Where You Should Be
Being prepared can significantly improve how your organization fares during the ICD-10 transition by minimizing the financial and productivity impacts in the first years of implementation. This is especially significant because ICD-10 compliance provides limited ROI opportunities; the priority is often to neutralize revenue spending and optimize investment in the compliance—the more expeditious the process, the more savings in cost.
Organizations that will realize the benefits of ICD-10 more quickly are those that plan ahead, use innovative technology, and meet the recommended deadlines dictated by CMS.
How can health care organizations do this?
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Become familiar with the new code sets and provide training to preview the structure and conventions of ICD-10
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Educate staff regarding the challenges of translating clinical documentation into appropriate codes and understand the tools that can help
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Assemble a team, develop an impact assessment and priorities, schedule training, and utilize technology and available mapping tools
The Big Picture
The ICD-9 code set has been standard for nearly 30 years, coding for diseases and signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. However, ICD-9 is not flexible enough to incorporate emerging diagnoses and procedures, nor is it accurate enough to identify diagnoses and procedures precisely. Transitioning from the ICD-9 code set to ICD-10 provides detailed information on procedures, allows ample space for capturing new technology and devices, and provides a logical structure with clear, consistent definitions. This improves the amount and detail of data that can be sent electronically between health care organizations, resulting in improved quality of care and reduced costs.
Unique considerations
However, ICD-10 codes cannot be inserted into the existing processes and business rules used for ICD-9. As the deadline for ICD-10 implementation approaches, health organizations are under pressure to assess their current capabilities, determine their ICD-10 readiness needs, and close the gap in the way that best protects against operational disruptions. Throughout the course of ICD-10 preparation and implementation, business systems, processes, and other components at the heart of the health care organization will need continuing inspection. Many organizations worry they may not be able to prepare for the change in time or fear the cost of upgrading IT systems will not be affordable.
What’s Driving the Change?
The transition to ICD-10 is a business-enabled compliance mandate that will provide better data for measuring health care service quality, safety, and the efficacy of care by allowing clinical IT systems to record far more specific and rich diagnostic information. The complete ICD-10 code set contains more than 155,000 codes, compared to only 17,000 in the ICD-9 set.
Because the additional codes can accommodate a host of new diagnosis and procedures, ICD-10 will help to enable the implementation of electronic health records by providing more detail for electronic transactions and will help boost efficiencies by helping to identify specific health conditions
As a result, ICD-10 can help:
- Improve care outcomes
- Streamline operations
- Reduce costs