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Compliance

01:26 PM
Marianne Kolbasuk McGee, InformationWeek
Marianne Kolbasuk McGee, InformationWeek
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ICD-10 Conversion: Do Or Die

Failure to meet upcoming deadlines could mean major disruptions in claims payments for healthcare organizations.

While most providers are busy deploying financial, technology, and people resources to meet the Meaningful Use program requirements in the hope of obtaining large government bonuses, these payments--between $44,000 and $63,000 per eligible professional--are a drop in the bucket compared to the revenue your organization could lose if you miss the ICD-10 conversion deadlines. To put it bluntly, ignoring the Oct. 1, 2013 deadline could mean zero payments coming in for patient care.

The transition from ICD-9 to ICD-10 involves expanding medical diagnosis codes from the current 14,000 to more than 67,000, and procedure codes from 13,000 to 85,000. The U.S. Department of Health and Human Services (HHS) hopes the move will help the industry identify more billing fraud, allow more thorough quality reporting by healthcare providers, and enable refinements in reimbursement models through more detailed diagnostic and procedure data. HHS also expects the conversion will improve patient care and outcomes through new insights that may be uncovered in analysis of the more detailed clinical data.

But the road to ICD-10 will be a rocky one. The conversion "has an impact similar to Y2K several years back. It was a cumbersome process," said Pradep Nair, senior VP of healthcare for IT services firm HCL in an interview with InformationWeek Healthcare. On a more positive note, as busy as healthcare organizations are with other mandates, these projects are "making some CIOs step back and reevaluate the IT landscape, helping them clean up their systems," Nair said.

Read the rest of this article on InformationWeek

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