Did you know?
Healthcare providers classify medical conditions and procedures using a standard coding system. The International Classification of Diseases, 9th revision, ICD-9-CM, (Clinical Modification) has been in use since 1979. Public health relies on the receipt of ICD-9 data from healthcare providers to conduct a variety of activities.
Many public health information systems and data sets rely on ICD-9 codes to classify disease morbidity. SHA programs that may use ICD-9 coded data may include:
as well as special studies ranging from asthma and children with special health care needs to diabetes and coronary heart disease. This coded data is usually received directly from hospital and other health care providers, Medicaid and other payers.
Change is coming.
A significant change is now coming which will require that all systems using the ICD-9 codes be prepared for an entirely new coding system, ICD-10-CM/PCS (Clinical Modification/Procedure Coding System, herein referred to as ICD-10). The reasons for this transition are that ICD-10 is a more robust classification system, providing vastly more detail for diagnoses and procedures, revealing more about quality of care and allowing data to be used to better track outcomes.
The Department of Health & Human Services has mandated that healthcare providers (specifically, all covered entities under the Health Insurance Portability and Accountability Act (HIPAA)) must transition to ICD-10 on October 1, 2014. There will be no transition period or grandfathering, and without preparation for the new coding system a range of public health activities will be impacted.
This transition will impact systems, processes, and users which rely on anything utilizing ICD codes to define medical conditions and procedures. The IT challenges faced include an addition of at least ten times more codes than ICD9-CM, which are in a completely different format than ICD-9-CM codes. There are ICD-9 to ICD-10 translation dictionaries developed, but implementation of tools to implement them are not currently being coordinated at the state public health level.
In addition to the inherent challenges of the ICD-10 transition, there will be additional impact due to competing priorities with shrinking budgets and Meaningful Use implementation.
What does this mean for SHAs?
To prepare for this State Public Health agencies need to assess everything within their scope of activities which depends on the ICD coding system to function and determine the steps necessary to prepare those systems to accept ICD-10 data by October 1, 2014.
ASTHO, in support of its members and in collaboration with other public health associations and the CDC, will offer support and resources to help public health agencies navigate the assessment and transition processes for implementation of ICD-10.
The North Carolina Division of Public Health (NC DPH) has worked diligently preparing their agency for the ICD9-10 Transition. A number of tools, training materials, and other documentation about their transition planning are presented. These materials will be useful to other state and territorial public health agencies in developing their own planning and implementation strategies.
A sample of what is available:
1. Background of ICD-10 transition (webinar, slides)
2. Implementation Training for NC DPH (webinar, slides)
3. Implementation Training for Local Public Health (webinar, slides)
4. ICD-10-CM Training Plan (slides)
4. An overview of the Business Impact Assessment planning for the NC Division of Public Health (webinar, slides)
Tools and references:
1. Business Impact Assessment template (Excel file)
2. Clinical Documentation Assessment (Word file)
3. Current NC DPH ICD-10 Project Plan (Word file)
4. Current NC DPH ICD-10 Implementation Plan (Word file)
CDC Background Document
Developed by the CDC ICD-10 Transition Workgroup, this is a brief overview of ICD-10 conversion and its implications.
Developed by American Health Information Management Association (AHIMA) this is an overview of ICD-10-CM/PCS (Clinical Modification/Procedure Coding System).
Benefits to Public Health
From the Journal of Perspectives in Health Information Management, this is a review of the benefits of using ICD-10 in public health.
This document developed by Centers for Medicare and Medicaid Services (CMS) for State Medicaid Agencies (SMA) is to provide a checklist to assist the SMA in identifying which policies, processes, and systems use ICD codes and how ICD codes are used.
Impact Analysis Template
This document developed by CDC’s ICD-10 Transition Workgroup is to identify, evaluate and prioritize risks to high-risk operating systems, and how to monitor and mitigate them.
Project Management Plan Template
This a CDC provided template for developing a project management plan which can be used to develop state plans for assessing ICD-10 transition needs and goals.
Developed by CMS this is an overview of the bi-directional translation tables, General Equivalence Mappings (GEMs) prepared to convert between ICD-9-CM codes and ICD-10-CM/PCS.
This is the CMS main page for all the updated GEM tables.
ICD-10 transition page from the International Society for Disease Surveillance (ISDS)
ICD-10 transition page from National Association of County and City Health Officials (NACCHO)
Paula Soper, Senior Director, eHealth
Scott Gordon, Director, eHealth
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