Main Office: 844.525.8500
Help Desk: 314.881.5299

How to create an ICD-10 budget

Written by: 
Carl Natale - ICD10Watch.com

An ICD-10 budget needs to include more than the cost of new software and ICD-10 training. There are many costs that may not be obvious.

The American Medical Association' (AMA) free educational resources is pretty light on budgeting. To get a pretty good picture of what you need to spend, download Navicure's handy budgeting spreadsheet.

Costs based on an impact analysis and discussions with healthcare vendors:

  • Purchase and implement public health reporting systems : Staff time/system(s) cost
  • Purchase and implement performance/quality data reporting system(s): Staff time/system(s) cost
  • Purchase and implement electronic prior authorization, referral, scheduling system(s): Staff time/system(s) cost
  • Purchase and implement data analytics interfaces: Staff time/system(s) cost
  • Purchase and implement practice management software updates: Staff time/system(s) cost
  • Electronic medical records software updates: Staff time/system(s) cost
  • Implement internally developed systems updates: Staff time/system(s) cost
  • Perform data conversion: Staff time/system(s) cost

ICD-10 Planning

  • Administrative and clinical staff ICD-10 planning time: Staff time
  • Administrative and clinical staff ICD-10 business and IT system changes testing: Staff time
  • Administrative staff vendor, payer, legal counsel contract negotiation and implementation: Staff time
  • Administrative staff consultant engagement and management: Staff time/consultant cost

Education/Training

  • In-depth ICD-10 coder education and certification: Staff time/certification cost
  • Provider and clinical staff ICD-10 education/training: Staff time/purchased training cost
  • Administrative staff ICD-10 education/training: Staff time/purchased training cost
  • Administrative and clinical staff dual coding: Staff time
  • Administrative and clinical staff ICD-10 business and IT system changes training: Staff time

Business Process Review and Implementation

  • Review and update prior authorization, referral process, utilization management : Staff time
  • Review and implement payer-specific medical policy, medical necessity requirements review and implementation: Staff time
  • Review and update payer contract for diagnosis based reimbursement: Staff time
  • Review and update payer contract for quality and/or performance-based reimbursement: Staff time
  • Review payer contract for possible additional reimbursement due to additional specificity reporting capabilities : Staff time
  • Review and update provider/clinical productivity measurement process and/or systems: Staff time
  • Review and update paper superbills and other paper forms: Staff time
  • Review and update compliance processes : Staff time

Clinical Processes

  • Review provider documentation query process : Staff time
  • Review and make necessary changes to clinical documentation to ensure ICD-10 readiness: Staff time
  • Assess computer-assisted coding (CAC) need, purchase and implement CAC if necessary: Staff time/CAC cost

Something that isn't very obvious is a need to cover staffing during training and other implementation activities. The work needs to be done so either staff need to work longer days (overtime) or someone else can be brought in to cover shifts (Additional payroll).