As we roll into the holiday season, the ICD-10 Project Management Office would like to offer thanks to the more than 75 core project team members and hundreds of additional NYP staff, management, and leadership who tirelessly continue to contribute effort and expertise to the ICD-10 transition initiative. Effort and expertise that is readying NYP to code for those dangerous ‘holiday season’ conditions. Conditions such as being pecked by a turkey (W61.42XA). Or for those ambitious but unqualified Christmas light installers, T75.4XXA (Electrocution, initial encounter). And of course, no holiday season would be complete without the stresses of dealing with… THE IN-LAWS (z63.1).

The ICD-10 Project is a microcosm of the ongoing multidisciplinary collaboration that makes NYP the successful organization it is and is evidenced by the team’s most recent accomplishments across several of its stated milestones.

• Operationalize a dual coding production environment.  NYP actually started coding using the ICD-10 code set more than one year prior to the October 1 implementation date. Through November, more than 5000 inpatient discharges and several hundred ambulatory surgery and emergency department visits have been coded in ICD-10. Though we can’t submit these codes to insurance companies, we are storing this information for external testing and analyzing it for potential reimbursement impacts and subsequent remediation activities.
• Complete end-to-end claims testing with payers.  Our best evidence that the transition to ICD-10 will be smooth and seamless lies in our ability to submit test claims electronically to insurance companies and have those insurance companies acknowledge receipt and demonstrate an ability to process those claims in the form of accurate payment. To date, NYP has performed tests of varying levels of complexity and size with 7 of our largest contracted payers representing nearly 40% of the Hospital’s revenue.
• Support hospital operations with an ICD-10 ready technology and data infrastructure.  All but one of the Hospital’s identified applications has been updated to be ICD-10 compliant. This means that the revised form and structure of ICD-10 codes can be accommodated for entry and storage and in many cases any functional processing for which the codes are used as criteria. In addition, to ensure those codes move seamlessly across different applications, approximately 10% of the affected interfaces have already been successfully tested.
• Manage the ICD-10 impact on quality and patient safety reporting.  Through an innovative approach developed by the NYP team, 9 quality and patient safety metrics affecting value based purchasing incentives have been assessed. Two, accidental puncture and laceration and DVT/perioperative pulmonary embolism have been identified as being potentially impacted by the transition to ICD-10. The workgroup is evaluating potential mitigation strategies.

Many other activities are ongoing and progressing nicely. For a complete overview of the project status, click here to view the Project Scorecard.

Projects as complex as ICD-10 are not without their challenges and as we head into the final 300 days before October 1, 2015 efforts are underway to address these. They include:

• Maximizing the benefit of computer assisted coding technologies
• Further accelerating and expanding dual coding activities
• Accelerating claims testing activities with payers
• Continuing to identify mission critical reports for ICD-10 conversion activities.

Because ICD-10 is the dictionary that defines our daily operation, it has the potential to affect as many as 10,000 to 15,000 NYP employees in some way. We all can play a role in NYP’s readiness activities and prepare our respective departments for the transition. Some of those items include:

• Recognizing the transition is coming and the differences between ICD-9 and ICD-10 code structures;
• Identifying reports, documents, and forms that are using ICD-9 codes today so that they can be converted to ICD-10;
• Thinking about how the additional specificity included in ICD-10 can help create efficiencies and improved outcomes in your operation; and
• E-mailing questions about ICD-10 and how it may affect you and your department to ICD10Help@nyp.org.

Happy Holidays to all!