ICD-9 codes provide a wealth of statistical information for healthcare organizations. There are many details that are captured within each code that tell a story of the complexity of each patient’s diagnoses and treatment course. These codes also provide a basis for determining reimbursement for healthcare organizations therefore the importance of coding in an organization cannot be understated. ICD-10 promises to bring even more specificity and detail to patient diagnoses and procedures which will be very beneficial but we have work to do to ensure a smooth transition. Are your organization’s reports ready to accommodate ICD-10 data?
The upcoming change to ICD-10 codes is going to make a huge impact for the HIM workflow especially when it comes to reporting. At this point, we should already be well along the way with updating administrative systems to capture the new code set once we begin officially using it. The best way to get moving with this is to identify all of the current reports that contain ICD-9 data and determine the steps it will take to update these reports to shift to ICD-10 data. If this requires working with vendors, these conversations need to be taking place on a regular basis to make sure important updates are installed as needed. Since the structure of ICD-10 codes is different from ICD-9, we must use precise fields to capture enough characters and details in reports beginning Oct. 1, 2015.
In HIM, we rely on many different reports to monitor data that impacts the daily functions of the HIM department. A major source of our information comes from coding data including ICD codes and DRGs. One of the biggest uses of coded data in HIM is the discharged not final billed (DNFB or DNB) report. Most organizations use this type of report to capture accounts that need to be coded or accounts that are missing documentation. Since we have used ICD-9 data for the last few decades, these reports are hard-wired for ICD-9 and will need a major overhaul or may need to be started again from scratch. Have you accounted for the time and resources it will take to get your DNFB report back in working order come Oct. 1?
A large amount of coded data is used for quality reporting purposes therefore we must update all of the systems that generate and export these reports. Many reports are used to compare current data to previous months and years. We must ensure our publicly reported data is accurate and that our historical data is maintained for reference as long as it is needed. Also remember that claim denials and audits can go back several years and we will need to be able to reference our logic used at the time the accounts were coded. Once we are live with ICD-10, we will need to validate trended data and make sure the data that we rely on for future planning is accurate. So now the challenge comes with determining how much historic data to maintain in order to run these comparison reports and for how long. This will be a significant transition period for us to update systems and maintain these reports in both code sets as needed. If you haven’t started this project yet, now is the time to prepare.
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