Case Management Society of America

Features

Revisiting “Ready or Not—Here Comes ICD-10!”

BY JANET COULTER, RN, MSN, MS, CCM, and TRACY SUTTON, CPC

The time is here! October 1, 2015, is literally right around the corner, so we wanted to share a great article originally published in CMSA Today, Issue 5, in 2014. It covers the basics of ICD-10, implications for case management and coordination of care, implementation, and advantages, along with a number of tables and charts that will further aid case managers.

The ICD-10 transition is coming! Are you ready? The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) takes effect on October 1, 2015. ICD-10 is a major transformation in our health care system.

The transition to ICD-10 code set has many implications for case management and care coordination. Ability to identify high-risk segments of the population, improved tracking of stages of diseases, and improved ability to coordinate care directly impacts case management. Information provided by an ICD-10 code set can help to trigger a flag for a health care provider to assign an individual to an appropriate case management program and assist with coordination of care based on severity and complexity of the case. Long-term disease management opportunities can also be identified.

This is an opportunity for improved collaboration and communication between providers and case managers to provide higher quality, more evidence-based care for patients.

To continue reading, visit CMSA Today magazine’s website at www.cmsatoday.com/?p=397.