This document discusses the impact of ICD-10 compliance on healthcare providers. ICD-10 will require significant changes to clinical documentation, billing systems, and provider workflows. It introduces over 69,000 diagnosis codes and 72,000 procedure codes, compared to 13,600 and 4,000 codes in ICD-9. Non-compliance could result in fines and rejected claims. Providers need to assess all clinical and financial systems, conduct testing, and train staff on the new codes. The presentation then describes Superia's ICD-10 compliance services, which include impact analysis, system remediation, testing, implementation tools, and staff 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. 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

7. ICD-10 Q&A Session

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