Monday, March 19, 2012

Playing the ICD-10 Who, What, Where Game

Whether you’re a payer or a provider, winning the ICD-10 compliance game necessitates that you rapidly obtain answers to the following questions:

1.       “What” applications and processes include anything related to ICD codes and their use? Ask your workers to briefly describe the workflow and work outcomes for anything that includes an ICD code or an ICD code-based derivative like DRG codes. If possible, have your workers provide the commonly used, internal name used to describe the application or business process. Often times the same work process, application or function within an application is referenced with a different name depending on the person or department.

2.       “Who” are the workers (employees, staff, consultants, business associates, and outside vendors) involved with the ICD-related activity? Describe these “who’s” by their roles as opposed to their name. Outside vendors include trading partners, software vendors, consulting firms, contract workers and others. Identify the name and nature of each outside worker.

3.       “How” is the ICD code used?  Include a description of the application software, business process, reports, forms, workflows, and other descriptive data that would help understand what is impacted. For software and other products, identify the vendor and version of the product(s).

4.       “Where” is the application and/or business process used?  This helps to understand the geographically distribution of workers who perform the activities and to understand potential duplicate and/or conflicting information. 

Because of the far-reaching impact ICD codes have across your business, you should create a simple template for collecting the answers to these four questions.  Request that survey participants attach supporting information such as screen shots, reports, operating procedures and any other information they believe would be helpful.  

The above seems like an obvious and simple game to win and it should be; but you’d be surprised at how many organizations do not have this simple, yet critical information needed to remediate their business and beat the ICD-10 mandate challenge.

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