Another “special” date for healthcare is quickly approaching – 10/1/2013. What makes this day so special? It is the date that the Centers for Medicare & Medicaid Services (CMS) will only accept services reported using the International Classification of Diseases, Tenth Revision, Clinical Modification, aka ICD-10-CM, not the current ICD-9 code set. Is this a big deal for your organization – indeed it is! But, before we go into that, let’s lay a little groundwork.

What is ICD-10-CM? It is the clinical modification of the World Health Organization’s (WHO) ICD-10 code set. Generally speaking the ICD code set has its roots dating back to the 17^th century when in London the causes of death were first recorded. One of the uses of this recording cause of death was an early warning system in case of bubonic plague reoccurrence (the first biosurveillance - pretty interesting, eh?).

So now back to the 21^st century, ICD-10-CM includes a greater detail level now required for morbidity classification and diagnostic specificity. ICD-10-CM is maintained by the National Center for Health Statistics. In addition, 153 countries around the globe use ICD-10 to some degree with the USA being conspicuously absent. Now for some factoids comparing the US’s currently used ICD-9 and ICD-10.

With this bit of background, lets investigate what this migration means for a care delivery organization? The biggest thing is the bucket of change gets even fuller. Most organizations are dealing with ARRA/HITECH Meaningful Use Sustainment. They are either in the middle of or just completed a series of upgrades and/or new system deployments. Now ICD modifications and changes!! The ICD-10 migration is as significant as Meaningful Use. The migration will impact all areas of care delivery from care delivery to billing to medical records and beyond – it is significant and mandated with a firm deployment date of 10/1/2013. Where are some of the areas of change? The following list is just a very brief listing and certainly not exhaustive.

• System upgrades to core clinical systems and billing to accommodate expanded field lengths and potentially additional fields. These upgrades could effect the front-end collection as well as the database for storage.

• Conversion of existing ICD-9 and local “vernacular” code sets to ICD-10

• Retraining for many areas primarily billing and medical records. These departments will have to learn new levels of code detail and how that will translate to new billing codes/DRGs

• Reworking of reporting. This will include the forms and potentially rewriting the reports themselves to accommodate the expanded detail.

There are many more areas of change, but these few serve to point out the significant impact of this change.

Just as you get Meaningful Use hopefully somewhat in hand, ICD-10 is in the queue. How does an organization manage these massive levels of change without the bucket overflowing? Planning and enterprise-wide involvement is key! Here is a best practice approach, identified by HIMSS, to maximize the probability of success:

• Strategy - Including resource plan, project approach and change management

• Schedule - Develop a realistic, well thought out plan spanning all touch points

• Impact Assessment - Evaluate impact on the classic three – people, process and technology

• Risk Assessment - Identify the risk and develop a mitigation approach

• Budget Estimate - Build a comprehensive budget for technology, external help, training

• Communication Plan - Employ an open and frequent approach to this upgrade, keep you organization informed and minimize surprises

• Testing Plan - Create a very detailed plan including approach, scripts and validation so when you go-live you know it will work.

• Go-Live Plan - Document go/no go decisions, back out plans, contingency plans and problem reporting

Lastly - Celebrate your success!!! (you have earned it)

So as your organization embarks on the ICD-10 adventure allow Santa Rosa’s experienced team to help your organization plan and execute your ICD-10-CM migration so that your bucket does not overflow and your organization can celebrate the success.

For more information on ICD-10 migration as well as our other services please visit us at http://www.santarosaconsulting.com