The transition to ICD-10 will affect the staff, revenue cycle processes, and technology infrastructure of a hospital. To receive accurate and timely reimbursement, hospitals will need to use transaction software that can handle the upgrade to ICD-10—which includes almost five times as many diagnostic and procedural codes than ICD-9.
Business Issues
Hospitals are likely to experience trials during and after the implementation of ICD-10 including:
- Reporting requirements for inpatient services may increase
- Older technology systems need to accommodate code detail for increased number of available diagnosis and procedure codes in ICD-10
- New value-based purchasing initiatives for hospital physicians may be introduced
- Budgets for investment in electronic health record (EHR) applications may need to be increased
- Computer-assisted coding may be introduced into the hospital documentation processes
- Clinical documentation must be improved to support higher level of specificity within ICD-10
- Many coders may opt for retirement rather than learn a new coding system; hospitals may provide incentives to retain experienced coders
- Productivity in hospitals may decrease due to coding backlogs and steep learning curve
- Clinical and non-clinical staff will need training on the new technology and ICD-10 code set
- Provider and payer processing errors may cause claim denials and reduced cash flow
Critical questions every executive should be asking:
- Do I trust that vendors of my critical IT systems will be ready by the ICD-10 deadline?
- Does the switchover to ICD-10 provide the cover we need to upgrade our older systems?
- Which aspects of the ICD-10 transition should I outsource?
- How do I implement a training program that is appropriate for different roles within my organization?
- What is my information systems implementation strategy?
- How do I use general equivalency mappers (GEMs) to analyze the difference between ICD-9 and ICD-10?
- Is there a program that helps coders learn more about anatomy, physiology, and interventions?
- Will I be able to translate historical data and will I still be able to use that data with ICD-10?
- Will this affect state and federal reporting requirements?
- How will this affect my clinical documentation program?
- Will this change my payments from Medicare for never-events or present-on-admission (POA)?
Why should you consider Ingenix as an ICD-10 partner?
In order to make a seamless and efficient transition to ICD-10, organizations need to start preparing now.
Ingenix can help you use the transition to ICD-10 to your greatest advantage. With Ingenix consulting services, technology, and data, you can begin identifying impacts and developing plans for an efficient, effective, and compliant conversion.
Ingenix understands every facet of the health care system. Because we provide services to payers, hospitals, physicians, government agencies, and other health care stakeholders, we bring a strategic perspective unmatched by other information technology providers. Our solutions are informed by 25 years of experience in coding, payment, and reimbursement methodologies.
Ingenix provides the following ICD-10 solutions:
- Web.Strat, an ICD-10 facility encoder with an optional integrated compliance module
- ICD-10 consulting services which include executive education, gap analysis, project management, and implementation planning
- Coding resources, including code description tables, mapping software, and reference manuals to help hospitals gain a better understanding of the new coding system
Ingenix technology solutions will be ICD-10 and 5010 compatible in advance of deadlines to enable clients to implement, test, and optimize needed upgrades.
