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Background: Encoded data is essential to all aspects of today’shealthcare system. Classification and coding system standards requirehealth information management (HIM) leaders to evaluate, educate, implement, and maintain ICD-10-CM and/or ICD-10-PCS.

purpose: The challenges associated with maintaining high quality data in electronic information environments require a clear understanding of data content standards and effective coordination andmanagement of the organization’s data requirements. As experts in themanagement and use of health records and encoded data, HIM profes-sionals should serve as the leaders in healthcare organizations throughthe transition of ICD-9-CM to ICD-10-CM and/or ICD-10-PCS.

leadership leadership sample management tools andgoal characteristics/Behaviors activities resources

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4Averill, Richard; Bowman, Sue. “There Are CriticalReasons for Not Further Delaying the Implemen-tation of the New ICD-10 Coding System.” Journalof AHIMA 83, no. 7 (July 2012): 42–48.

4Barta, Ann; et al. “ICD-10-CM Primer.” Journal ofAHIMA 79, no. 5 (May 2008): 64–66.

4Dimick, Chris. “ICD-10 Postcards: Canadians,Australians Share Experiences with ICD-10 Implementation.” Journal of AHIMA 79, no. 3(March 2008): 33–35.

4“US Must Adopt ICD-10-CM and ICD-10-PCS(AHIMA Position Statement).” Journal of AHIMA76, no. 9 (October 2005): 26, 28.

4AHIMA’s Coding Products and Services Team.“Destination 10: Healthcare Organization Prepa-ration for ICD-10-CM and ICD-10-PCS” (AHIMAPractice Brief). Journal of AHIMA 75, no. 3(March 2004): 56A–D.

4Rode, Dan. “AHIMA Testifies in Support of ICD-10.”Journal of AHIMA 72, no. 7 (2001): 16,18.

4Brouch, Kathy. “Where in the World Is ICD-10?”Journal of AHIMA 71, no. 8 (2000): 52–57.

4CMS ICD-10 Website

4Free Newsletter: ICD-TEN

Seek professional growth opportunities

Increase awareness,knowledge andunderstanding of the ICD-10-CM andICD-10-PCS codingsystems

Educate yourself and othersabout general structure and useof the code sets

AHIMA LEADERSHIP MODEL

ICD-10-CM/PCSTRANSITION

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4AHIMA CodeWrite ICD-10 Checkpoints provided monthly in the AHIMA Body ofKnowledge

4Bryant, Gloryanne. “Engaging Physicians inICD-10 Planning: The Documentation Link.”Journal of AHIMA 83, no. 5 (May 2012): 54–55.

4Stanfill, Mary H. “Preparing for ICD-10-CM in the Emergency Department: Approaches to Improve Emergency Department Documenta-tion.” Journal of AHIMA 83, no. 6 (June 2012):38–41.

4AHIMA. “Transitioning to ICD-10-CM/PCS inthe Classroom: Countdown to 2014.” Journal ofAHIMA 83, no. 6 (June 2012): 68–73.

4Majerowicz, Anita.“Developing an ICD-10-CM/PCSCoder Training Strategy.” Journal of AHIMA82, no.4 (April 2011): 58–60.

4Dimick, Chris. “Top-10 for ICD-10: EssentialTasks for the First Phase of the Journey.” Journal of AHIMA 82, no. 6 (June 2011): 38–41.

4Dimick, Chris. “Strategies to Prepare for ICD-10 Transition.” ICD-TEN: Top EmergingNews (June 2011).

4“HIPAA Administrative Simplification: Modifi-cations to Medical Data Code Set Standards ToAdopt ICD-10-CM and ICD-10-PCS; FinalRule.” Federal Register 74, no. 11 (January 16,2009): 3328–3362.

4“Health Insurance Reform: Modifications to theHealth Insurance Portability and AccountabilityAct Electronic.” Federal Register 74, no. 11 (January 16, 2009): 3296–3328.

4AHIMA ICD-10-CM/PCS Academic TransitionWorkgroup. “Transitioning to ICD-10-CM/PCS—An Academic Timeline” Journal of AHIMA 80,no. 4 (April 2009): 59–64.

AHIMA Leadersh ip Mode l

init iative

Work independentlywith little or nosupervision toadvance awareness.

Adaptable Self-assess for areas of weakness in skill sets

4Project Manager

4HIM Director

4Workflow Data Analyst

4HIM Systems Administrator

4Data Quality Manager

4Clinical Vocabulary Manager

4Coding Manager

influence

Educate decisionmakers on need for education and training in the new code sets to influenceorganization andfinancial support

Utilize appropriate training designed to lead code assignment and code useactivities

Facilitates communication

Gather and share :

4Regulatory requirements

4Educational requirements

4Evaluation of training needs

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4Coplan-Gould, Wendy; Carolan, Katie; Friedman,Beth. “Re-engineering the Coding Workflow: Assessing Today with an Eye toward Tomorrow.”Journal of AHIMA 82, no. 7 (July 2011): 20–24.

4Bowman, Sue, and Ann Zeisset. “ICD-10 PreparationChecklist” (Updated Sept 2012)

4Sullivan, Tori. “Budgeting for ICD-10: HardwareCosts Should be Peaking Next Year, Contract Support Rising.” Journal of AHIMA 81, no. 9 (September 2010): 30–33.

4AHIMA.“HIM and Health IT: Discovering Common Ground in an Electronic Healthcare Environment” Journal of AHIMA 79, no. 11 (November–December 2008): 69–74.

4Hughes, Gwen. “A Strategic Approach to RequestingCapital.” Journal of AHIMA 75, no. 7 (July–August2004): 52–53.

Convince others toprovide fundingand/or support forresources requiredfor education

AHIMA Leadersh ip Mode l

4Develop sample budget plansfor awareness orientation forstakeholders

4Explore fundingopportunities to assist in thepreparation process

4Work alongside and/orvolunteer to lead committeesfor local and state associations

4Identify or conduct programs fororganization stakeholders andothers impacted by the transitionfrom ICD-9-CM to ICD-10-CM orICD-10-PCS

4Partners with others

4Giannangelo, Kathy; Hyde, Linda. “ICD-10’s Impacton Quality Measures.” Journal of AHIMA 83, no. 4(April 2012): 46–47.

4Piselli, Caroline. “What’s Your ICD-10 Plan?: Findings and Recommendations from Research on ICD-10 Implementation.” Journal of AHIMA 76,no. 2 (February 2005): 34–37.

4AHIMA. Role-based Model for ICD-10 Implementation: Health Plans (2009).

Emphasizecollaboration and inclusion fortraining plans

Conduct a needs assessment ofstakeholder groups in theregion by partnering withothers

Examples include:

4Quality improvement organizations

4Regional CMS offices,

4State hospital, long-term care,or home care associations

4Health insurers

4Healthcare finance associations

4Medical societies

4Health information technol-ogy vendors or associations

4State government agenciesusing ICD such as the statedepartments of health

Tailor training to meet specific needs ofthe stakeholder group involved

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AHIMA Leadersh ip Mode l

Act as a diplomatand use politicalskills to accomplishresults

Acquire budgeting or funding for train-ing sessions or courses

Develop and present information to healthcareboards, conferences, or executives in the listing of stakeholders above

4Butler, Rhonda. “Bridging the Translation Gapfrom ICD-9.” Journal of AHIMA 79, no. 3 (March2008): 31.

4Kloss, Linda L. “ICD-10 Malaise: A Symptom ofUS Healthcare’s Ills.” Journal of AHIMA 79, no. 3(March 2008): 23.

4Rode, Dan. “Why ICD-10 Can’t Wait” Journal ofAHIMA, no. 10 (October 2008): 18–20.

Accountable to self and others Develop and document projectmethodology objectives andtimelines to keep transitionplanning moving ahead

4Bowman, Sue, and Ann Zeisset. “ICD-10 Preparation Checklist” (Updated Sept 2012)

Facilitate communi-cation about the new code sets

Sharpen presentation and communication skills

Develop communication plans to gauge interest and support for workflow changes required

4Fenton, Susan H., Giannangelo, Kathy, Stanfill,Mary. “Essential People Skills for EHR Implemen-tation Success (AHIMA Practice Brief).” Journalof AHIMA 77, no. 6 (June 2006): 60A–D.

Develop communication plans to gauge interest and support for workflow changes required

4Beguelin, J. “Breaking Down Barriers, BoostingVisibility. How to Move Beyond the HIM Department.” Journal of AHIMA 74, no. 5 (May 2003): 513

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AHIMA Leadersh ip Mode l

Seek opportunities for data analysis projects

Identify key stakeholders earlyin the process to identify changerequirements

4AHIMA. “HIM and Health IT: Discovering Common Ground in an Electronic Healthcare Environment” Journal of AHIMA 79, no. 11 (November–December 2008): 69–74.

Share expertise Mentor others towardsleadership within their area ofinfluence

4Buck, Stacie L.; et al. “The Value of Mentoring”Journal of AHIMA 79, no. 9 (September 2008):38–40.

Pioneering 4Introduce ideas for workflowinnovation

4Understand transition from ICD-9-CM to ICD-10-CM/PCS requirements specific to organization’s needs

4Inventory existing code set and data requirementsand perform gap analysis between what is currentlyavailable versus what is needed

Conduct requirementsanalysis and riskassessment to assessorganizationalreadiness

Identifies and achieves goals Utilize and promote effectiverisk assessment tools and tech-niques

Position operational problems andneeds at the strategic level

Evaluate organizational readi-ness for transitioning to new code sets using recognized strategic management techniques

4Carolan, Katie. “An ICD-10 Vendor Checklist: Planning Now Makes for a Smoother Transition.”Journal of AHIMA 82, no. 2 (February 2011): 26–28.

4AHIMA Top 10 List: Phase 1, ICD-10-CM/PCSImplementation Plan Development and ImpactAssessment (2010).

4Burrington-Brown, Jill. “Risk Assessment: DoingMore with Less.” Journal of AHIMA 74, no. 9 (October 2003): 64, 66.

4Barnhouse, Lou Anne, et al. “ICD-10: Turning Regulatory Compliance into Strategic Compliance.” Deloitte Center for Health Solutions.

4Environmental Scanning (Wikipedia, accessedDecember 10, 2012)

Engage and convene stakeholdergroups

Conduct a thorough environmental scan

Possess vision and foresight Develop or use a risk assessmenttool to facilitate prioritization ofactivities to meet strategicobjectives

4Keith, Ron. “Creating the Vision...Facilitating the Results.” AHIMA Convention Proceedings,October 2001.

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influence

Gain access to recognizedstandards directories thatinterface with the code set(s)

4Rhodes, Harry B., Scichilone, Rita A. “The USHealth Information Knowledgebase: A MetadataRegistry that Makes Sense of the Myriad Standards” Journal of AHIMA 80, no. 5 (May2009): 52–53.

4AHIMA. “Recommended Regulations and Standards for Specific Healthcare Settings (Updated)” Journal of AHIMA 80, no. 1 (January 2009): 61–67.

4USHIK Website

Stay cognizant oforganizational culturefor coded data use fordecision making

Identify common ground with otherdepartments

Establish a forum for discussionabout data sources and data in-tegrity management

4Fernandes, Lorraine; O’Connor, Michele. “Data Gov-ernance and Data Stewardship: Critical Issues in theMove toward EHRs and HIE” Journal of AHIMA 80,no. 5 (May 2009): 36–39.

Possess credibility—is trusted by others Recognize challenges and barri-ers as well as benefits of thetransition process

4Butler, Rhonda. “When to Use the GEMs, When Notto Use the GEMs: A Common Sense Approach.” 2011AHIMA Convention Proceedings, October 2011.

4AHIMA House of Delegates. “AHIMA Standards ofEthical Coding.” (September 2008).

4Harman, Laurinda.“HIM and Ethical DecisionMaking: Complex Challenges.”AHIMA ConventionProceedings, October 2001.

4Identify and bridge gaps

4Emphasize collaboration and inclusion

4Identify gaps in requirementsand code set content standards defined to date

4Establish an interdisciplinarysteering committee to guideand inform organizationalsteps towards implementation

4Identify and engage decisionmakers, subject matter experts and stakeholders tosupport the implementationprocess

Knowledgeable; serve as an expert incoded data usage

4Fernandes, Lorraine; O’Connor, Michele.“DataGovernance and Data Stewardship: Critical Issues inthe Move toward EHRs and HIE” Journal of AHIMA80, no. 5 (May 2009): 36–39.

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AHIMA Leadersh ip Mode l

Team leadership Guide research and recommendimplementation tactics andprocedures

4Piselli, Caroline. “What’s Your ICD-10 Plan?:Findings and Recommendations from Research onICD-10 Implementation.” Journal of AHIMA 76, no.2 (February 2005): 34–37.

4Dimick, Chris.“Top-10 for ICD-10: Essential Tasksfor the First Phase of the Journey.” Journal ofAHIMA 82, no. 6 (June 2011): 38–41.

Establish a team to research,monitor and recommend an approach and process to transition from ICD-9-CM toICD-10-CM/PCS

4Bryant, Gloryanne H. “Planning and ImplementingICD-10, Using a Team Approach.” 2004 IFHROCongress & AHIMA Convention Proceedings,October 2004.

Lead evaluation andanalysis for datamigration approaches

Decide if legacy data should be standardized or the organization will code data from a specified dateforward

4Evaluate the stability and current industry use of ICD-10-CM/PCS (e.g. provingillustrative examples) alongwith other code sets.

4Evaluate and understand thebenefits and challenges ofimplementing the code setand determine any issues related to interoperability

4Assess the scale of the codeset implementation based onorganizational needs/require-ments (e.g., process to fullyimplement the code set mapto the code set , etc.)

4Establish a single, uniformprocess for reviewing, approving and implementingcode set standards in your organization

4Monitor code set develop-ment activities to evaluate applicability to new or updated standards

4Rihanek, Theresa. “Nuances in ICD-10-CM WillAffect Some MS-DRG Assignments.” Codewrite(January 2012)

4Rihanek, Theresa; DeVault, Kathy.“Converting Datato ICD-10 with GEMs: Reference Mapping ToolsWill Aid in System Transition.” Journal of AHIMA83, no. 5 (May 2012): 42–43.

4Long, Peri L. “The DRG Shift: A New Twist for ICD-10 Preparation.” Journal of AHIMA 83, no. 6(June 2012): 76–78.

4Butler, Rhonda; Mills, Ron; Averill, Rich.“Readingthe Fine Print on ICD-10 Conversions: Even HighlyAutomated Conversions Require Review.” Journal ofAHIMA 82, no. 6 (June 2011): 28–31.

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AHIMA Leadersh ip Mode l

Achieve successfultransition results for all parties involved

Maintain a balance between competing interests

Provide guidance and supportfor decision making that servesorganizational data manage-ment interests

4Harman, Laurinda.“HIM and Ethical DecisionMaking: Complex Challenges.” AHIMAConvention Proceedings, October 2001.

Risk taker Gather business intelligence related to ICD-10-CM or ICD-10-PCS and share withplanning teams

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organizational change management

AHIMA Leadersh ip Mode l

Embrace change for theopportunities it bringsfor improvement andefficiency

Courage to change the status quo Create a program describingstrategic advantages

4“Transforming the Healthcare Delivery System;Proposals to Improve Care and Reduce Health CareCosts.” Senate Finance Committee, April 29, 2009.

Identifies gaps Identify, develop, and utilize capabilities and strengths of individuals

4Fox, Leslie Ann; Clark, Jean; Bowen, Rita; Postal,Susan. “Using Systems-based Leadership toAdvance the Future State of HIM.” AHIMA’s 79thConvention and Exhibit Proceedings, October 2007.

4Johnson, Spencer and Blanchard, Kenneth. WhoMoved My Cheese? An Amazing Way to Deal withChange in Your Work and in Your Life.New York:G.P. Putnam’s Sons, 2002.

4Kotter, John P. Leading Change. Boston: HarvardBusiness School Press. 1996.

Bridge the past and future Reengineer workflow, re-imagine roles

4Dimick, Chris. “Change is the Constant: HIMDirectors Must Bridge Past and Future.” Journal ofAHIMA 78, no. 9 (October 2007): 88.

Seek opportunities for improvementin electronic health records workflowassociated with data capture usingcodes for storage

Anticipate potential stakeholderconflict, struggles or disagree-ments

4Bryant, Gloryanne. Managing Change andEmbracing ICD-10 ICD-10 Monitor, July 17, 2012.

4AHIMA e-HIM Workgroup on the Transition toICD-10-CM/PCS. “Planning OrganizationalTransition to ICD-10-CM/PCS.” Journal of AHIMA80, no. 10 (October 2009): 72–77.

4Butler, Rhonda. “Crossing the Bridge to ICD-10:Using the General Equivalence Mappings (GEMs)to Create a ICD-10 Ready Workplace.” 2008 AHIMAConvention Proceedings, October 2008.

4Cassidy, Bonnie S. “Embracing the ICD-10Transition.” Journal of AHIMA 82, no. 6 (June 2011): 10.

4Weiss, Alan. Organizational Consulting: How to bean Effective Internal Change Agent. Hoboken, NJ:John Wiley, 2003.

4Wilson, P.S. “What Mapping and Modeling Meansto the HIM Professional” Perspectives in HealthInformation Management (2007)

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AHIMA Leadersh ip Mode l

Position changerequirements at thestrategic level

Act as a diplomat, possess politicalskills

Engage and convene stakeholders to obtain buy-in for changes important for strate-gic advantage. Keeps an eye on the big picture.

Maintain a balancebetween what hasworked in the past andwhat may improveefficiency in the future

Ask questions about inadequacy ofcurrent system to manage uniform release and update cycles for code sets

Periodically survey stakeholders on adequacy of communication process and use feedback to modify change strategies related to update cycles and systemupdates

Communicate the valueof HIM involvement intransition andimplementationactivities

Remain flexible, open to alternatives,identify gaps

Support and encourage HIM representation for all ICD-10-CM or ICD-10-PCS transition activities

independence

Ability to see a business problem frommany different perspectives

Identify the best mode(s) and frequency of communication

Naturally inquisitive Anticipate tough questions and create a document with possible answers to findout all of the issues have been identified

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organizational systems integration, planning and data migration

AHIMA Leadersh ip Mode l

Advance developmentof a graceful evolutionof code sets to avoidhigh cost andorganizationalworkflow disruptionand data loss

Use vision and foresight to challenge the current process

Incorporate code set transition-related activities into the organizational project life-cycle;Exploit the benefits of the newcode sets as required to meetboth clinical and business needs

4ICD-10-CM/PCS Implementation Toolkit—February 2012

4“Electronic Documentation Templates SupportICD-10-CM/PCS Implementation.” Journal ofAHIMA 83, no. 10 (October 2012): 66–71.

4AHIMA. Top 10 List Phase 2: ICD-10-CM/PCSImplementation Preparation. July 2011.

Position operationalproblems related toelectronic systems andrequirements at thestrategic level

Knowledgeable, serves as an expert;Makes decisions where consensus isnot appropriate or possible

Develop a strategy for ICD-10-CM/PCS implementationand maintenance; Select or lead a task force to identifyfunctionality requirements

4ICD-10-CM/PCS Implementation Toolkit—February 2012

4“Electronic Documentation Templates SupportICD-10-CM/PCS Implementation.” Journal ofAHIMA 83, no. 10 (October 2012): 66–71.

4AHIMA. Top 10 List Phase 2: ICD-10-CM/PCSImplementation Preparation. July 2011.

4AHIMA ICD-10-CM/PCS Readiness Assessmentand Prioritization Took Kit

4AHIMA. ICD-10 Vendor Readiness AssessmentQuestionnaire

4CMS. Assembling an ICD-10 Project Team (August 2012)

4HIPAA Administrative Simplification:Modifications to Medical Data Code SetStandards To Adopt ICD-10-CM and ICD-10-PCS:Final Rule (HHS Final Rule for ICD-10-CM/PCSImplementation)

4CMS. ICD-10 Implementation Guide for LargePractices (September 2012)

4CMS.ICD-10 Implementation Timelines (August2012)

4CMS Implementation planning—includingtransition to ICD-10 (July 2012)

4CMS. ICD-10 Website (main website for ICD-10and ICD-10 transition)

Select appropriatesoftware to aid in codeselection, mapping, andreimbursement

Ability to engage and convene projectgroups

Communicate the value of HIM perspectives towards implementation (including design of a program budget)

4CMS. The ICD-10 Transition: An Introduction(September 2012)

4CMS. FAQs: ICD-10 Transition Basics (July 2012)

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icd-10-cm/pcs transition AHIMA Leadersh ip Mode l

Knowledgeable, serves as an expert Develop resources and tools that work with existing systems;Fosters vendor relationships;

4CMS. Version 5010 Industry Resources (July2012)

4AHIMA. ICD-10-FAQs

4CDC—International Classification of Diseases,Tenth Revision, Clinical Modification (ICD-10-CM)

4AHIMA. “HIM and Health IT: Discovering Common Ground in an Electronic Healthcare Environment” Journal of AHIMA 79, no. 11 (November–December 2008): 69–74.

4Bradley, Philip; Rich, Mark; Isaacson, Allen. ICD-10 Conversation: Planning Ahead. Presentedin Collaboration with HIMSS Financial SystemsSteering Committee, December 3, 2008.

4Bowman, Sue. “Coordination of SNOMED-CTand ICD-10: Getting the Most out of ElectronicHealth Record Systems.” Perspectives in Health Information Management Spring 2005(May 25, 2005).

4Bryant, Gloryanne H. “Planning and Implement-ing ICD-10, Using a Team Approach.” 2004IFHRO Congress & AHIMA Convention Proceedings, October 2004.

4CMS. Transaction & Code Set Standards (March2012)

Negotiation skills, articulate, facilitatescommunication

Collaborate for interoperabilityto enable health information exchange; Present argumentssuccinctly

Team Leadership

Asks tough questions related to the information systems or technologychanges related to ICD-10-CM/PCS.

Facilitate communication be-tween systems support andusers of software programs ortools related to the new codesets; Keep stakeholders in-formed of system selection, de-velopment and deploymentstatus

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AHIMA Leadersh ip Mode l

Knowledgeable, serve as an expert;Partner with other

Leverage membership in professional associations andindustry groups to inform organizational policies and procedures

4Rode, Dan. “AHIMA’s 2012 Advocacy Goals: AnAgenda for the Knowns and Unknowns in the YearAhead.” Journal of AHIMA 83, no. 1 (January2012): 16–18.

4Leadership in Action: HIM’s Role in HealthcareTransformation: HIM Core Model Extended(AHIMA Winter Team Talks, 2011)

4Yount, Shane. “Leadership GPS—Growth,Performance, Sustainment.” 2011 AHIMAConvention Proceedings, October 2011.

4Mangin, W. “Getting Engaged for Life” Journal ofAHIMA 79, no. 11 (November–December 2008): 8.

Contribute to domainknowledge byparticipating in relevantprofessional associationwork and mentoringothers

Possess vision foresight and courage tochallenge the status quo

Share experiences regardingICD-10-CM or ICD-10-PCS stan-dards implementation and use.

Seek opportunities Submission of abstracts and/orpapers describing benefits ofHIM leadership

Possesses credibility, is trustworthy Article submission to professional associations or trade newsletters

4Guidelines for Submitting Manuscripts for theJournal of AHIMA

Empathize with people and understandtheir challenges

Serve as a mentor to other professionals seeking ICD-10-CMor ICD-10-PCS expertise

4Buck, Stacie L.; et al.“The Value of Mentoring”Journal of AHIMA79, no.9 (September 2008): 38–40.

4“Mentoring with Passion: ACE Member HandsDown HIM Knowledge” AHIMA Advantage 12:2(March 2008).

Pioneering Nominate yourself or others for the AHIMA ACE program(AHIMA Action Community fore-HIM® Excellence.

4AHIMA Action Community for e-HIM® Excellence (ACE)

4“ACE Member Shares Her Passion for HIM”AHIMA Advantage 12:2 (February 2008).

Follow the development andprogress of the next version ofICD

Serve as an HIM domain expert Review or provide feedback toprofessional groups or standardsdevelopment organization onproposed regulations, mandatesor standards involving the code sets.

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AHIMA Leadersh ip Mode l

Communicate effectively with diversegroups and organizational levels

Volunteer for local, regional, ornational committees working on coding related standards orissues.

4AHIMA Application to Serve

Partner with Others Participate in standardsdevelopment activities includingthe Health InformationTechnology Standards Panelvolunteer work groups.

independence

Contribute to thedevelopment andharmonization ofindustry andprofessional standards.

Possess the ability to see a business problem from many different angles

Write articles, offer to deliverpresentations, consider joiningstandards development workgroups

4Guidelines for Submitting Manuscripts for theJournal of AHIMA

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