US Healthcare is going through some mandatory compliance changes which will have a direct impact on the way information data exchange happens between Providers and Payers. ICD10 migration which impacts the Healthcare codes used for Patient diagnosis and procedures performed on them is one among these changes and has a massive voluminous impact within existing healthcare systems using these ICD (International Classification of Disease) codes.
International Classification of Disease (ICD) is used to provide a standard classification of diseases, symptoms, complaints and external cause of injury for the purpose of health records.
It is the responsibility of The World Health Organization (WHO) which assigns, publishes, maintains and uses the ICD to classify diseases and to track mortality rates based on death certificates and other vital health records. These codes are revised periodically and currently they are in its tenth edition commonly called as ICD10CM. Next version which will be ICD11 is slated to be rolled out around 2015.
The change adopted within US Healthcare systems has two final changes supporting the continued transformation of the U.S. healthcare system toward a comprehensive electronic data exchange environment.
First is the adoption of the Accredited Standards Committee (ASC) X12 005010 standards for healthcare transactions and the National Council for Prescription Drug Programs (NCPDP) Version D.0 for pharmacy transactions (ASC X12 5010/D.0.). This is a pre-requisite for the implementation of the second rule which addresses the adoption of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for diagnosis coding and the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding.
In order to assist healthcare entities with meeting the ICD-10 transition deadline, Shree Partners currently offers the following services to healthcare payers and providers and integrated delivery networks to help them achieve a smooth transition to using ICD-10 code sets.
Shree Partners will work with your organization to help guide the transition to ICD-10 at an accelerated pace using our pre-built jump-start solutions that will be customized to your specific needs.
Some of the important feature a Testing solution should have:
5010 AND ICD-10 APPLICATIONS IMPACT ILLUSTRATIVE
|Patient Access System||Patient Care and Ancillary Systems||Patient Care Management Systems||Records Management and Coding Systems||Billing and Editing Systems||Claims Process and Management Systems||Contract Management||Performance Management|
|Scheduling||EHR Clinical Documentation||EHR Ordering||Case Management||Billing||Claims Submission and Claims Reconciliation||Provider Management||Clinical Performance|
|Pre-Registration||Charge Capture||Host Edits||Claims EDI||Evaluation of Care||Financial Performance|
|Eligibility and Verification||Discharge Planning Care Completion||Billing System Edits||Rejections Processing||Clinical Performance|
|Registration and Admission||Chart Compliance Management||Contract Pricing||Denial and Appeals|
|Coding/ Grouper and/ or Regrouping|
ICD – 10 Testing Methodologies - Provider
ICD-10 Tools Overview