ICD-10 Gap Analysis includes a review of organization, process, people and systems as well as external entities that the HIPAA covered entity interacts with in the exchange of clinical, claims and financial data.
ICD-10 Gap Analysis may include:
- Organization gap analysis (ICD-10 training, management readiness)
- ICD-10 IT Vendor Assessment
- ICD-10 related process impacts
- ICD-10 governance planning
- ICD-10 impacted processes
- ICD-10 clinical documentation quality to support documentation of medical necessity and diagnosis related groupings (DRGs)
- ICD-10 clinical documentation quality to support documentation of medical necessity for ambulatory and professional fee claims (ICD-10 CM and CPT coding)
- For Medicare and Medicare Advantage providers, quality measures that will directly impact reimbursement under Affordable Care Act (HCC, RAPS, RAFS, HEDIS scores)
- ICD-10 testing readiness
- ICD-10 contracting plans
- ICD-10 physician change management and education (both employed and non-employed groups, by specialty)
- ICD-10 financial risk assessment and risk mitigation plans
…and more