Leadership Messages Regarding ICD-10 Shared With Upstate Community

Successful compliance with the national rollout of ICD-10 is highly important to Upstate, the region's only teaching hospital. Messages from leadership have been circulated to raise awareness among all faculty and employees, not only those directly affected by the conversion.

From CFO Stuart Wright
September 30, 2015

Dear Colleagues:

October 1 is the national go-live date for ICD-10, the new code set for medical diagnoses and inpatient hospital procedures. The current code system, ICD-9, has been in place for more than 35 years so this is a big deal and a big change!

If you work in a clinical area, you already know about this. To date, countless hours have been committed to ensuring the appropriate training materials have been made available and that our systems are prepared for the change. I want to thank our ICD-10 steering committee members for their tireless efforts in making sure Upstate is positioned to succeed in this endeavor. Additionally, I want to extend my appreciation to all the physicians, providers, clinical and non-clinical staff who have diligently completed the training necessary for optimizing our success. I am confident that we are well prepared for this event and that we have the appropriate monitoring tools to ensure our success post go-live.

I also want to take this opportunity to put in one last plug for available training and resources. Should you have any related questions or concerns, please visit our ICD-10 website.

Here you will find new resources such as:

  • clinical documentation tip sheets for 20 specialty areas
  • help line phone numbers
  • tip sheets for providers and ways to use "diagnostic calculators" in Epic

Following tomorrow's launch, we will be closely monitoring key metrics on a daily and weekly basis as well as following up with areas needing support.

Thank you all again for your support of this critical endeavor, and I look forward to communicating our ICD-10 successes over the coming months.

Stuart Wright
Chief Financial Officer
Upstate University Hospital


From Chief Quality Officer Hans Cassagnol, MD
Aug. 20, 2015

Dear Upstate University Hospital colleague:

Less than two months from now, the nationwide implementation of the ICD-10 system will greatly change the way we code medical records. For those who use these codes, ICD-10 will require more specificity and attention to detail among care providers, coders and billing staff.

Documentation is the key to so much of what we do here, from quality assessments to billing. One way that the change to the new systems can be viewed positively is that it provides one more platform for our ongoing effort to capture the level of disease that our patients carry. Knowing how sick someone is -- and in much greater detail -- helps us to deliver care, predict the outcome, and compare ourselves to peers around the country.

We strive to make our quality assessments transparent to our patients, our providers and our community, and all should be improved by thorough documentation that provides a larger picture of the care provided at Upstate.

Success in these efforts will rely on how accurately we as providers enter those codes from the start. To that end, I encourage all providers and non-providers to take advantage of the informational and instructional material that Upstate has prepared to support the transition to ICD-10, which includes web-based resources and support tailored to subspecialties.

I wish to thank you for your time and effort as we prepare for the Oct. 1 changeover.

Best regards,

Hans Cassagnol, MD, MMM, FACOG
Chief Quality Officer
Upstate University Hospital


From CMO Anthony Weiss, MD
August 4, 2015

Dear Upstate University Hospital colleague:

On Oct. 1, with the implementation of ICD-10, hospitals and providers face a substantial change in the way we code patients' medical information. This will require greater attention to detail in our documentation, so that the specificity our coders need can be found in our notes.

We often see very sick patients here at Upstate, and our documentation is the key component in verifying that. The records generated in the new ICD-10 system will be used to calculate a variety of statistics, ratings and payments – everything from quality of care to mortality rates to reimbursement rates.

This increased level of detail also relates, to a degree, to our ongoing process to provide thorough and accurate documentation of our patients' illnesses.

Upstate has prepared support tailored for this transition. Providers and non-providers are being contacted directly with appropriate resources and education. Upstate also has established a website with details on its trainings, as well as background information on the transition, and web-based resources that have been deemed useful by the ICD-10 transition committee. Visit: www.upstate.edu/icd-10/

Those of us who are directly involved in this coding change will be helping to uphold the overall reputation and smooth operation of University Hospital. These efforts by hundreds of providers, coders and billing staff ultimately touch everyone who works here.

I want you to thank you for your time and effort already put forth as we prepare to carry out this effort.

Best regards,
Anthony P. Weiss, MD
Chief Medical Officer, Upstate University Hospital
Associate Dean for Clinical Affairs,
Associate Professor of Psychiatry and Behavioral Sciences, Upstate Medical University


From CFO Stuart Wright
July 17, 2015

Dear Upstate University Hospital colleague,

Over the next several months, you will continue to receive regular communications regarding the nationwide change to a new medical coding system. On Oct. 1, the 30-year-old system that anchors patient diagnoses and billing will be transitioned to a new system--one that is more adaptable to modern medicine.

As with any major change, one of the biggest questions is if this transition to ICD-10 will have a negative financial effect on the hospital and our physician faculty. While different national projections exist, the answer for any institution, including Upstate, is not yet known. For example, it may take longer at first to provide reports using the new code. Payors may take longer to consider reimbursements and payments may take longer to process. And there is an investment in training. However, as every hospital and care provider will be required to change to the new system, we do know that being prepared certainly will help mitigate financial risk.

Upstate is fortunate that we are well on our way to readying our self for this transition. As the region's largest employer, the scope of support will be wide ranging and available to all those who will be adapting to the new system: from the doctors, NPs and PAs who document each patient's condition; to the coders who create the record; to the staff who handle registration, billing and follow up functions. During August, additional training will be made available to all who need it to get ready for October.

The costs associated with the process are common to all providers; what will make the difference between a hospital that enjoys a successful roll out, and one that experiences a materially negative financial impact, is preparedness. A smooth and conscientious adaption to the new coding system will allow the hospital to keep its ultimate focus on providing the best possible care to our patients.

Through your efforts, we were extremely successful with our Epic electronic medical record implementation--a project that also carried an element of financial risk as people adapted to a new system. I am confident that with the same level of commitment and planning, we will be equally successful with this transition. Thank you all for your continued support of this critical endeavor.

Stuart Wright
Chief Financial Officer
Upstate University Hospital


From CEO John McCabe, MD
July 1, 2015

Dear Upstate University Hospital colleague:

We are fewer than 65 business days away from a major change to the nation's medical coding system. On October 1, 2015, the current system of the International Classification of Diseases will transition from the ninth to the 10th version.

While this change had been delayed before by Congress, it is now going ahead. The United States is the only advanced country still using ICD-9. The system has been in use for more than three decades to help set diagnoses but does not completely encompass today's advances in medicine and technology. In an environment such as ours, where we are caring for some of the region's most seriously ill and injured, ICD-9 also has some limitations on being able to fully reflect that.

The change to ICD-10 will directly affect healthcare providers who document their patients' conditions, including physicians, physician assistants, nurse practitioners, physical therapists and radiation technologists, as well as our staff who perform coding and billing.

To prepare, Upstate has embarked on significant planning to accommodate this nationwide change. Already our coders have been using the new system and the infrastructure is in place to make the transition go as smoothly as possible. Over the summer and into fall, updates, information and access to training will be shared with you.

Upstate already has had a success with the Epic system, and was praised at the national level for that roll out. I am confident that the faculty and staff who are on the front lines of care, along with those who support our patients behind the scenes, will meet the arrival of ICD-10 with the same degree of skill and professionalism.

Thank you.

John B. McCabe, MD, FACEP
Senior Vice President for Hospital Affairs
Chief Executive Officer of Upstate University Hospital
Upstate Medical University Health System