ICD-10 Migration Services


On January 15, 2009, the U.S. Department of Health and Human Services (HHS) published a final rule establishing ICD-10 as the new national coding standard. The new ICD-10 code set means that services can be more accurately defined, and more specific diagnosis and treatment information can be documented for a much wider variety of illnesses and diseases. By October 1, 2013, all inpatient records will need to be coded in ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes in order to receive reimbursement from Medicare and many other payers. Even before this significant transition to ICD-10, health systems must convert claims submissions to HIPAA X12 5010 Standards as well as auxiliary transactions including eligibility, referrals, claims status, coordination of benefits, and claims attachments no later than January 1, 2012.

At Santa Rosa Consulting, we believe that the healthcare industry has rarely had such compelling business events and pressures driving significant change in our industry with the combination of Healthcare Reform, ARRA/HITECH and the conversion to ICD-10.

Health system executives must gain a thorough understanding today of the requirements and the potential impact this transition will have and take the critical first step now toward planning for migration, mitigating risk and implementing effectively.

Santa Rosa Consulting can help with your ICD-10 Migration Services. Our methodology looks at both the technical and the business issues involved in the transition, helping our clients understand the IT Systems impact, required upgrades and migrations as well as the financial impact to their key MS-DRGs, clinical documentation workflow and coding accuracy.

Santa Rosa Consulting’s ICD-10 Migration Services include:

  • ICD-10 Systems and HIPAA X12 5010 Assessment & Planning:
    • Reviewing all systems that store ICD-9 codes and will be impacted, inventory and document
    • Identifying system application versions, timing of releases necessary for migration
    • Review and evaluate interfaces for X12 5010 compatibility
    • Gap Analysis for identified systems, interfaces or applications at risk for compliance
    • Migration Planning – Risk Mitigation, Key Milestones, Capital, Resources, Implementation Plan
  • ICD-10 Business Impact Assessment & Planning:
    • Claims Data Analysis: 12 months of claims data analyzed to understand how current data will translate to ICD-10 including the MS-DRG’s most severely impacted, identification of ICD-9 codes that do not translate directly to an ICD-10 code, and all the potential ICD-10 codes for them
    • On-Site Record Review: Comprehensive review of selected chart documentation and MS-DRG assignment and determining documentation accuracy for both ICD-9 coding guidelines and specificity for ICD-10
    • Comparative analysis of codes under ICD-9 and ICD-10, recommendations related to MS-DRG assignment, documentation improvement opportunities for both ICD-9 and ICD-10 to support accurate coding
    • Process improvements recommended to prepare for ICD-10 Implementation
    • Identification of documentation improvement opportunities for both ICD-9 and ICD-10 to support accurate coding

News Release: Santa Rosa Consulting and 3M Health Information Systems Team to Deliver ICD-10 Migration Services