You may be neck-deep in an EHR implementation in hopes of scoring American Recovery and Reinvestment Act incentive payments, but don't forget about the coming transition to ICD-10 coding. "To put it simply, postponing critical steps now could lead to noncompliance come the ICD-10 deadline, which would result in not getting paid after Oct. 1, 2013. It's that critical," Nelly Leon-Chisen, director of coding and classification at the American Hospital Association, writes in a Hospitals & Health Networks commentary.

How critical? Leon-Chisen calls ICD coding "the DNA of hospital diagnosis-related grouping (DRG) payments." She notes the widespread use of administrative claims data, featuring current ICD-9-CM codes, for setting reimbursement and value-based purchasing policies, evaluating care quality, for biosurveillance and public-health research. (We're not fans of mining claims data for evaluating clinical performance, but that's the best there is until EHRs become the norm.)

"Successful transitioning to ICD-10-CM and ICD-10-PCS requires careful strategic planning and coordination of resources across your entire hospital. The transitioning process begins by examining every application in which diagnosis or procedure codes are captured, stored, analyzed or reported," Leon-Chisen says. Involve executives from finance, information services, clinical decision support, compliance and the medical staff, she advises.

And don't wait. Before the end of 2010, a typical hospital should be able to assign responsibilities for the transition, create awareness among all employees and medical staff of the impact ICD-10 will have on their work, analyze gaps in current clinical documentation, identify budgeting needs and set a timeline for the transition.

"The ICD-10 assessment is an opportunity to review your current work flow and medical documentation practices, as well as to develop functional requirements for the EHR. You can streamline future processes and strengthen the basis for code assignment. Certainly, this is an area that can produce benefits even today, by supporting code assignment to withstand recovery audit contractor audits," Leon-Chisen writes.

For more advice:
- read Leon-Chisen's commentary in Hospitals & Health Networks

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ICD-10 implementation: Are you ready for Oct. 1, 2013?
Prep for ICD-10 now or risk nonpayment in 2013
EHRs aren't mandatory, but ICD-10 soon will be