1. The ICD-10 Transition | Simplified
Kunal Bajaj, Principal |

2. Summary About Ordysy What is ICD-10? Example
Current View of ICD-10 Implementations
Challenges with ICD-10
Ordysy and CodeFlex Solution Introduction
Value Proposition
ICD-10 should yield more than a check on an Audit form.
Embracing the ICD-10 initiative opens up un-thought of opportunities.
An answer exists to questions not previously asked. Until now, many organizations did not have an inventory of systems and applications that generate ICD-9 codes.
An ICD-10 transition done correctly will enable an organization to become nimble to meet future compliance changes. This is the time to create a blue print of business processes and how technology ties to them.
This effort will also enable decision makers to identify bottlenecks, ask questions about redundancies and substantiate improvements through data to back up decisions.
By undertaking a holistic approach as opposed to a silo based approach, organizations can use ICD-10 as the initiative to lay a foundation for the future.

3. About Ordysy Advanced IBM Partner Founded in 2008
Provide solutions and services to Healthcare and Financial Services clients
Experienced Team of Consultants
Healthcare Analytics
Healthcare Data Integration and HL7
IT Planning and Business Process Optimization
Over 75+ years of collective experience

4. Clients
Government
Commercial

5. ICD = International Classification of Diseases
What is ICD-10?
ICD = International Classification of Diseases
October 1st, 2014 is the healthcare industry’s deadline to migrate to ICD-10, the latest set of diagnosis and procedure codes
The currently-used ICD-9 codes contain 13,000+ permutations, vs. the 170,000+ codes for ICD-10
Affects providers, payors, clearing houses, research organizations, public health orgns, non-profits
ICD-10 should yield more than a check on an Audit form.
Embracing the ICD-10 initiative opens up un-thought of opportunities.
An answer exists to questions not previously asked. Until now, many organizations did not have an inventory of systems and applications that generate ICD-9 codes.
An ICD-10 transition done correctly will enable an organization to become nimble to meet future compliance changes. This is the time to create a blue print of business processes and how technology ties to them.
This effort will also enable decision makers to identify bottlenecks, ask questions about redundancies and substantiate improvements through data to back up decisions.
By undertaking a holistic approach as opposed to a silo based approach, organizations can use ICD-10 as the initiative to lay a foundation for the future.

6. GEMS = General Equivalency Mapping System
Example of ICD-10
GEMS = General Equivalency Mapping System
ICD-9
ICD-10
8470
Sprain of Neck
S134XXA Sprain of ligaments of cervical spine, initial encounter
S138XXA Sprain of joints and ligaments of other parts of neck, initial encounter
ICD-10 should yield more than a check on an Audit form.
Embracing the ICD-10 initiative opens up un-thought of opportunities.
An answer exists to questions not previously asked. Until now, many organizations did not have an inventory of systems and applications that generate ICD-9 codes.
An ICD-10 transition done correctly will enable an organization to become nimble to meet future compliance changes. This is the time to create a blue print of business processes and how technology ties to them.
This effort will also enable decision makers to identify bottlenecks, ask questions about redundancies and substantiate improvements through data to back up decisions.
By undertaking a holistic approach as opposed to a silo based approach, organizations can use ICD-10 as the initiative to lay a foundation for the future.

7. Other possible matches
Example of ICD-10
Other possible matches
ICD-9
ICD-10
8470
Sprain of Neck
S138XXS
Sprain of joints and ligaments of other parts of neck, sequela
S139XXA
Sprain of joints and ligaments of unspecified parts of neck, initial encounter
S139XXD
Sprain of joints and ligaments of unspecified parts of neck, subsequent encounter
S139XXS
Sprain of joints and ligaments of unspecified parts of neck, sequela
ICD-10 should yield more than a check on an Audit form.
Embracing the ICD-10 initiative opens up un-thought of opportunities.
An answer exists to questions not previously asked. Until now, many organizations did not have an inventory of systems and applications that generate ICD-9 codes.
An ICD-10 transition done correctly will enable an organization to become nimble to meet future compliance changes. This is the time to create a blue print of business processes and how technology ties to them.
This effort will also enable decision makers to identify bottlenecks, ask questions about redundancies and substantiate improvements through data to back up decisions.
By undertaking a holistic approach as opposed to a silo based approach, organizations can use ICD-10 as the initiative to lay a foundation for the future.

8. Opportunity Payors: Collaboration and Testing
Large Providers: Collaboration and Testing
Mid and Small Providers: Wide open opportunity
WEDI Survey
PAYORS
PROVIDERS
% Complete
% In Progress
Impact Assessment
50%
40%
20%
Readiness
33% ?
Testing 0%
ICD-10 should yield more than a check on an Audit form.
Embracing the ICD-10 initiative opens up un-thought of opportunities.
An answer exists to questions not previously asked. Until now, many organizations did not have an inventory of systems and applications that generate ICD-9 codes.
An ICD-10 transition done correctly will enable an organization to become nimble to meet future compliance changes. This is the time to create a blue print of business processes and how technology ties to them.
This effort will also enable decision makers to identify bottlenecks, ask questions about redundancies and substantiate improvements through data to back up decisions.
By undertaking a holistic approach as opposed to a silo based approach, organizations can use ICD-10 as the initiative to lay a foundation for the future.

9. Top 3 Impacts of ICD-10 (based on 50+ conversations with ICD-10 PMOs)
How do we create custom maps from ICD-9 to ICD-10 and vice-versa for each specialty?
How do we identify matching of codes with physicians?
How do we identify and provide appropriate training to physicians, nurses and coding staff?
How do we manage the rise in DNFB (Discharged Not Final Billed)?
How do we forecast DRG Shifts and reimbursement changes?
How will increased rejections & denials impact cash flow?
Finance &
Revenue
Cycle
Clinical
Operations
ICD-10
Operations & Information Technology
ICD-10 should yield more than a check on an Audit form.
Embracing the ICD-10 initiative opens up un-thought of opportunities.
An answer exists to questions not previously asked. Until now, many organizations did not have an inventory of systems and applications that generate ICD-9 codes.
An ICD-10 transition done correctly will enable an organization to become nimble to meet future compliance changes. This is the time to create a blue print of business processes and how technology ties to them.
This effort will also enable decision makers to identify bottlenecks, ask questions about redundancies and substantiate improvements through data to back up decisions.
By undertaking a holistic approach as opposed to a silo based approach, organizations can use ICD-10 as the initiative to lay a foundation for the future.
How do we identify and plan upgrades of impacted applications/ systems?
How do we maintain business continuity?
How can we accelerate upgrade of impacted systems?

10. The CodeFlex Solution
To support the ICD-10 transition, our solutions are built inside 3 CodeFlex modules:
Module 1:
Code Translating Modeling
Module 2:
Financial Impact Analytics
Finance &
Revenue
Cycle
Clinical
Operations
ICD-10
ICD-10 should yield more than a check on an Audit form.
Embracing the ICD-10 initiative opens up un-thought of opportunities.
An answer exists to questions not previously asked. Until now, many organizations did not have an inventory of systems and applications that generate ICD-9 codes.
An ICD-10 transition done correctly will enable an organization to become nimble to meet future compliance changes. This is the time to create a blue print of business processes and how technology ties to them.
This effort will also enable decision makers to identify bottlenecks, ask questions about redundancies and substantiate improvements through data to back up decisions.
By undertaking a holistic approach as opposed to a silo based approach, organizations can use ICD-10 as the initiative to lay a foundation for the future.
Operations & Information Technology
Module 3:
Collaboration Lifecycle Management

11. Module 3: Collaboration
CodeFlex: Module Overview
Module 1: Code
Translation Modeling
Baseline map built by clinicians to provide single best-case map for a given ICD-9 code
Code analyzer capability that identifies reasonable and valid ICD-10 alternatives for specific ICD-9 codes
Premier Code Group Manager that allows effective management of translation of groups of codes
Module 2: Financial
Impact Analytics
Analyze usage of ICD-9 codes and identify key areas of concern
Reimbursement Delay Analytics models effect of ICD-10 on receivables delay
DRG Shift Simulation & Forecasting: Execute scenario analytics on reimbursement changes
Over 40 dashboards and reports to analyze financial impact of ICD-10
Clinical
Operations
Finance &
Revenue
Cycle
ICD-10
Operations & Information Technology
Module 3: Collaboration
Lifecycle Management
Industry-leading Collaboration Software for deadline-driven mandates such as ICD-10
Pre-built TOGAF* based Enterprise Architecture model for impact analysis and planning IT initiatives
Pre-built templates for Requirements across specialties
Pre-built Testing scenarios with Simulation capability to shorten testing and delivery cycles
ICD-10 should yield more than a check on an Audit form.
Embracing the ICD-10 initiative opens up un-thought of opportunities.
An answer exists to questions not previously asked. Until now, many organizations did not have an inventory of systems and applications that generate ICD-9 codes.
An ICD-10 transition done correctly will enable an organization to become nimble to meet future compliance changes. This is the time to create a blue print of business processes and how technology ties to them.
This effort will also enable decision makers to identify bottlenecks, ask questions about redundancies and substantiate improvements through data to back up decisions.
By undertaking a holistic approach as opposed to a silo based approach, organizations can use ICD-10 as the initiative to lay a foundation for the future.
* The Open Group Architecture Framework

12. Faster Implementation
Delivering Value to Our Clients
IT Implementation
Resources
ICD-10 READY!
No CodeFlex
ICD-9
Organization
Systems Discovery
Planning & Requirements
Execution & Testing -
ICD-10 READY!
With CodeFlex
ICD-10 should yield more than a check on an Audit form.
Embracing the ICD-10 initiative opens up un-thought of opportunities.
An answer exists to questions not previously asked. Until now, many organizations did not have an inventory of systems and applications that generate ICD-9 codes.
An ICD-10 transition done correctly will enable an organization to become nimble to meet future compliance changes. This is the time to create a blue print of business processes and how technology ties to them.
This effort will also enable decision makers to identify bottlenecks, ask questions about redundancies and substantiate improvements through data to back up decisions.
By undertaking a holistic approach as opposed to a silo based approach, organizations can use ICD-10 as the initiative to lay a foundation for the future. =
Faster Implementation
Increased Quality
Less Resources

13. Please contact Kunal Bajaj
Questions and Answers
Please contact Kunal Bajaj
Thank you!
CodeFlex simulates claims in ICD-9 to facilitate remediation and analyze the shift in DRGs. CodeFlex takes the ICD-9 code and generates all possible combinations in the ICD-10 code set. This is also a mechanism for going deeper into Financial analysis.