Impending ICD-10 2014 Implementation

CHAPTER 1: INTRODUCTION3

Introduction3

Statement of the Problem3

Research Questions4

Sub -Research Questions4

Hypotheses5

Source(s) of data5

Assumptions5

Delimitations6

Positive Social Change6

Definition of Terms6

Coding History9

Coding of ICD-1011

Impending ICD-10 2014 Implementation12

The Affordable Care Act (ACA)13

What impact will ICD-10 implementation have on Oncology Coding15

Cost concerns of patients with Cancer17

CHAPTER 3- RESEARCH METHOD20

Introduction20

Research method21

Chosen research method23

Planning for data collection24

Data collection Method25

Instrumentation26

Data analysis27

Inclusion and exclusion criteria28

Generalisability29

References30

CHAPTER 1: INTRODUCTION

Introduction

Since ICD-10-CM (Clinical Modification) is used for diagnosis coding, it will have a very significant impact on all practitioners, including radiation oncologists. ICD-10-PCS (Procedure Classification System) is used for inpatient procedure coding by hospitals and is not expected to impact physician practices. The International Classification of Diseases, 10th Edition (ICD-10) implementation is fast-approaching. Effective October 1, 2014, ICD-10-CM/PCS will replace the ICD-9 code set, and it must be used by all providers for Medicare and private payer health care transactions. Since ICD-10-CM (Clinical Modification) is used for diagnosis coding, it will have a significant impact on all physicians, including radiation oncologists. Non-compliant Claims Will is rejected ICD-10 Implementation October 1, 2014. Issued on August 24, 2012, final rule CMS-0040-F delayed implementation of ICD-10 from October 1, 2013 to October 1, 2014.

Statement of the Problem

As there are no plans to further extend the compliance date for implementation of ICD-10 beyond October 1, 2014, it is expected that claims that are not compliant with the new code set by the new implementation date will be rejected. The transition to ICD-10 will not affect the use of CPT codes. Physicians will continue to use CPT codes to document procedures on their claims. The rationale for replacing the ICD-9 code set was that it was outdated and inadequate to accommodate new codes. There is also mounting pressure on the U.S. to transition to ICD-10, which has been the international standard to report and monitor diseases and mortality for several years. Effective October 1, 2014,This rule is one of a series of changes required by the Affordable Care Act (ACA) to address administrative simplification International Classification of Diseases, 10th Edition (ICD-10) will replace the current ICD-9 code set, and must be used by all providers for Medicare and private payer health care transactions. Therefore, Implementation of ICD-10 in 2014 will present significant challenges to oncology coders.

Research Questions

How does impending ICD-10 2014 Implementation change or improve Oncology coding, what will those changes mean to ICD-ONCOLOGY coding data sets?

Will ICD-10 Implementation enhance the statistical database or will it remain the same?

Sub -Research Questions

Sub-research question formulated for this study are listed below:

Will the implementation of ICD-10 will have a major impact on other specialties' such as hematology, pathology and as a whole?

How will it affect any freestanding centers which may be directly responsible for updating systems and ensuring that staff is trained in ICD-10?

How will hospital based coders as well as physician office coders are impacted by this change and should they plan to participate in their institution's implementation plans?

How will the rule help or hinder in establishing a unique health HPID-A unique health plan identifier will ...