Assessing the planning and implementation strategies for the ICD-10-CM/PCS coding transition in Alabama hospitals.

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The article written in 2013, emphasized the importance of planning for converting International Classification of Diseases, Ninth Revision, (ICD-9) to International Classification of Diseases, Tenth Revision, Clinical Modification Procedure Coding System (ICD-10-CM/PCS), specifically for hospitals in Alabama. The main focus for the ICD-10-CM/PCS was training and coding. Implementation challenges were also identified.[1]


A total of 116 surveys were distributed to volunteers that were members of the Alabama Association of Health Information Management. The study obtained a 37 percent response rate from volunteers. Records were stored in Both and Microsoft Excel were used to evaluate survey results.


The results were characterized into the following categories: Planning for ICD-10-CM/PCS, Training plans and Approaches for ICD-10-PCS, and Challenges and Barriers. Approximately a third of respondents were in the process of developing a team or had not started the planning process for the transition. High percentages were reported for user training and organizational structure. The majority of respondents (approximately 53%) started the planning tasks in 2011. Of those that started implementation plans, tasks were either 50% or less completed. Training was rolled out in three phases for varies levels within the organization from Senior Executives to financial staff. The top challenges identified included the ability to meet code requirements through the ways of working between physicians and providers; the importance of training; and the need to work closely with vendors to ensure successful upgrades are implemented for ICD-10-CM/PCS systems.


It was concluded that, the planning did start in 2011 even though teams were not in place. Respondents emphasize the importance of having team participation with physicians.

It was recommended that each hospital should identify the best training strategy and plan for their area (small vs. large organizations, etc.). Other options included online training courses as well as in-house training.

The surveys were also helpful in determining that hospitals in Alabama were better prepared to roll out the implementation of ICD-10-CM/PCS by following the planning recommendations.


After reviewing the article, it was determined that there is a need for hospitals to make more efforts in planning for implementation of changes. Perhaps an in-house project management office would facilitate planning or perhaps out source this piece of work to consultants.

The study discussed the importance of training plans; however, the change management process also emphasizes the need to ‘communicate’ change through different channels to have a successful implementation.

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  1. Houser, S. H., Morgan, D., Clements, K., & Hart-Hester, S. Assessing the planning and implementation strategies for the ICD-10-CM/PCS coding transition in Alabama hospitals.