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ICD-10 For The Underprepared Practice

It’s no secret that many practices are behind the curve when it comes to ICD-10. While there is no dearth of literature on the subject of ICD-10 transitioning, I thought it might help to provide you with some action-oriented information. I recently had the opportunity to interview Tony Onorad and Jason McCormac of where they share their 5 Steps in 10 Days to Jumpstart Your ICD-10 Transition.


  1. Convert your top 20 codes and identify new documentation elements.

Take a look at your top 20 ICD-9 codes going back weeks or months. Convert these codes either manually using code books or using software. McCormac recommends using GEMS (General Equivalency Mapping System). “The only issue with the GEMS translation is that ICD-9 isn’t very specific, so you might not get a direct translation.”

  1. Create training tools to help implement the new documentation within the practice.

Use training tools to help doctors and staff learn the new codes, and to make sure that the additional documentation elements are included to prevent billing errors. “One way to do this is with flash cards,” says Onorad.”These can be created manually or using software. There are webinars available specific to each specialty that can help reinforce the training.”

  1. Conduct simple chart reviews.

Review charts and their associated billing, particularly those cases which have been more challenging. “This helps to identify where providers are having a tough time already,” says Onorad. Also bear in mind that ICD-9 will continue after ICD-10 is implemented so both ICD-9 and ICD-10 will run in parallel. McCormac explains that “the reason behind this is some entities such as Workers Compensation and Auto Insurance aren’t required to use ICD-10 codes, so you will need dual-coding capabilities.”

  1. Engage your software vendors and payers.

The ICD-10 transition will impact practices both on the documentation side – EMR and EPM (practice management system) – and the billing side (various insurance payers). For those practices using an EMR, don’t accept a simple “Yes, we are ready for ICD-10” from your vendor. Specifically ask them how an upgrade will impact the project. “What does that include? What is it going to look like? How are you going to get me there?”

As far as the payers, testing should be performed to make sure that claims are going through. If there is a problem, this can help determine whether it is the coding or documentation elements that are slowing things down.

  1. Prioritize your timeline, create deadlines and accountability.

Everyone is familiar with the October 1 deadline. Work back from that date and create a realistic timeline. It is also important not to suffer from analysis paralysis. What can you start doing right now? Form project teams, identify when to put staff through training and who needs training. Think about the impact of the transition on workflow. Will you need to reduce your patient volumes? McCormac adds, “It is also important to monitor things going forward after October 1. Is my provider productivity going down? Is my revenue stream? Are there any dips as a result of ICD-10, and if there are, why?”



Here’s the daily breakdown for getting your jumpstart done in 10 days: “Convert your top 20 codes. Using software this will take only a few minutes. Training aids could be created in a day or two. Chart reviews may take a little longer (2 days). Plan on getting questions answered by a couple of vendors or payers each day for 10 days Pick a project strategy (1 day to review and select) and go with it. Develop your project strategy so it fits your personal practice’s efforts (4 days) and initiate the project (1 day) if you are diligently communicating and getting everyone on the same page.”



Get the jumpstart infographic, a checklist for doing step 5 and the full transcript of the one-hour ICD10Coach interview by emailing


Peter J Polack MD FACS is co-managing partner for Ocala Eye, a multi-subspecialty practice in Florida. A champion of the physician perspective, he is also founder of Emedikon, a consultancy dedicated to practice excellence. He can be reached at .


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