The move to ICD-10 will be dramatic and challenging.  The ICD-10 coding system uses a level of specificity beyond the ICD-9 system and requires more details that match up with the CPT code.  For example, ICD-10 codes may include site and severity information which will have to be consistent with your procedure codes and modifiers.

In order to use an EHR to support your ICD-10 coding challenge, you cannot expect to address ICD-10 coding in the middle of your EHR effort.  Indeed, you will want to have completed the rollout of the EHR before you tackle the ICD-10 challenge.  Consider the following calendar issues as you plan ahead to meet ICD-10 coding with the help of an EHR:

• Selection of PMS and EHR products can take 2 to 4 months or more before you have finalized your decision.
• Implementation of an EHR can take 4 to 6 months depending on a variety of policy, and practice issues.
• Once the EHR implementation is complete, your practice will need 4 to 8 months to transition individual patients to the EHR.
• If you will be replacing your PMS system as part of your EHR project, allow an additional 4 to 6 months for your project.

A full PMS/EHR project can take anywhere from 10 to 18 months or more.  Considering that you should be ready to focus on ICD-10 by the beginning of the summer of 2013, it is not too early to tackle the EHR project on your critical path to ICD-10 compliance.

Note that differences between ICD-9 and ICD-10 coding systems will probably lead to changes to the EHR and PMS systems that you use leading up to the ICD-10 start date.

Depending on the size of your practice, you need to be well along on your transition to an EHR before you focus on the transition to ICD-10.  Otherwise, you could be facing overwhelming uncertainties in your clinical and billing operations that could lead to disruptions in patient service, clinical operations and cash flow.