Implementation of ICD-10 in the Health Information Department





Implementation of ICD-10 in the Health Information Department

Quality Improvement Special Project

HIT/CIM Practicum


Project Title ICD-10 Implementation


This plan will outline the manner in which the health department will transition from the old to the new inpatient procedure codes and diagnosis. Thus, it will offer a detailed account of the process.
Problems Description Many of the codes for the previous classification are already full and lack specificity for making accurate anatomical descriptions. In addition, the ICD-9 codes use outdated terminologies that are not compatible with current trends. Similarly, the code lengths are short thereby preventing an extensive analysis of health care information.


Goal(s) To create a robust classification system that facilitates automated claim processing. Similarly, this plan will be geared towards reducing claim-payment delays. Furthermore, lowering the rate of payer-physician inquiries will be addressed. It will also streamline performance measurement for health care providers.
Background and Assumptions There has to be planning by the management to establish governance and risk management procedures. These developments need to be communicated with external partners as well. Consultations with other staff members should be carried out in order to identify the different roles they will play. Meanwhile, a training plan can be formulated to act as a guide for new recruits. Likewise, an assessment of the ICD-10 impact on the business and the respective policy changes are required. For example, budgetary allocations need to be made to cater for software upgrades.

An evaluation of all vendors has to be done to ensure that they comply with the requisite technological modifications. Preparation for system migration is essential at this stage and training sessions need to be scheduled to inform all personnel of their responsibilities. Consequently, an internal examination of the readiness of the institution will be conducted and thereafter, an external one completed. As such, an overhaul of the corporate culture will be made to align the activities with the new structure.

Benefits This plan enhances flexibility, which simplifies future updates. It also provides consumers, oversight agencies and integrity contractors with an opportunity to detect and investigate potential fraud. It also helps the department to design modern reimbursement and pricing structures as well. Moreover, a better analysis of disease patterns is possible while tracking and responding to outbreaks is feasible. Payment operations are streamlined too and coding accuracy is enhanced. Operational processes are improved across the health care industry as well.
Constraints There is a likelihood of large number of physician incompatibilities. This would force many doctors to partake in intensive and costly training sessions. The strict timelines would make the various facilities vulnerable to dual format processing in which delays in dispatching claims will affect the nature of the details to be filled. This is influenced by the date of service rather than the date of transmission. Similarly, the flow of cash will stall or halt a company’s financial operations since the changes will affect the entire industry with no guarantee of a smooth transition phase. Short-term budget falls could be experienced as well due to lower reimbursements. Additionally, a decline in productivity will occur, as employees will be engaged in training activities instead of performing their usual duties.
Outcome(s) The cost of healthcare provision will be reduced and the diagnosis of ailments will be more accurate. Furthermore, treatment of diseases will be done much faster thereby shortening the recovery period. There will be an improvement in the quality of services as well and this would boost the confidence of patients in seeking medical treatment at various outlets within the country.


Submitted by: _________________________________________________

Date: ___________________________


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