Transition to ICD-10 can reduce risk, improve workflow


The ability to better analyze clinical and cost data to secure stronger patient and revenue outcomes will rely heavily on the ability to access more granular clinical documentation as healthcare providers transition to a new coding framework.

That is the message of a new white paper released by Genpact, a provider of business process management and technology services. The paper is intended to help guide healthcare providers covered by HIPAA during the transition to the International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS), also known as ICD-10.

With this transition, providers are facing unprecedented changes, such as adding thousands of codes for recording patient conditions and requiring much more detailed documentation to support claims across multiple systems and processes.

The costs associated with implementing these changes will be significant, with estimates for some large practices being as much as $2.7 million according to a December 2012 American Medical Association letter to the Centers for Medicare and Medicaid Services.

The white paper explains how healthcare providers can obtain more targeted insights from the new ICD-10 system and therefore gain greater clarity and reduce denials and claims appeals. It explains how managing processes effectively and applying the right resources to adapt to ICD-10 is critical to reducing risk, improving workflow and increasing productivity -- resulting in optimized business operations and positive bottom line impact.

"The ICD-10 transition represents the most significant coding upgrade in 30 years, and organizations must be capable of capturing the essential benefits of the new system from day one," said Damandeep Kochhar, Genpact senior vice president and business leader, Healthcare and author of the white paper.

"To do so, companies must evaluate current processes, reengineer billing and claims operations, implement better documentation support, and leverage greater resources in order to fully optimize the transition for performance and proficiency, which will lead to enhanced patient care and improved revenue streams."

ICD-10, workflow, Medicaid Services, Medicare, patient safety events