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ICD-10: Why Payers Must Embrace ICD-10 and How They Should Prepare For It

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Making the Transition To This New Classification Structure

The Centers for Medicare & Medicaid Services (CMS) has published the final rule adopting ICD-10-CM and ICD-10-PCS as medical data code sets under HIPAA, replacing ICD-9-CM. The final rule requires an ICD-10 compliance date of October 1, 2013, providing a two-year extension from prior published notices.

Some payers may feel temporary relief from the extended timeline and, given current economic conditions, may think about delaying work on ICD-10 until 2010 or 2011. By doing so, payers will find themselves pressed for time to implement the required changes. Instead, HP believes payers now have adequate time to plan for and optimize ICD-10 in their business processes and operations if they start soon. For payers who start work now, the new timeline provides an opportunity to spread out cost and planning and to fully consider potential system replacement, modernization, and other optimization strategies. One of the best steps payers can take in 2009 is to perform an application and business process assessment in order to plan, budget, and schedule activities for 2010 to 2013.


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