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Texas Health Preparing for Major Coding Transition

Texas Health Resources, along with other U.S. health care providers, is in the process of transitioning from the ICD-9 to ICD-10 coding system to be compliant by the Oct. 1, 2014 deadline. Originally, this transition was scheduled for October 2013, but was postponed by the U.S. Department of Health and Human Services over a year ago.  Although the postponement gave the industry more time, Texas Health Resources did not stop preparations to ensure a smooth transition.

"Texas Health will be prepared since planning started several years ago," said Elaine Anderson, Texas Health Resources senior vice president and chief compliance officer.

The ICD (International Classification of Diseases) is a coding system of diseases, symptoms and causes used internationally to classify morbidity and mortality data for health statistics and in the United States for reimbursement. Since the United States originally implemented ICD-9 in 1979, the system has become outdated.  The new ICD-10 system has approximately 141,000 diagnosis and procedures codes, more than eight times ICD-9, providing additional detail for diagnosis and procedure codes.

"ICD-10 will advance health care by producing better data for quality measures, research, monitoring, performance and reimbursement," said Anderson.

While the transition has many benefits, there are significant implementation challenges for providers and payors.  The functional areas most impacted by this transition have been preparing for quite some time.  ITS has worked to ensure our clinical, financial and quality applications are ready to accommodate ICD-10. Coding staff have been intensively training.  Super bills and mapping strategies are being evaluated, forms and requisitions will be revised and work flows will be modified. Even after the initial switch on October 1, 2014, THR will have processes in place to accommodate dual coding systems for several months and the revenue cycle will be monitored to identify problems or unexpected results. 

In 2014, Texas Health Resources and THPG will provide learning opportunities for our physicians to understand how the ICD-10 coding system will impact their practices and the level of documentation needed to describe hospital patient conditions and procedures performed.  Greater detail in documentation about complications, quality of care and disease specificity will be required to accurately implement ICD-10. To help physicians prepare, we will provide online training opportunities for all Medical Staff and THPG physicians.  We will also offer focused face-to-face training for hospitalists, selected high-impact specialties and THPG physicians.  Next Spring, more communication will be provided about these learning opportunities.

The systemwide ICD-10 Steering Committee formed in 2009 includes functional area representatives from across the system and is chaired by Anderson. In addition, there are ICD-10 teams at THPG and each hospital entity.

Functional Areas Represented

  • ITS
  • Health Information Mgt/Coding
  • Revenue Cycle
  • Finance
  • Compliance
  • Central Business Office
  • Texas Health Partners
  • THPG
  • Managed Care Contracting
  • Decision Support
  • THRE
  • Hospital
  • Quality/PI
  • Physician Champions
  • Documentation Improvement

Entity team chairs are invited to participate in the monthly systemwide steering committee conference call to keep communication flowing to entity teams, identify gaps, assist in deployment and develop entity action plans, if needed.

For more information, please contact Elaine Anderson for Texas Health Resources at 682-236-7055 or Dr. Lynn M. Myers, Medical Director, Coding, Healthcare Compliance & Education for THPG, at 682-236-5551.