Welcome to ICD-10 Compliance

This site provides an overview of ICD-10 for executives of healthcare payer and provider organizations and recommends actions that should be taken to achieve compliance. ICD-10 is the most recent standardized set of diagnosis and procedure codes used for describing health conditions and will be the successor to ICD-9. As part of the HIPAA Transactions and Code Sets Rule, ICD-10 will require substantial investments from healthcare organizations and serve as a key enabler for increasing efficiency and lowering costs within the healthcare industry.

The Department of Health and Human Services has announced an effective date of October 1, 2013, for ICD-10 compliance. However, by the effective date of January 1, 2012, healthcare organizations must implement the precursory 5010 electronic transactions standards.

Those organizations that have not begun compliance efforts and have yet to establish a very clear strategy and approach may have difficulty meeting these deadlines. The estimated time to achieve compliance will be governed largely - but by no means solely - by the number of legacy systems and interfaces that are involved. With proper planning and implementation, the estimated time to achieve compliance is approximately three years.

TM Floyd & Company offers a set of services designed to assist healthcare organizations in achieving compliance. Our approach is based on a Change Leadership/Business Process Reengineering methodology. Additionally, we offer critical success factors designed to reduce complexity, cost, time, and physician resistance.

Key ICD-10 Facts

• Number of procedure and diagnosis codes increases substantially
• ICD-10-CM contains over 68,000 codes
• ICD-10-PCS contains over 72,000 codes
• Structure of codes changes from three to five predominately numeric characters to three to seven alphanumeric characters
• Reimbursement processes and levels will change because of the precision of new codes
• ICD-10 will have a major impact on inpatient care setting through the implementation of ICD-10-CM and ICD-10-PCS
  
• ICD-10 will have a major impact on payers operating legacy systems
• ICD-10 affects all code-capturing, code dependent, and code driven processes, interfaces, and systems
• There is potential for significant loss of productivity during and after transition
• There is potential for significant increases in accounts receivable and decreases in cash flow for provider organizations
• There is potential for significant increases in call volumes due to rejected claims
  
• There is potential for increased audits and sanctions