breathing room in adopting Meaningful Use standards, the fact remains that, sooner or later, practitioners will need to make the jump to Stage 2. When that time comes, make sure to only invest in the best chiropractic EHR software, guaranteeing compliance without any disruptions your day-to-day workflow.

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The ICD-10 implementation deadline delay has left many in the healthcare industry confused about next steps to take. While some organizations will use this additional time to revise their plans, others will stick to their original timelines. The industry website ICD10 Monitor provided the following suggestions on how healthcare organizations can make the most of the delay:

Continue dual coding

According to the source, many of ICD-10's earliest adopters have been dual coding for at least a year. The delay will allow for an easier transition for healthcare organizations that may need to move slower. There is also the opportunity to cross-train more staff and reinforce more educational initiatives. 

"Dual coding delivers tremendous advantages in coder accuracy, payor testing and financial impact assessments," the source states. "More time for dual coding with ICD-10, even if it only involves a few cases per week, can offer a benefit windfall for health information management (HIM)." 

Improve clinical documentation integrity (CDI)

The majority of healthcare providers already have some type of CDI program in place, but ICD-10 will require greater specificity. ICD10 Monitor recommends that organizations review charts of their top 10 to 15 procedures and recode them under ICD-10. They can then use this information to make adjustments for documentation improvement or template redesign. 

Review and adjust 

New programs need to be continually reviewed and updated to improve efficiency. While the latest delay is frustrating, it may be beneficial to take advantage of this extra year.

So what should your practice do with the extra year before the ICD-10 deadline? There is no simple solution to fit the needs of every healthcare organization. What you can do however, is purchase chiropractic EHR software that is ICD-10 compliant.

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With ICD-10 delayed for at least another year, many healthcare providers and payers have turned to the Centers for Medicaid & Medicare Services (CMS) for answers on what comes next. Unfortunately, the response so far has been silence.

Last week, one CMS official told the press that an announcement would be coming shortly on when the new ICD-10 upgrade deadline will be, but declined to offer any specific timeline. The reticence on the federal agency's part to lock down any concrete date nearly a month after the ICD-10 delay was made official has frustrated many in the healthcare industry, who aren't sure how to proceed with no known deadline to work toward.

This prompted the Coalition for ICD-10 — a group consisting of organizations like the American Hospital Association and America's Health Insurance Plans — to pen a letter to CMS last week, calling for October 1, 2015, to be officially marked as the start date for ICD-10 implementation.

"Without an established implementation date, ICD-10 preparations will be delayed until the last minute, creating a hurried transition when the date of implementation actually arrives," wrote the Coalition, adding that the extension coupled with a new vague date, "will add significant demands on limited resources and will measurably increase the overall cost of completing the transition."

As CMS readies the announcement of its official timetable for what ICD-10 implementation will now look like going forward, you can take steps to ensure your clinic is up to speed by purchasing chiropractic EHR software. Adopting the right chiropractic documentation software for your staff will not only help ensure ICD-10 compliance, but will do so without impeding your regular workflow.

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Many in the healthcare industry are disappointed by the ICD-10 delay and there's quite a bit of uncertainty about how it will affect providers, though the exact consequences of the decision won't be fully known for some time. However, it's worth asking whether or not the delay presents at least some advantages, even if it's is viewed as a generally negative development.

Industry news source HealthDataManagement.com recently sat down with healthcare consultants Ed Hock and Jim Lazarus, to ask their thoughts on how the delay will affect health providers and payers. They acknowledged that the delay would likely result in extra costs for those who have already invested in compliance, but these costs aren't wasted.

"Continuing to invest in [clinical documentation improvement programs] is a no-regret tactic for providers," Lazarus says. He and Hock went on to say that the extra time afforded by the delay means that providers can develop dual code systems, through which they are able to compare compensation rates for both ICD-9 and ICD-10 to determine how reimbursement rates will differ once the new system is adopted.

There is, of course, a large segment of providers who have been dragging their feet when it comes to transitioning to ICD-10, so for these individuals and organizations, the delay is a welcome reprieve. Still, all signs point to the ICD-10 switch taking place within the next two years, and when that happens it will be crucial for DCs to use the best chiropractic EMR software available. This will ensure that they are in compliance with federal standards, and will also improve their ability to handle higher volumes of patients while keeping more accurate records.

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Although many in the healthcare industry were anxiously anticipating the October 1 deadline for ICD-10 implementation — an upgrade that many clinics and practices were reportedly behind on — President Obama's signature on a law that pushed this date back for at least a year actually elicited more groans than cheers. With so practitioners and providers alike gearing up for a 2014 launch of the new system, a year-long delay has undercut what had been a building momentum and, according to a new poll, disappointed the majority of healthcare providers.

Health Data Management reports that a recent survey conducted by the Deloitte Center for Health Solutions found that 58 percent of respondents were concerned that the ICD-10 delay would negatively impact their resources and funding going forward. Additionally, 59 percent of the 1,250 healthcare professionals who were polled expected their ICD-10 preparation timelines to lose momentum, if not fall off schedule entirely, due to the delay. Only 30 percent of those surveyed reported that they would be able to stick to their original plan.

"To many in the healthcare industry, this delay falls into the category of unexpected news," the Deloitte blog wrote in an April 14 post. "After two previous delays, many were operating under 'full steam ahead' plans."

The majority of the poll's respondents said they believe the best scenario for moving ahead would be to set a firm deadline for October 2015, but the Centers for Medicare & Medicaid Services (CMS) have yet to address the matter.

In the meantime, clinicians and practitioners can make the best of a less-than-ideal situation by equipping themselves with the best chiropractic EHR software available, ensuring ICD-10 compatibility with minimal workflow disruptions.

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