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.
ICD-10 Financial Risk Assessments should include an analysis of historical healthcare claims data for one, two, or ideally three retrospective periods. A data quality assessment is essential, making sure that claims are not duplicates, and that they therefore represent unique events. This is particularly important in view of interim billing on hospital claims. It’s very easy to count hospital admissions multiple times from claims data unless you reconcile claims to a single hospital stay.
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.