Beginning on Oct. 1, 2015, the U.S. healthcare industry must cease using ICD-9 codes to categorize and document patient treatment and convert to the larger ICD-10 code set. The American version of the newer coding set, ICD-10-CM, consists of 68,000 codes -- a dramatic increase from the 13,000 codes that make up ICD-9-CM. Some providers readied their practices to make the transition to ICD-10 by the previous 2014 deadline, while others took the second delay as an opportunity to perform more coding tests and evaluate their staffs' readiness. There remain providers that are unsure it will be business as usual for their practice post-ICD-10 implementation. In this guide, IT experts explain which healthcare facilities are feeling the pressure of moving from ICD-9 to ICD-10 and how they got in that position.
Not everyone is feeling trapped by ICD-10. To aid providers converting from ICD-9 to ICD-10, CMS announced that for the first year after the ICD-10 implementation date, providers won't be charged with improper coding as long as a valid code from the proper code family -- if not the specific code -- is used. The stories in this guide illustrate exactly how providers arranged all aspects of their medical and business workflows to apply to ICD-10, complete with specific examples and tips from hospital CIOs.
1Inside ICD-10 coding-
The mechanics of upgrading to ICD-10
Healthcare providers had ample warning that they'd have to change over from ICD-9 to ICD-10 codes. This collection of features and tips gathers the perspectives of hospital CIOs. Those CIOs shared what they did to get ready for the coding conversion and how they expect the aftermath to unfold. Also, SearchHealthIT writers discussed what they learned in speaking with ICD-10 experts. Finally, our expert contributor suggested it's not too late for providers to offer training and education for employees that will come in contact with ICD-10 codes.
The appointment of an ombudsman and creation of an ICD-10 communication center are two ways CMS is assisting providers with the new codes. Continue Reading
ICD-10 has significantly more codes than its predecessor, but not every healthcare professional has to deal with the full ICD-10 code set. Uncover how providers are sectioning off codes in separate medical departments. Continue Reading
John Halamka, M.D., CIO of Beth Israel Deaconess Medical Center, made a humorous and insightful remark about the coding specificity required by ICD-10. Continue Reading
2Accepted codes and exceptions-
ICD-10 coding preparation and adjustments
Four state Medicaid programs were recently granted the right to use coding crosswalks after the ICD-10 deadline. Other providers were given a break by CMS when it said coders wouldn't be penalized for not using the exact ICD-10 code for a year after the implementation date. Not all providers are relying on those exceptions to navigate through the ICD-9 to ICD-10 conversion period. Read on to find out which claims providers tested more than others, as they adjusted their coding operations to suit ICD-10.
Improperly coded claims are a learning opportunity, not a disaster waiting to happen, for organizations gearing up for ICD-10. Continue Reading
The state Medicaid programs in Montana, Louisiana, Maryland and California won't have to use ICD-10 codes come Oct. 1. Find out what coding crosswalks are and why those states get to use that approach. Continue Reading
Health Level Seven (HL7) International worked to ensure its Fast Health Interoperability Resources standard will play nicely with ICD-10 codes. Continue Reading
3ICD-10 skeptics speak up-
The struggles of adopting ICD-10
Physicians at small practices aren't the most confident bunch, as October approaches. Some of them aren't sure how their EHRs and billing software will cooperate with ICD-10, because they've been unable to run tests between the two systems. Whether the technology and physicians are ready or not, ICD-10 is coming, and there will be no going back once it's here.
A poll from physician social network SERMO showed that more than 70% of physicians think they aren't prepared for ICD-10. Anonymous SERMO members didn't hold back in stating their feelings about the new codes. Continue Reading
Two SearchHealthIT reporters relayed that large healthcare providers are ready for ICD-10, but that it will cause revenue and productivity to drop. Continue Reading
The minority of revenue cycle professionals thinks the move to ICD-10 will be seamless from a business perspective. Read on to find out why they feel that way. Continue Reading
Find out why workflow slowdowns and reductions in revenue have providers worried, as they go from ICD-9 to ICD-10. Continue Reading
4CIOs go on the record-
Lights, camera, ICD-10
Two hospital CIOs were asked if ICD-10 would benefit U.S. healthcare and provided opposite answers. Watch the videos in this section to see why one of them believes the difference between the amount of codes in ICD-9 and ICD-10 is merely nominal, and that not all of them will be used.
Kristen Lee, news writer for SearchHealthIT, interviewed a few experts who weren't shy in questioning the ICD-9 to ICD-10 transition.
Albert Oriol, vice president and CIO at Rady Children's Hospital, said he expects better medical outcomes to result from the more precise ICD-10 codes.