Preparing for ICD-11: Lessons learned from implementing ICD-10

The transition to ICD-11 is coming and 3M HIS is here to help. We'll debrief the major updates for you and provide an analysis on how the proposed changes could affect your organization. And more importantly, what you can do to prepare for this historic change. 

Have you ever heard the saying, “Doesn't expecting the unexpected make the unexpected expected?”  It's a short quote, but says a lot about where we are headed in the world of diagnosis coding. 

If there is one thing I learned with the transition from ICD-9 to ICD-10, it's to be prepared and expect the unexpected. I began working for 3M about a month before the official change. Before that, I was consulting and helping clients with ICD-10 education and preparing internally for a successful conversion. The differences from ICD-10 to ICD-11 are not as drastic as the differences from ICD-9 to ICD-10, but there are enough changes to disrupt internal processes for health care organizations. 

When I think back to that time and look at what is on the horizon with ICD-11, several lessons learned from the ICD-10 transition are important to share. 

• Many organizations failed to take inventory of policies that would be impacted by the ICD-10 change in 2015. Therefore, they found themselves with outdated documents while trying to navigate ICD-10 coding.
  • Even with no definitive implementation date for ICD-11, health care organizations should be thinking about internal processes and what may be impacted—identifying policies and procedures sooner rather than later alleviates a last minute rush to update documents.  
• Because of the delays in implementing ICD-10, HIM departments put off coder education, causing coders to be unprepared with diagnosis code knowledge.
  • Timing for education is tricky because most organizations don't want to start too early, causing coders to lose what they don't use. However, getting an early start on education is critical for coders to be prepared. Coders should familiarize themselves with the ICD-11 structure and coding guidelines (WHO ICD-11).
• Not all organizations were prepared financially for the disruption in the revenue cycle. Software glitches, coding issues, claim submission delays and payer reimbursement problems caused hospitals, clinics and other health care organizations to feel a financial pinch.
  • Transitioning to ICD-11 will not be as big of a leap as ICD-10, but you should expect disruptions in the revenue cycle.
• Hospitals and clinics had not cleaned up the backlog before implementing ICD-10. This created workflow issues for coders having to clean up backlog from ICD-9 and working with issues for ICD-10.
  • Take the time to ensure your backlog is cleaned up or manageable. Resolving past claims issues is critical for coders to remain focused on the new coding system and better manage their workload. In addition, if you need help with your backlog, it's better to get assistance sooner rather than later. Organizations that waited until the last minute to try and contract for additional resources were in a bind or out of time.

The moral of the story is it’s never too early for discussion, initial planning and education around ICD-11. Think about your own experience with the transition from ICD-9 to ICD-10, what went right, what went wrong and what could have been better. Early preparation will help your organization with a successful transition from ICD-10 to ICD-11.

Karla VonEschen is a coding analyst at 3M Health Information Systems.

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