ICD-10 and HIPAA 5010 Form Transitions May Not Be Ready To Meet Scheduled Deadlines-Aggregated and Shared Data Methodologies Req
Posted May 31 2011 12:58am
This should be be a big drop dead hint for anyone as if you follow how complicated healthcare software has become it’s only natural. New emerging technologies play their role to with disruption and then add on meaningful use and ACOs too, so how is all this going to fit in? Just back a few years ago rolling out new formats and rules was not that hard as all data was pretty much still on the desktop and stored on local servers, but it’s not that way anymore. With connected and aggregated data, one change has to feed an update to 20 other additional places and even though data travels fast, it sometimes snags at one of the updating destinations too and we again have unintended consequences arise. One example is cited below on the difference between ICD-9 and ICD-10 coding.
It’s hard to believe the deadline is a few months away being January 1, 2012. It was kind of shocking to hear that 67% of payers are not ready, but we know they focus on profits and shareholders first. This is why it pays to have someone at the top of the ranks with some “hands on Health IT” experience, some who have rolled up their sleeves and been in the front lines as those who have not tend to set unreasonable deadlines, we see it over and over today.
Just under half of the clearinghouses said they were not ready and believe it or not the article said that 66% said did say that implementation of meaningful use took center stage and that’ why they were not ready. See, you can’t do all of these massive aggregated data projects quickly as it takes time as all data has a ton of tentacles today. We are to the point where walking and chewing “bits” and “bytes” is becoming a challenge with the massive amounts of complexity of the healthcare data. I can see how someone on the outside of all of this can be critical and wonder why it takes so long, but again there’s good reason for it and when overwhelmed, hands go up and people give up.
While I’m on this topic of data we have a Congress who is just as bad and can’t see the value of technology and how it could help them create better laws, so it’s not just healthcare and those lawmakers who are digitally illiterate and can’t come out of denial of the 70s, make it worse for healthcare to move forward too as they don’t get it when it comes to effective laws. The healthcare law that was passed over a year ago was not bad, but things changed in a year and thus time for review again and modify where needed, it’s the way the world works today. Those folks and in state legislatures are still stuck on abortions and want to pass laws to put doctors in jail over the matter. This is stupid but it goes a long way to demonstrate the ridiculous lawmaker values on what really matters and what is important and by living in the past. those companies that use algorithms for profit just keep on doing it and the rest of us suffer as the balance of ethics sits in the background as we don’t seem to have the caliber of lawmakers who can “see” ahead. The best thing we end up with as consumers is getting is another useless mobile health application or a insurers putting a game online to gather more data to sell that tells us this is the way to better health. They just don’t get it.
In short our Congress and other lawmakers are so far behind that bat they can’t see the light on what is important and that link above proves it with the abortion focus and says a lot for digital illiteracy and wasting time when more important items on are on agenda.Those same folks will sit there and also scratch their heads to as to why technology takes so long in healthcare. All they can think about is spending millions of dollars on putting doctor Medicare claims on the web, what a farce as I have written many times it will not prove to be a good tool and would cost millions as there are tons of data errors and then one senator thought all of this could be done in 6 moths!
DIGITAL ILLITERACY AT IT’S FINEST AGAIN.
So as the time rolls on here we shall see how tight those deadlines will be. Sure there will be a few that are ready, but that’s not enough for what the new rules intend to accomplish so we can get our care. We know claims and data issues will delay payment and both consumers and doctors have been this route before and are well aware of what’s going to be dished out and we will be on the losing end of the stick again. BD
Two disruptive events in the world of coding , billing , and claims reimbursement are about to engage the full attention of clinical laboratories and pathology groups. First is implementation of HIPAA 5010 forms for claims submission by all types of healthcare providers. This is scheduled to occur on January 1, 2012—just seven months away!
Second is implementation of ICD-10 codes . Federal law currently requires all payers and providers to begin using ICD-10 on October 1, 2013. On that date, the existing ICD-9 codes will no longer be used.
Consultants in medical laboratory billing, coding, and reimbursement predict that implementation of the ASC X12 Version 5010 transaction standards , commonly referred to as the HIPAA 5010 form, will be easier on clinical laboratories than implementation of the full ICD-10 code sets in 2013.
Rather, the problem will be that some health insurance plans and payers did not fully prepare for the transition. Thus, their computer systems and their claims processing staff became overloaded as all classes of payers begin using the new HIPAA 5010 forms.
But the requirements of implementing the 5010 forms are relatively small compared to the major effort that will be required of all providers and payers to transition from ICD-9 to ICD-10.