The document discusses the transition from ICD-9 to ICD-10 diagnostic and procedure coding sets, which will be the most significant change to medical coding in 30 years. It outlines a three phase approach for healthcare organizations to successfully manage the transition: 1) A readiness workshop to understand the changes and impacts of the transition, 2) An assessment phase to identify impacts to processes, people and technology, and 3) An implementation phase based on the assessment results to support the transition across affected areas through project management, training and system updates. The transition involves changes to comply with HIPAA 5010 transaction standards by 2012 and adopting ICD-10 by 2013.

1. HIPAA 5010 & ICD-10 Transition
Now is the Time to Manage the Transition to
HIPAA 5010 and ICD-10
With the most significant change in diagnosis classification and procedure code
sets in 30 years, the adoption of ICD-10-CM & PCS promised to provide far reaching
benefits. It will not, however, come without significant implications for health
care organizations. In these times of economic uncertainty is your organization
ready to meet the challenges of budgetary restrictions and the demand for better
health information management? Are you ready to face the challenges related to
advanced technology in health care and ever increasing regulatory mandates?
ICD-10-CM & PCS Phase 1: The Readiness Workshop
READINESS WORKSHOP Making the transition from ICD-9 to ICD-10 requires a significant amount of strategic planning
Infogain’s ICD-10-CM & PCS and tactical execution. During the Readiness Workshop, Infogain educates and develops and
Readiness Worshop provides
the thought leadership and the awareness of all the implications around this very important strategic initiative. Topics covered
strategic “next step” guidance during the workshop include:
required to ensure a successful
transition to the HIPAA x12 1. Understand the Prerequisites to ICD-10
5010 by Jan 1, 2012, and to
ICD-10 by October 1, 2013. l What is the relationship between the diagnostic classification coding structure
and the HIPAA x12 5010 Transaction standards?
Topics include:
l Are the changes between the HIPAA x12 4010A1 and 5010 understood?
l Understand the Prequisites l Are the benefits and the complexity of moving to HIPAA x12 5010 understood?
to ICD-10
l Defintion of ICD-10 2. Definition of ICD-10
l Understand the Prequisites
l What is ICD-10-CM and ICD-10-PCS?
to ICD-10 l How does ICD-10 compare to ICD-9 code structure and format?
l Recognize Organizational 3. Recognize Organizational Impact of ICD-10
Changes
l What are the key information systems that will be affected?
l Leverage Benefits of ICD-10
l What are the business processes that will be affected?
l Best Practic Approach to l Who are the people that will be affected?
ICD-10 Success
4. Identify challenges of ICD-10
l How will the organization manage crosswalk tables to avoid manual processes
and loss of historical data?
l How will the organization prevent improper payments, fraud and abuse?
l How will your vendors’ readiness impact your organization?

2. HIPAA 5010 & ICD-10 Transition
5. Leverage the Benefits & Opportunities of Implementing ICD-10
l What benefits will you derive from the new coding structure?
l How can you position your organization to be a Market Leader through the
innovative use of ICD-10 data?
6. Best Practice Approach to ICD-10 Success
CORE OFFERINGS l Strategy – “Planning the Approach”
HIPAA ANSI Version 4010 to ANSI l Operations – “Assessment and Roadmap”
Version 5010 Transition
l Technology – “Supporting the Approach”
l 5010 Impact Assessment
l 5010 Project Management
l 5010 Implementation Phase 2: Roadmap to Assessment
In this phase, Infogain undertakes the mission critical task of discovery. Discovery sessions
ICD-10-CM & PCS Transition
cover the affected components of People, Process and Technology. Infogain carefullly
l Readiness Solution inventories and evaluates systems and processes.
n Operational Impact Analysis
n Remediation Strategy l Strategic Overview
n Compliance Framework l Implementation Project Planning
l Implementation Solution
l Information Technology
n Project Management
n Education and Training l Functional/Operational Areas
n Business Process Alignment n Product Development - Plan and Benefit Design
n Enrolment & Premium Billing
n Claims Management
n Provider Contracting
n Finance
n Customer Service (Member, Provider, Employer, Broker)
n Health and Medical Management
n Rating, Underwriting & Actuarial Services
Phase 3: Implementation
Implementation is based on the results of the Assessment and provides the support to perform
the transition of all the affected components to ICD-10, crafted to meet your organization’s
unique needs.
l Driven by the Needs Identified in the Assessment, including:
n System & Technology Procurement / Implementation
n Business Process Alignment
n Education & Training Program
n QA & Testing
n System Integration
n HIPAA 5010 Implementation
n Application Development & Remediation
l The following services are involved:
n Project Management
n Technical Architects
n Business and Technical Analysts
n EDI Analysts and Developers
n Testing Management and Testing Analysts
n Procurement Management
n HIPAA Transaction Implementation Consultants
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