2. Agenda
• ICD 10 Compliance-An Introduction
• ICD 10 Compliance-How it will impact the
providers?
• How to comply with ICD 10?
• Superia ICD 10 Compliance Service
• Q&A session
3. ICD 10-An Introduction
• ICD-10 CM & PCS is an upgrade of the US-developed
clinical modification (ICD-9-CM) of Diagnosis and
Procedure Codes, first adopted in 1979.
• Department of HHS has ruled that all coding must be
done in ICD-10 starting Oct 1, 2013.
• ICD-10-CM volume is 69000 alphanumeric codes
compared to ICD-9-CM volume of 13,600 numeric
codes
• ICD-10-PCS volume is 72000 alphanumeric codes
compared to ICD-9-PCS volume of 4000 numeric
codes.
ICD-9-CM Code ICD-10-CM Code
Flatulence, eructation, and gas pain R14.0 Abdominal distension (gaseous)
R14.1 Gas pain
787.3 R14.2 Eructation
R14.3 Flatulence
Abdominal pain, unspecified site
789 No Code
4. ICD 10 Compliance-How it will impact the
providers?
• Complexity and volume (5 times) in the coding will
demand changes to existing “Superbills”.
• Practice management Systems, Insurance Coverage
Systems, Billing Systems will have to changed
• An inability to comply with implementation may
result in massive fines and rejected claims
• According to Delloite, significant changes in
reimbursement patterns may impact provider cash
flow for a considerable period of time.
• Significant changes to Health Plans, documentation
requirements, coverage considerations.
• Across-the-board training to clinical and admin staffs
for learning the new codes and relearning of code
relationships.
5. How to comply with ICD-10?
• Evaluating all clinical, financial and business systems
that currently use ICD-9 codes.
• Overall Risk and Impact Assessment.
• Gap Analysis between current and future state.
• Compliance Project Plan
• Identification of capital cost, one time cost and
recurring cost and budget for it.
• Compliance Implementation
• Conduct internal testing
• Payer system integration
• Conduct external testing
• Start Parallel processing
• Complete Transition
6. How to comply with ICD-10?-Suggested timeline by
CMS
Phase 1: Implementation plan development and impact
assessment.
Timeline: 1st qtr 2009 – 2nd qtr 2011
Phase 2: Implementation preparation
Timeline:1st qtr 2011 – 2nd qtr 2013
Phase 3: “Go live” preparation
Timeline: 1st qtr 2013 – 3rd qtr 2013
Phase 4: Post-implementation Follow-Up
Timeline: 4th qtr 2013 – 4th qtr 2014
7. Superia ICD-10 Compliance Service
• Assessment and Planning Services- A combination of
tools, processes and services for ICD-10 assessment
and planning
• Impact Analysis- An automated tool will provide
comprehensive assessment of home grown
applications
• Remediation Service- Includes a dual remediation
approach with application remodeling and
enhancement, data migration and post-
implementation support and maintenance
• Testing-Complete manual and automated testing to
ensure 100% implementation.
• Implementation Translator-Tool to help your
organization to do parallel processing.
• Training-Training to help your staff in learning the
new codes and it’s usage in the new system
