This document discusses how the transition from ICD-9 to ICD-10 coding will impact healthcare providers. ICD-10 codes will be significantly more complex, with 69,000 diagnosis codes compared to 13,600 in ICD-9. This will require providers to update clinical documentation, billing systems, and practice management systems. Providers could face fines and rejected claims if not compliant. Training clinical and administrative staff on the new codes is also necessary. The document outlines a suggested timeline for compliance and introduces Superia Inc.'s ICD-10 compliance services to help providers with impact assessments, system updates, testing, and training.

1. Impact on Providers
Presented By: Superia Inc.

2. Agenda
• ICD 10 Compliance-An Introduction
• ICD 10 Compliance-How it will impact the
providers?
• How to comply with ICD 10?
• Superia ICD 10 Compliance Service
• Q&A session

3. ICD 10-An Introduction
• ICD-10 CM & PCS is an upgrade of the US-developed
clinical modification (ICD-9-CM) of Diagnosis and
Procedure Codes, first adopted in 1979.
• Department of HHS has ruled that all coding must be
done in ICD-10 starting Oct 1, 2013.
• ICD-10-CM volume is 69000 alphanumeric codes
compared to ICD-9-CM volume of 13,600 numeric
codes
• ICD-10-PCS volume is 72000 alphanumeric codes
compared to ICD-9-PCS volume of 4000 numeric
codes.
ICD-9-CM Code ICD-10-CM Code
Flatulence, eructation, and gas pain R14.0 Abdominal distension (gaseous)
R14.1 Gas pain
787.3 R14.2 Eructation
R14.3 Flatulence
Abdominal pain, unspecified site
789 No Code

4. ICD 10 Compliance-How it will impact the
providers?
• Complexity and volume (5 times) in the coding will
demand changes to existing “Superbills”.
• Practice management Systems, Insurance Coverage
Systems, Billing Systems will have to changed
• An inability to comply with implementation may
result in massive fines and rejected claims
• According to Delloite, significant changes in
reimbursement patterns may impact provider cash
flow for a considerable period of time.
• Significant changes to Health Plans, documentation
requirements, coverage considerations.
• Across-the-board training to clinical and admin staffs
for learning the new codes and relearning of code
relationships.

5. How to comply with ICD-10?
• Evaluating all clinical, financial and business systems
that currently use ICD-9 codes.
• Overall Risk and Impact Assessment.
• Gap Analysis between current and future state.
• Compliance Project Plan
• Identification of capital cost, one time cost and
recurring cost and budget for it.
• Compliance Implementation
• Conduct internal testing
• Payer system integration
• Conduct external testing
• Start Parallel processing
• Complete Transition

6. How to comply with ICD-10?-Suggested timeline by
CMS
Phase 1: Implementation plan development and impact
assessment.
Timeline: 1st qtr 2009 – 2nd qtr 2011
Phase 2: Implementation preparation
Timeline:1st qtr 2011 – 2nd qtr 2013
Phase 3: “Go live” preparation
Timeline: 1st qtr 2013 – 3rd qtr 2013
Phase 4: Post-implementation Follow-Up
Timeline: 4th qtr 2013 – 4th qtr 2014

7. Superia ICD-10 Compliance Service
• Assessment and Planning Services- A combination of
tools, processes and services for ICD-10 assessment
and planning
• Impact Analysis- An automated tool will provide
comprehensive assessment of home grown
applications
• Remediation Service- Includes a dual remediation
approach with application remodeling and
enhancement, data migration and post-
implementation support and maintenance
• Testing-Complete manual and automated testing to
ensure 100% implementation.
• Implementation Translator-Tool to help your
organization to do parallel processing.
• Training-Training to help your staff in learning the
new codes and it’s usage in the new system

8. ICD-10 Q&A Session

9. Thank You
Superia Inc.
info@superiainc.com