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.
ICD-10 Financial Impact Assessments should include an understanding of: ICD-10 Financial Impact to Revenue Cycle Management ICD-10 Financial Impact based on DRG shifts ICD-10 Financial Impact based on ICD-9 to ICD-10 mapping risk ICD-10 Financial Impact based on use of unspecified codes Health Information Technology (HIT) Impacts: ICD-10 Financial Impact to the Health Information Management (HIM) department ICD-10 Financial Impact to IT as distinct from the clinical applications such as resource conflicts ICD-10 Financial Impacts to training budgets, which should include the Human Resources Department ICD-10 Financial Risk and Impacts to denial management with respect to payer relations and contracting
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.
Delaying ICD-10, AMA believes will help preserve its relevance, and its control over physician compensation. Sadly it seems that AMA hasn't served its own members well, or the healthcare industry. ICD-11 won't "arrive" in a year or two. Our health system needs to digest it and then determine when and how to move to it. While ICD-11 has some intriguing benefits, it is a long way off. The base version from WHO is expected in May 2015. After that, the United States will probably need another two years for development of the US version. The earliest it would be available for study would be 2017, and we would need another 4 years to implement it – so that brings us out to 2021, way too far in the future.
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.
ICD-10 readiness information collected from 2,600 providers, health plans and vendors indicates that the industry would not have been ready on time for ICD-10 according to the Workgroup for Electronic Data Interchange (WEDI).
Today's Wall Street Journal article on Reverse Mentoring sparked a thought. Healthcare needs reverse mentoring. RM was championed at GE by Jack Welch when he was chief executive. He ordered 500 top-level executives to reach out to people below them to learn how to use the Internet. Mr. Welch was matched with an employee in her 20s who taught him how to surf the Web. The younger mentors "got visibility," he said. For healthcare to change physicians, administrators, IT people and others should reach out to youth.
ICD-10 will re-write the book on diagnosis and procedure coding, utilization pattern history will shift. HIPPS and ICD-10 should not be viewed as separate issues for ICD-10 assessments.
ICD-10 will drive initiatives such as bundling, as a component of health care payment reform. Therefore reimbursement, and case management and other areas must be viewed in a broader landscape. HIPAA mandates and health care reform impact one another.
ICD-10 implementations must move forward despite Presidential campaign promises to repeal 'Omabacare' or the Affordable Care Act. As Business Week pointed out this week, repealing the Accountable Care Act is not that easy. And even if it were repealed ICD-10 is a HIPAA mandate that was enacted prior to President Omaba's election in August 2008. Hospital systems should push ahead on ICD-10 Assessments, ICD-10 Implementation Plans, and get ready for the shift to ICD-10-CM which includes many more diagnosis codes than ICD-9. ICD-10 PCS also include many more procedure codes than ICD-9.
HIPAA 5010 and ICD-10 implementation timelines were published as widgets for payers, large providers, small providers and vendors by Health and Human Services Centers for Mediare and Medicaid (CMS). There are helpful items such as actions to take immediately, for HIPAA 5010 and more regarding ICD-10.