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Overview of ICD-10 Transition

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1 Overview of ICD-10 Transition
ICD 10 University of Toledo Medical Center University of Toledo Physicians, LLC Overview of ICD-10 Transition

2 What is ICD-10 The US health care industry uses ICD-9-CM codes for identifying and reporting diagnoses and procedures. ICD-9-CM stands for International Classification of Diseases Ninth Revision. Although ICD-9-CM had been in widespread use in healthcare, the Health Insurance Portability and Accountability Act (HIPAA) named it as the standard code for reporting diagnoses and inpatient procedures as of 2003. ICD-10 is the Tenth Revision of the International Classification of Disease. ICD-10 has nearly 160,000 new codes that contain more specificity. This is more than 12 times the number of codes currently used in ICD-9. Source : American Medical Association, 2012

3 ICD-10 Mandate On January 16, 2009, Department of Health & Human Services (HHS) published a regulation requiring the replacement of the ICD-9-CM code set with the updated version, ICD-10. The Final Rule was set with a compliance date of October 1, 2013. On April 17, 2012, HHS published a proposed rule which moved the ICD-10 compliance date to October 1, 2014 siting the following reasons proposed delay Lack of provider and payer readiness for the transition Competing statutory initiatives Transition to 5010 did not proceed as effectively as expected. Aug 24, 2012 Final Rule announced effective date as October 1, 2014. Source : UnitedHealth Group , 2014

4 ICD-10 Adoption Timeline Worldwide
US is the last industrialized nation to not use ICD-10 as their standard for reporting Source: American Association of Professional Coders: http//

5 ICD-10 Advantages: Greater recognition of risk, severity and complexity in quality and other key measures Improve Disease Tracking/Trending Improve Clinical Communication Contribute to Healthcare Quality Improving Initiatives Potential for streamlining payments and authorization based on improved coding detail Enable the US to exchange information across country boarders Better ability to manage risk in accountable care, value based purchasing environments Enhancements in population based research Potentials for participation in payment models that recognized and reward more complex conditions Use More Current Medical Terminology Source: HIMSS ICD-10 for Physician Practices and other Providers: 2012

6 ICD-10= Information Collection
A New Way to Think about the Transition ICD-9 = Coding ICD-10= Information Collection Source: United Health Group

7 Winning the Race to ICD-10

8 ICD-10 Implementation Milestones
January, Established Executive Steering Committee and Project Manager. March, Established 7 Workgroups and Team Leaders to form readiness assessments and remediation planning. January, Completed Documentation & Financial Gap Analysis -Identified top impacted DRG and Clinical Services Departments June, UTMC/UTP Certified Coders Completed ICD10 Coding Education & Training modules. July, Completed Phase one of implementation planning and development phase -Full inventory/survey of all system applications -Full inventory/survey of all Third Party Payers & Business partners December, Planning for budgetary impacts FY15 and beyond.

9 Looking Forward to October, 2014 and beyond
January, Internal System Testing January, 2014 thru Go Live Physician Education Online Modules/Internal Training March, HAC upgrade May, 2014 thru Go Live Department/Staff Education June, Dual Coding July, External Testing

10 Thank You Betty Zenk, MBA ICD-10 Project Manager
University of Toledo Medical Center

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