ICD-10–CM/PCS and V5010 Services

The compliance date for the implementation of the International Classification of Diseases, 10th Edition, Clinical Modification/Procedural Coding System (ICD-10-CM/PCS) is October 1, 2013 for all covered entities.  This new coding system incorporates much greater specificity and clinical information than the current ICD-9-CM coding system (increasing the number of codes from 13,000 to 68,000) and as such requires an in-depth assessment of the impact of the conversion on the organization and the development of a remediation action plan to successfully address and prepare for the changes that will impact the workflow and policies of many departments across the organization.  In addition, for healthcare organizations to be successful with the implementation of ICD-10-CM/PCS and also meet the criteria for Meaningful Use, physician documentation must be thorough.  Avery Partners Healthcare provides certified ICD-10 specialists to assist the hospital in the assessment of current state, development of future state and associated roadmap, implementation and migration to the new coding system and finally attaining operational optimization.

A prerequisite for ICD-10 is the conversion to the new HIPAA required EDI transaction sets called V5010.  All hospital billing systems must begin utilizing this format for all claims processing beginning no later than January 1, 2012 (On November 17, 2011, CMS extended the compliance date to 3/31/12).  These changes are aimed at increasing standardization and automation to improve the speed and accuracy of payer and provider electronic interaction.  The revenue cycle vendors’ systems must be able to support this new format but there are other significant considerations for the hospital.

Avery Partners Healthcare services in this area include business and IT impact analysis, development of high level roadmap and business case, requirements definition and integration with the vendor’s approach, design and implementation of new workflows and training and testing.

ICD-10 and V5010 services engagements typically range from 4 weeks to 4 months in duration.