Analyzing the ICD-10 Final Rule

AHIMA has posted a 13-page analysis of the final rule on the implementation of ICD-10-CM and ICD-10-PCS. The summary is a good overview of the lengthier final rules published in the Federal Register.

The final rule was published January 16. It designates ICD-10-CM and ICD-10-PCS as medical data code sets under HIPAA, replacing the 30-year-old ICD-9-CM set. There is a single compliance date of October 1, 2013.

In the final rule, the Department of Health and Human Services states that the greater detail and granularity of ICD-10-CM/PCS will enhance the ability to measure quality outcomes and provide more precision for value-based purchased initiatives such as the hospital-acquired condition payment policy.

As the US moves toward an electronic healthcare system and increasingly uses codes for quality purposes, there is a need to capture more precise information, and the new code sets will greatly support these efforts.

The transition to ICD-10-CM (diagnoses) will affect all components of the healthcare industry.

Adoption of ICD-10- PCS will only affect those components of the industry that currently use ICD -9-CM volume 3—inpatient procedures.

HHS anticipates the estimated impact of ICD-10-CM/PCS transition costs on providers, suppliers, payers, and software and system design firms is $1,878.68 million. It projects the benefits at $4,539.63 million over 15 years.

Other regulation analysis and official comment are also available from AHIMA’s Advocacy and Public Policy Center.

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