The ICD-10 Delay and Its Impact on Care Management

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Posted by on April 8, 2014

by Christopher Mathews, MD – SVP and Chief Medical Officer, ZeOmega

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Christopher Mathews, MD is Senior Vice President and Chief Medical Officer for ZeOmega, and serves on the Board of Directors. He is a board certified internal medicine physician and physician executive with over 25 years experience in health care delivery systems and managed care.

Not much has been made of what this all means from a care management perspective. Will the delay have an impact, and, if so, what will it be? The short answer is yes, it will. Aside from the fact that ICD-10 allows for greater granularity and higher-value identification of patients who would most benefit from care management interventions, as these data are analyzed and processed, it will remain necessary to be able to read ICD-10 codes in addition to ICD-9. The key is to utilize technology that can do both; to continue building toward ICD-10 while still being able to work with ICD-9. The implementation delay shouldn’t be misinterpreted as an excuse to slow down building toward ICD-10. Those efforts should remain on track because, again, the conversion is inevitable.

The delay has a second implication for care management. Up to now, payers and providers have been rushing to prepare for ICD-10 in siloes; their respective efforts have been distinctly separate from each other. The additional time will give them an opportunity to collaborate and work more closely together to ensure a smooth transition.

In the long run, for health plans, whether it’s ICD-9 or ICD-10, the bottom line is paying for services and performing care management. ZeOmega has ample resources in place now for either and both, and we look forward to helping our clients make a smooth transition when the time comes. And it will. Inevitably.

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