ICD 10

Registration is now open for the Dec. 7 - 2012 CPT and ICD-9 Update – please use the attached information to submit your registration. Please note, registrations are due by Dec. 4. AAPC CEUs are available (4.5).

Making The Transition To ICD-10 Is Not Optional

What is it?
On October 1, 2013 a key element of the data foundation of the United States’ health care system will undergo a major transformation. We will transition from the decades-old Ninth Edition of the International Classification of Diseases (ICD-9) set of diagnosis and inpatient procedure codes to the far more contemporary, vastly larger, and much more detailed Tenth Edition of those code sets—or ICD-10—used by most developed countries throughout the world.

How does it impact us?
This transition will have a major impact on anyone who uses health care information that contains a diagnosis and/or in-patient procedure code, including:

• Hospitals
• Health care practitioners and institutions 
• Health insurers and other third-party payers 
• Electronic-transaction clearinghouses 
• Hardware and software manufacturers and vendors 
• Billing and practice-management service providers 
• Health care administrative and oversight agencies 
• Public and private health care research institutions

Why are we doing this?
ICD-9-CM limits operations, reporting, and analytics processes because it:

• Follows a 1970s outdated medical coding system
• Lacks clinical specificity to process claims and reimbursement accurately 
• Fails to capture detailed health care data analytics 
• Limits the characters available (3-5) to account for complexity and severity

ICD-10 codes refine and improve operational capabilities and processing, including:

• Detailed health reporting and analytics: cost, utilization, and outcomes;
• Detailed information on condition, severity, comorbidities, complications, and location;

What is the key to success?
Documentation is everything. In virtually every aspect of healthcare and healthcare management, documentation often is the difference between success and failure. It impacts payments, protects the financial condition of all providers, mitigates losses when quality of care is questioned and provides objective support when a practitioner or healthcare manager seeks costly change.

The individual professional practitioner who refuses to document care in accordance with the medical staff bylaws and applicable rules, regulations and federal laws is compromising our organization’s prospects of continued existence. It matters not if his or her admissions represent 20 percent of our business; it matters not if he or she is recognized as the “leading specialist in his field.”  What matters is that our organization can prove that it provides the best possible care to all patients, and that we can keep our doors open. When we close our doors for lack of funding, it’s too late to talk about what we should have or could have done.

ICD-10 affects many areas and organizations in the health care industry. Figure 1 illustrates various impacts for hospitals, health care payers/clearinghouses, providers, patients, the treasury and banks.