The Ingenix Global Code Manager is a high-performance translation engine that can effectively and concurrently process ICD-9 and ICD-10 transactions, as well as enable value-added mapping analysis.

Payers

Hospitals

Public Sector

Providers face multiple changes in the ways they use electronic data interchange to transmit claims and related transactions.

There's a lot of work to get ready for 5010 and it doesn't all fall on claims management software vendors and clearinghouses, says Larry Watkins, managing consultant at Ingenix Consulting, a unit of revenue cycle management vendor Ingenix Inc., Eden Prairie, Minn. "The approach in the industry is that, 'My vendor and clearinghouse will take care of me,' that's very much what we're hearing now," he contends. "We're also hearing it from 'experts' who should know better." Read more in the February 2, 2010 article by Health Data Management Magazine
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One of the many wide-ranging impacts of the ICD-9 to ICD-10 transition is its impact on Medicare's Local and National Coverage Determination (LCDs and NCDs) policies. There are approximately 8,400 active NCDs and LCDs published by CMS and its responsible contractors, and 80% of those policies have diagnosis codes. The policy types break down for ICD-9 diagnosis codes as follows:

• NCD – 308 active policies, 43 have ICD-9 diagnosis codes (14%)
• Part A – 3212 active policies, 2803 have ICD-9 diagnosis codes (89%)
• Part B – 4638 active policies, 3848 have ICD-9 diagnosis (85%)
• DME – 216 active policies, 96 have ICD-9 diagnosis codes (44%)
• RHHI – 23 active policies, 9 have ICD-9 diagnosis codes (39%)

The transition's effect on coverage determination will likely be limited to ICD-10-CM (Clinical Modification). As of today, no NCD or LCD policies specifically address ICD-9 procedure codes, so we suspect the impact of ICD-10-PCS (Procedural Coding System) will be minimal on coverage determination policies.
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ICD-10 planning should start soon, if it hasn't already, considering that provider and payer organizations need to begin their preparations no later than Jan. 18, 2010 if they are to meet the Oct. 1, 2013 deadline, according to recent research. To help organizations prepare, this blog is going to publish a series of posts detailing the strategies that organizations can employ to plan and implement ICD-10 successfully. This first strategy post, preparing to prepare, kicks off the series.

Initial steps to begin preparations include:
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CMS released a new fact sheet in August, titled ICD-10-CM/PCS: An Introduction Fact Sheet. The new fact sheet includes information about the benefits of adopting the new coding system, structural differences between ICD-9-CM and ICD-10-CM/PCS, and implementation planning recommendations. This new fact sheet is an update to a previous CMS fact sheet that was titled ICD-10-Clinical Modification/Procedure Coding System Fact Sheet.

Of particular interest in the fact sheet is a section devoted to illustrating the differences between ICD-9-CM and ICD-10-CM when coding specific conditions, such as pressure ulcers, angioplasty, and others.
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