ICD-10 consulting will shift to testing and revenue cycle impacts in the next few months. Testing is the only way to ensure business continuity.
When thinking about ICD-10 program governance, one of the key areas for both traditional Fee for Service (FFS) medicine and the transition to episodic (short-term) and longitudinal data for comparative effectiveness medicine in the Affordable Care Act is the Case Management process and supporting software and reports.
Does your organization have Standard Operating Procedures (SOPs) that use ICD-9 CM diagnosis or ICD-9 procedure code information? If so, those procedures and systems need to be evaluated as part of the ICD-10 Impact Assessment.
Case Management should benefit the entire system, bridging clinical and financial ares of healthcare. Underlying Case Management processes are a number of functions. Case Management also relies on specific diagnosis codes. If hard-coded information or ICD-9 specific methods of capturing this information are in Case Management Systems, they will need to be remediated or replaced to support ICD-10.
Finally, uncertainty about ICD-10 is lifted. "...rule changes the compliance date for the ICD-10-CM and ICD-10-PCS medical data code sets (hereinafter "code sets") from October 1, 2013 to October 1, 2014."
We do not support a delay in ICD-10. The delay hurts not only those who have invested dutifully to meet the CMS mandate on time, but it hurts independent contractors, small businesses, and Healthcare IT vendors who fill knowledge gap in Covered Entities who don't have the staff internally to meet this mandate.
On April 9, 2012 at 10:10am Pacific / 1:10pm Eastern time the Centers for Medicare and Medicaid announced a one year delay in ICD-10 to October 1, 2014.
In the ICD-10 Consortium social network this week, health plans posted questions regarding processing ICD-10 claims that have date of service periods that span the mandated timeline as well as an outreach to other health plans regarding the pros and cons of receiving an ICD-10 claim, mapping it to an ICD-9 to adjudicate it. Also, ICD-10 is expected to impact auto adjudication rates for plans.
Health care providers should ensure that the EMR vendor is on track toward ICD-10 compliance, however they should not rely on their EMR vendor as the panacea. Most hospital systems we work with have many more ancillary systems in radiology, etc. that are also impacted, and the EMR isn't the core system of record (yet) for everything that goes on in a hospital.
Benefits of ICD-10 in health care - more detailed descriptions of the patient condition and the procedures to treat the patient.