Top Considerations for Transitioning to ICD-10 – Guest Post

Chuck Podesta is Fletcher Allen Health Care’s chief information officer.

ICD-10 would not be so daunting if the deadline was not occurring during the rush to get EHRs for meaningful use. Add in value-based purchasing, bundled payments and transitioning to ACOs, and you can see why many CIOs are retiring early or migrating to the vendor or consulting world. We are just over two years away from the October 2013 deadline, and there is much work to be done. ICD-10 contains 68,000 codes, as opposed to the 13,000 currently used in the ICD-9 world. There is a code for every condition that exists on the planet.

The revenue cycle system, which includes registration, HIM and billing/AR, will be the lynch pin to ICD-10 readiness. Having a solid vendor partner and a strong product is key to a successful transition. Many solution providers – like GE Healthcare, who recently launched the 5.0 version of their Centricity Business product – are updating their systems to better comply with ICD-10. GE Healthcare also allows existing Centricity Business customers to retrofit the new ICD-10 functions to the 4.6 version of the product. Strong vendor partners take the burden off you by being ahead of the game and delivering the appropriate technology in time so you are not racing to the finish line.

By now, you should have at least a steering committee in place. Your IT shop should have completed an inventory of all applications that are impacted by ICD-10, including reporting systems. You will be surprised by the number of applications, even if you have taken the one-vendor approach for most of your IT needs. You will need to contact all affected application vendors to see what the plans are for ICD-10 compliance. Most likely, upgrades will be required that will need to be scheduled.

Training of coders will be critical, along with implementing clinical documentation improvement programs. Documentation improvement programs are difficult to implement and will be viewed by providers as more work on top of an already busy schedule. New technologies such as computer-assisted coding will definitely help, but success will be a combination of process improvements and technology.

Lastly, remember that the deadline is for Medicare and Medicaid patients only. Unless the rest of the payer industry follows the same deadline (highly unlikely), you will need to run both ICD-9 and ICD-10 systems.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Unfortunately, there are not codes for every condition on the planet.
    There are fluffed out combinations of most things. Right vs left is two codes. So everything dealing with the musculoskeletal system at least doubled in numbers of codes.
    I have far too many codes for diabetes. Every code about complications has 4 divisions, depending on type 1 or type 2 diabetes and controlled or uncontrolled glucose levels. But with pituitary tumors or pituitary dysfunction, I am still unable to code some things.
    The coding system was devised by general surgeons and then specialties of surgery. Next came the cardiologists and the cardiology codes have a flavor of 1950 antiquity about them that is sort of cute historically. But you have to be a near geezer doc like myself to even appreciate the historicity of the cardiology codes.
    So the ICD-10 codes really create a lot of problems and have never solved any that I see. I expected these ten years ago and I wish we could stall them off for another ten or more.

  • The deadline is not just for Medicare and Medicaid patients. It is for all electronic HIPAA transactions, except HIPAA-excluded entities like Worker’s Compensation Insurance. If a payer accepts electronic claims, they will have to accept them with ICD-10 codes starting October 1, 2013. Paper claims could be excluded from the change, but it seems completely unlikely that a payer would keep two systems running just for the small number of paper claims that they have. There are also lots of tools like SpeedECoder,, to help in the ICD-10 conversion process. Here is a great link that address some ICD-10 myths:

  • DocJim,
    I feel your pain. Is there any way that it will be delayed? It seems like the only slight possibility is if they think there is too much change happening with MU, ACO’s etc. Although, that seems like a really big long shot to me.

  • Dr. West,
    “Nothing’s certain until you’re dead and even then I think God will make an allowance.” -Name that Movie (and I might have missed the exact quote, but it’s close)

  • Many deadlines have been held to, and if you stay up to date on MU, the feeling at CMS and the ONC is that deadlines will be held to no matter what.

    ICD-10 has that same feeling of finality. The period between between Jan 1 2012 and Oct 1 2013 is plenty of time for many, daunting to more, and seemingly impossible to some as well. The fact is that if many can accomplish it, then nearly 100% can as well.

  • Spencer S.,
    I have to agree that this deadline feels much more final than previous ICD-10 deadlines. The only cause for possible doubt of the deadline is the impact of ALL the changes that are happening in healthcare (meaningful use and ACO’s at the top of the list).

    I guess what’s interesting is that 100% will have to accomplish it. There won’t be many options.

Click here to post a comment