On January 15, 2009, the HHS released the final regulation to move from the current ICD-9-CM coding system to the ICD-10-CM coding system beginning October 1, 2013.  This timeline allows for time to plan and implement the regulatory change.

The final rule to update the current 4010 electronic transaction standard to the new 5010 electronic transaction format for electronic health care transactions was also published with an implementation of January 1, 2012.  Version 5010 provides the framework needed to support ICD-10 diagnosis and procedure codes and is the prerequisite to implementing ICD-10. Quality is here to help you meet regulatory requirements for both EDI 5010 and ICD-10 implementation.  The need to update skills is not limited to medical coders, information systems will need to be updated or changed and the workflow and processes many have been using for years may also need to be changed or adjusted.  Our team of senior consultants realizes this will be one of the largest code set changes impacting the healthcare industry in over 20 years, and we are prepared to offer expertise in both clinical and financial systems, integration, and project management.

The key focus areas we address in assisting our clients achieve regulatory compliance include:

• Identify Current Use
• Identify current applications that use  ICD-9 codes  including but not limited to: 
• Clinical Documentation
• Coding
• Contract Management
• Interfaces/Interface Engine
• Reports/Queries
• Billing

• Investigate Current Vendor Systems
• What plans do they have in place for conversion
• What software changes are needed
• Determine whether they can support both the legacy and the new coding system and for how long
• Review contracts to determine if upgrades are included as part of your agreement
• Will hardware upgrades be needed for optimal system performance

• Implementation and Process-Improvement Plan
• Provide a step by step plan and timeline to phase in ICD-10
• Assist with facility staff in reaching goals and milestones within the timeline
• Identify opportunities that could improve decision making and reimbursement

• Education and Training
• Provide an assessment of education and training needs
• Assist in development of programs that are effective in meeting education and training needs