With the October 2013 deadline for ICD-10 implementation looming, providers are looking for solutions to make the shift as painless as possible.
St. Paul, Minn.-based 3M Health Information Systems recently released its 360 Encompass System, which offers auto-suggested codes and real-time clinical documentation improvement prompts that are delivered at the point of care. The application codes in ICD-10 and also enables coding in ICD-9 while viewing the ICD-10 equivalent.
“We think this will really help. Imagine if you only had auto coding, but you don’t have the documentation that you need to get to specific codes. That would translate into lower reimbursements,” said JaeLynn Williams, 3M’s senior vice president of marketing and client operations.
According to Williams, automation is integral to successful ICD-10 implementation.
“Automation is about taking problems you have and coming up with new ways to solve them with technology,” said Williams. “It’s critical in the ICD-10 transition to make sure to use technology to improve the documentation improvement process and coding and to do it at the point of care.”
Among the positive outcomes providers can expect from 360 Encompass are more accurate outcome measures, improved reimbursement rates and increased productivity, said Williams.
Ron Jones, senior vice president of hospital solutions at Eden Prairie, Minn.-based healthcare consulting firm OptumInsight, agrees that automation, specifically computer-assisted coding, is essential.
“Computer-assisted coding does three things,” said Jones. “It increases productivity, if used correctly. It increases revenue sources. It also improves compliance because the higher accuracy of coding minimizes risk and organizations can better defend their coding.”
Jones believes increasing automation within the ICD-10 process is a logical extension of the work most providers have already begun doing to digitize their records.
“Most hospitals have automated medical records now. Paper has been minimized. (This) allows computer assisted coding to utilize those records with tools like a natural language processing engine,” said Jones.
Jones says one product OptumInsight recommends to clients is Denver-based Health Language Inc’s LEAP I-10, a mapping tool for local and standard terminologies, which aids in converting ICD-9’s roughly 15,000 codes into ICD-10’s roughly 140,000 codes.
“With LEAP I-10, payers and providers can use their actual claims data to electronically simulate the financial, technology and operational impact of migrating from ICD-9 to ICD-10,” said George Schwend, president and CEO of Health Language Inc.
“Without the solution, organizations would have to perform those simulations and mappings manually, which would be very time consuming and costly. By automating those processes, LEAP 1-10 makes it easy for users to identify and compare the clinical and financial impacts of every ICD- 9 diagnosis and procedure code to its ICD-10 equivalent and vice versa,” continued Schwend.
“It not only helps users protect their bottom line but also allows them to make informed clinical decisions,” added Schwend.
As providers prepare for ICD-10, Jones warns against thinking of it as primarily an IT problem. “ICD-10 is not a coding issue. It’s a revenue cycle issue. It’s also a clinical documentation issue and hospitals need to be thinking about doing things differently,” he said.
For her part, Williams thinks the challenges of implementing ICD-10 will be worth it in the end. “The data and the details are absolutely required for where we as an industry and a country want to go. As we all think about the headaches, we should also think about the benefits.”
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