ICD10 and It's Impact

 

ICD-10 will mark one of the biggest changes to health care in the United States in many decades.

 

ICD-10 Compliance Date

CMS announced a Final Rule that requires the use of ICD-10 codes effective October 1, 2015

•Claims for dates of service on or before September 30, 2015 will use ICD-9 codes

•Claims for dates of service on or after October 1, 2015 must use ICD-10 codes

•This change impacts HEDIS 2015 which collects performance information about the 2014 calendar year

  

What’s Different? 

·         Much greater specificity!

o   Diagnosis codes increase from 13K to 68K (92K in our resource)

o   Procedure codes increase from 4K to 87K

·         Changes to format and structure

·         Concepts added

·         Concepts moved

·         Concepts deleted 

Why Change? 

·         Feasibility

o   ICD-10: An increase in the number of diagnosis and procedure codes, combined with the need to list codes individually, makes tables very large.

·         Improvement

o   Managing codes electronically will allow NCQA and customers to manage a large volume of information more efficiently and more accurately.

o   Using Value Sets standardizes terminology and definitions across measures and products.

 

Specific Changes 

·         Some HEDIS tables contain codes for a single concept, and any code meets criteria for reporting

o   All codes will be included in a single Value Set

·         Some HEDIS tables separate codes by Description

o   If different Descriptions are required for reporting, a Value Set will be created for each Description

o   If different Descriptions are not required for reporting, a single Value Set will be created

·         Value Set naming convention

·         Value Set references in HEDIS Publications 

 

Successful practices will have the right tools in place to make the transition as smooth as possible. AccuChecker is the RIGHT tool ! AccuChecker is The Complete Tool for Medical Reimbursement.

  

Questions

 

FOR MORE INFORMATION PLEASE CONTACT:

HPP Management Group, Corp.

Developers of the AccuChecker Product Line

Phone: (305) 227-2383

Email: sales@accuchecker.com

Website: http://www.accuchecker.com

 

 

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