Let's assume you're relieved that ICD-10 implementation has been extended a year because you haven't done anything about it yet.

Improve ICD-9 coding

Nope. That isn't a typo. By improving ICD-9 coding, medical practices can be in a better position to transition into ICD-10 implementation. Better ICD-9 coding can lead to increased revenues and higher medical coding productivity. Look to make gains via:

• Computer assisted coding (CAC)
• Clinical documentation improvement (CDI)
• ICD-9 training for medical coders

Medical coder training that starts with reinforcing their anatomy and physiology knowledge will help them with ICD-9 codes now.

The theory behind CAC's short-term impact says that it can immediately boost productivity. Which is why another suggestion — examining and improving work flows — is worth mentioning. If a hospital or medical practice can increase productivity without paying for expensive systems, then that's a huge benefit now.

It's a smart strategy because all the arguments for ICD-10 implementation cite benefits that aren't concrete or immediate. Frankly, we're going to have to wait a long time to see if all that granularity is going to improve patient care. Focus on improving the business of healthcare.

Call your vendors

Find out what they can do for you. You're going to want to look at the following systems for ICD-10 upgrades:

• Claims submission
• Billing system
• Posting payments
• Clinical documentation, e.g., patient reports, electronic medical record
• Patient registration system
• Quality reporting
• Public health reporting
• Disease registry/disease management
• Laboratory systems
• Where else?

Use these questions:

• Will your products be ready for the ICD-10 compliance date?
• Will a mapping or crosswalk strategy be used between ICD-9 and ICD-10 code sets?
• What is your timeline for system modifications and what do those modifications include?
  Make sure testing is part of the timeline
• Will you continue to support applications or are you discontinuing some products in the wake of the ICD-10 transition?
• Are there any new hardware requirements associated with ICD-10-related software changes?
• What are the costs involved? Will modifications and upgrades be covered by existing contracts?
• Will customer support and training be provided for any new ICD-10-related functionality, and is there a charge?
• Is there a phased approach for implementing ICD-10?

Even if your vendor is answering these questions correctly, do not let your vendors run on autopilot. No matter how much or how little a vendor is hired to do, their work needs to be managed by someone in house as if it is a project.

Start learning about ICD-10 coding

It's time to understand what is ICD-10 coding and what it takes to accommodate it. Medical practices can start ICD-10 training by:

• Browsing ICD-10 code books to get a sense of the differences.
• Assign guideline chapters among the staff to identify how ICD-10 codes can impact the organization.
• Get formal training for at least one staff member who can start sharing information.

The sooner a medical practice starts these steps, the better everyone can understand what needs to be done to best implement ICD-10 coding.