ComplyMD ICD-10 Positioning


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In advance of the adoption of ICD-10 as the standard for documenting diagnoses, ComplyMD has reviewed its impact on users of our system. In this presentation, we show how (relatively) simple the cutover from 13,000 codes to 68,000 codes will be for users of ComplyMD Surgeon Notes.

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ComplyMD ICD-10 Positioning

  1. 1. ICD-10 Ready!<br />ComplyMD’s migrationfrom ICD-9-CM to ICD-10-CMfor diagnoses<br />
  2. 2. ICD What?<br />The International Classification of Disease (ICD)<br />Was created for mortality reporting <br />Is expanded with “CM,” (clinical modification) in the United States  ICD-9-CM and ICD-10-CM<br />Operates on a hierarchical rubric system, so that all codes begin with 3-digit categories, which group disease systems<br />
  3. 3. ICD-9 vs. ICD-10<br />The World Health Organization (WHO) published ICD-9 in 1975 and ICD-10 in 1994<br />ICD-9 is over 20 years old<br />ICD-9 is not always precise or unambiguous<br />ICD-10 now used everywhere except Italy and United States<br />ICD-10-CM will add capacity<br />ICD-9-CM is running out of room<br />First character is alpha, so instead of 10 choices, there are up to 26<br />Codes have up to seven characters<br />Spaces reserved for growth<br />
  4. 4. ICD-9-CM vs. ICD-10-CM Code Structure<br />ICD-9-CM<br />Alphanumeric: Numeric except for V and E codes<br />Minimum: 3 digits<br />Maximum: 5 digits<br />Decimal point: yes,after third digit<br />Dummy placeholder?<br />ICD-10-CM<br />Alphanumeric: All codes are alphanumeric<br />Minimum: 3 digits<br />Maximum: 7 digits(some chapters have 7th character extension<br />Decimal point: yes,after third digit<br />Dummy placeholder: “x”<br />
  5. 5. ICD-10 Attributes<br />First character is ALPHA, followed by up to6 characters<br />Decimal point after 3rd character (like ICD-9)<br />Valid codes can have 3, 4, 5, 6, or 7 characters<br />From 13,500 ICD-9 codes to 68,000 (up to 120,000) ICD-10 codes<br />Much greater specificity<br />
  6. 6. ICD-10… Coming Soon (Finally) <br />Final rule to Adopt Adopt ICD-10-CM and ICD-10-PCS published January 17, 2009.<br />Calls for adoption of ICD-10-CM to replace ICD-9-CM diagnosis codes and ICD-10-PCS to replace ICD-9-CM Volume 3 (procedure codes)<br />October 1, 2013 implementation <br />Single implementation date for all covered entities<br />Based on discharge date for inpatient services<br />Based on date of service for outpatient and physician services<br />
  7. 7. RAND Study<br />Costs…<br />Hardware and software changes, lost productivity, and training <br />Transition estimated at $425MM to $1.15B for the first year,and $5MM to $40MM a year thereafter<br />Assumes a simultaneous switch… if separate, add another$20MM to $170MM<br />Benefits<br />Harder to quantify, but appear to outweigh the costs<br />Estimated between $700MM and $7.7B over 10 years<br />Benefits Include:<br />improvements to the quality of care and patient safety<br />fewer rejected or questionable reimbursement claims<br />improved information for disease management<br />more accurate reimbursement rates for emerging technologies<br />better understanding of the value of new procedures<br />
  8. 8. Provider Impacts<br />Documentation of diagnoses and procedures<br />Codes must be supported by medical documentation<br />ICD-10-CM codes are more specific<br />Requires more documentation to support codes<br />Expect a 15% increase in documentation time (per AAPC)<br />Revenue Impacts of specificity<br />Denials<br />Additional Documentation<br />Coverage and Payment<br />New coding system will mean new coverage policies, new medical review edits, new reimbursement schedules<br />Changes will be made to accommodate increase specificity<br />May need to discuss changes with patients<br />Expect increased reject, denials, and pends as both plans and providers get used to new codes<br />Source: AAHM (June 2009)<br />
  9. 9. What Will It Cost to Convert?<br />Training - $195 per provider/admin staff and $1625 per coder<br />Changes to superbills<br />IT Costs – Much higher than transaction implementation<br />Documentation – 15% increase in time<br />Increases in claim inquiries, reduction in cash flow – 1% at a minimum<br />Source: AAHM (June 2009)<br />
  10. 10. ComplyMD is ICD-10 ReadyToday!<br />ComplyMD’s migrationfrom ICD-9-CM to ICD-10-CMfor diagnoses<br />
  11. 11. ICD-9 vs. ICD-10, a Comparison<br />More Data… Same User Interface<br />ICD-9<br />ICD-10<br />
  12. 12. ICD-10 Within ComplyMD’s Application<br />
  13. 13. ICD-9 vs. ICD-10, a Comparison<br />Reports are almost identical<br />ICD-9<br />ICD-10<br />
  14. 14. ICD-10<br />Ready When You Are!<br />