What You Need to Ask Your Software Vendors About ICD-10

What You Need to Ask Your Software Vendors About ICD-10

What You Need to Ask Your Software Vendors About ICD-10

With the ICD-10 conversion rapidly approaching and the prospect for another delay fading, it’s time to talk with your software vendors. Are they ready for ICD-10? You’ll need to ask the right questions to find out what they know and to determine whether they’re ready for the big switch.

Here are seven important questions to ask your software vendors about ICD-10.

What’s your schedule?

“The first critical question to ask of a software supplier is ‘what is the earliest date the ICD-10 compliant application version will be available?’” says Janice Wurz, a senior advisor at healthcare information technology firm Impact Advisors. “The sooner ICD-10- related functionality can be verified, the better.”

What about extra costs?

Asking about training is important, says Stuart Newsome, vice president of business development of Alpha II, which provides software solutions for coding, compliance and other healthcare issues. “Will there be additional cost for software training, upgrades to hardware or software, or interfaces to other systems required to receive ICD-10 codes?”

What exactly are you doing?

Brian White, founder of healthcare consulting firm Competitive Solutions recommends asking the basics, such as “when and how the vendor is testing in preparation for ICD-10.” Knowing how rigorous a vendor's testing is can help you judge whether it’s sufficient.

What about your GEMs?

General Equivalency Mappings make it possible to convert data from ICD-9-CM to ICD-10-CM and ICD-10-PCS and vice versa. These “crosswalks” are important for tracking quality and morbidity/mortality and calculating reimbursements

“How will conversions occur?” Newsome says. “Will they be using GEMs (General Equivalency Mappings)? And has the vendor considered the discrepancies that exist in GEMs?”

Are you 5010 compliant?

Some practice management systems are having clearinghouses convert their 4010 EDI format to 5010 before sending to their payers, Newsome says. “This cannot be done once ICD-10 is a requirement. So the confirmation that the software can create the 5010 formatted file is critical.” Check with your clearinghouse to see if they are converting your claims from the 4010 format to 5010. If so, contact your PM/EMR vendor now to get 5010 working.

Can you handle both ICD-9 and ICD-10?

Even though the Oct. 1 deadline represents the official conversion date, White recommends asking whether your vendor can handle ICD-9 and ICD-10.

Newsome agrees. “Systems will have to maintain both ICD-9 and ICD-10 since Workers Compensation and Personal Injury Protection (PIP) insurance is not subject to HIPAA and therefore is not mandated to use ICD-10 by the Oct. 1, 2014 deadline,” he says. “Additionally, historic patient data must be maintained and old claims must still be filed using ICD-9. What is the vendor’s plan for maintaining both code sets in tandem?”

What’s your Plan B?

The ICD-10 conversion is expected to be difficult. Do your vendors have a backup plan? “If the software release is not imminent, providers need to understand the vendor's ‘Plan B,” Wurz says. “Is there a work-around? Many vendors have ICD-10 readiness statements prepared to share with their customers which address these questions and more.”

If you have questions about preparing for the ICD-10 conversion, please contact us. We're happy to help.

Logan Solutions uses a combination of clinical practice expertise and technological skill to help physician practices throughout the U.S. implement, customize and improve their EMR and Dragon Medical software systems. Contact us to find out how our clinical-practice expertise can help your practice with its clinical documentation software needs.