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| − | ICD-10 Impact Statement
| + | #REDIRECT [[ICD]] |
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| − | The upcoming ICD-10 transition scheduled for October 1, 2013 will require all HIPAA covered businesses operating in the Healthcare Industry to convert or map current systems using ICD-9 codes over to the new ICD-10 codes. Any claims submitted for Outpatient services with a date of service or Inpatient discharges with a discharge date on or after October 1, 2013 must be submitted using ICD-10 codes to avoid immediate denial. Claims that were denied due to use of ICD-9 codes will need to be resubmitted using ICD-10 codes [1].
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| − | Everyone will need to either convert or map existing systems over to use the new ICD-10 codes well in advance of the October transition date [1].
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| − | Changing from ICD-9 to ICD-10 will not only require changes to coding systems, but billing systems as well. The current HIPAA transaction standards for electronic health care transactions, such as claims processing systems, will change from version 4010/4010A1 to Version 5010. Health plans, healthcare clearing houses, and providers are impacted by this change. Any system used or claims processing, remittance advice, claim status inquiry, or eligibility inquiry must be adapted to accommodate the new ICD-10 format [2].
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| − | This transition will occur on January 1, 2012, well ahead of the ICD-10 transition date. Transactions from non-compliant systems will be rejected as of January 1, 2012 [3].
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| − | Hospitals that have converted to native ICD-10 codes will see minimal impact in reimbursements. However, hospitals that have chosen to map ICD-9 to ICD-10 codes may encounter problems with reimbursement due to differences with interpretation of codes used in mapping [4].
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| − | The overall cost of converting to ICD-10 is substantial due effort involved in changing systems, hiring technical staff/consultants, and training employees. According to RAND estimates, the benefits over 10 years may exceed $7 billion and far outweigh the costs. Mapping applications for backwards compatibility is less costly initially, however, the benefits are not predictable and maintaining application compatibility will be problematic [5].
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| − | References:
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| − | [1] "Overview ICD-10." Centers for Medicare & Medicaid Services. Web. 27 Feb. 2011. <http://www.cms.gov/ICD10/>.
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| − | [2] USA. Centers for Medicare & Medicaid Services (CMS). New Health Care Electronic Transactions Standards Versions 5010, D.0, and 3.0. Vol. ICN 903192. January 2010. Print.
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| − | [3] "Version 5010 ICD-10." Centers for Medicare & Medicaid Services. Web. 27 Feb. 2011. <http://www.cms.gov/ICD10/11a_Version_5010.asp#TopOfPage.>.
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| − | [4] Mills, Ronald E., Rhonda R. Butler, Richard F. Averill, Elizabeth C. McCullough, and Mona Z. Bao. Impact of the Transition to ICD-10 on Medicare Inpatient Hospital Payments. Tech. Wallingford, Connecticut: 3M Health Information Systems. Print. | + | |
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| − | [5] Converting MS-DRGs 26.0 to ICD-10-CM and ICD-10-PCS Page 6. http://www.cms.gov/ICD10/Downloads/CMS_ICD-10_ImpactAnalysis.zip | + | |
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| − | Submitted by Kenneth Gridley
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| − | [[Category:BMI512-WINTER-11]]
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