Lean Forward: Easing the ICD-10 October Implementation for Rural Arizona Health Providers

What is ICD-10? In October of 2015, all physicians, hospitals, and health plans will begin using ICD-10 (International Classification of Diseases), an upgrade from ICD-9 used in the U.S. for 30 years. The World Health Organization (WHO) adopted ICD-10 in 1990, used by other countries for many years.  ICD-10 will be used to classify disease, report illnesses, monitor morbidity and mortality, and importantly - to provide better individual and population health data to continuously improve and inform clinical treatment.  

Why is ICD-10 such a big deal? Public and private health insurers will use ICD-10 to receive and pay all bills (claims) submitted by hospitals and physicians, through electronic claims processing. Because ICD-10 will be used for every fiscal transaction related to health provider service delivered in hospitals, clinics, and other sites it is crucial that providers, payers, health plans and other vendors understand and are trained to use it.

Why should the U.S. upgrade from ICD-9 to ICD-10? The Health Insurance Portability and Accountability Act of 1996 (HIPPA) directed the Secretary of the U.S. Department of Health and Human Services (HHS – currently - Secretary Burwell) to set and regularly update standards for the electronic exchange of health information, including claims processing. Another federal agency housed in HHS, the Centers for Medicare and Medicaid Services (CMS) tasked with evaluating the aging ICD-9 coding system found many problems.

Why has ICD-10 been delayed so many times? Opponents to ICD-10 cite cost concerns related to training staff to use the new system to submit electronic bills, and new requirements including e-prescribing, buying and meaningfully using electronic health records, and reporting quality measures.  But there are growing costs of delaying implementation, and an American Hospital Association survey in 2013 found 95% of member hospitals confident of successful ICD-10 implementation.

What resources are available to ease the transition to ICD-10? The CMS Road to 10 webpage has ICD-10 basics and benefits, webcasts, and more. CMS videos explain that by “Using ICD-10, doctors can capture important details about a patient’s health. Also, researchers and public health officials can better track diseases and health outcomes nationwide.”

What is the Arizona Center for Rural Health (CRH), and its Arizona Rural Hospital Flexibility Program (AzFlex) doing to help hospitals and health providers prepare for ICD-10? CRH ICD-10 Boot Camp - Jill Bullock, CRH Rural Health Services Coordinator, facilitated the ICD-10 Boot Camp in Phoenix, Tuesday March 17th & 18th on reimbursement, coding and compliance. The CRH, AzFlex and the Association of Rural Health Professional Coders (ARHPC) co-sponsored the camp held at the University of Arizona Phoenix Biomedical Campus. It offered 9 continuing education credits to the 48 billing and coding staff, office supervisors and physicians attending from across Arizona including participants from 9 of Arizona’s 15 Critical Hospitals (rural hospitals with <25 beds).

“I thoroughly enjoyed our ICD-10 training. I feel confident we are beginning the successful implementation of ICD-10!” said Wickenburg Community Hospital staff after the boot camp. “When ICD-10 goes live in October, we will help answer questions and address issues through a listserv and blog to ease the transition and better serve rural Arizona.”  


Useful Resources

  1. CMS ICD-10 Website: http://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10
  2. CMS ICD-10 Resources: http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10ResourcesFlyer20141105.pdf
  3. CMS ICD-10 Fact Sheet: http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10Introduction20140819.pdf
  4. WHO ICD-10: http://apps.who.int/classifications/icd10/browse/2015/en

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