ICD-10-CM/PCS实施之路:预测供应商、支付方和其他医疗保健组织的转型。

Tekla B Sanders, Felicia M Bowens, William Pierce, Bridgette Stasher-Booker, Erica Q Thompson, Warren A Jones
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引用次数: 0

摘要

本文将研究美国医疗保健系统即将转换为使用国际疾病分类第十版临床修改/程序编码系统(ICD-10-CM/PCS)的好处和挑战,并将审查转换的成本影响。讨论了包括提高护理质量、提高付款准确性和减少未付索赔带来的潜在成本节约以及改进与公共卫生和生物恐怖主义事件相关的医疗保健数据跟踪等好处。在规划和实施、过渡的财务成本、合格编码人员短缺、需要对医疗保健工作人员进行进一步培训和教育以及过渡期间生产力的损失等领域都注意到了挑战。虽然过渡将需要大量的实施和转换成本,但可以在数据完整性、欺诈检测、增强成本分析能力和改进对患者健康结果的监测等领域实现潜在的好处,随着时间的推移,这些好处将产生更大的成本节约。讨论最后向医疗保健组织提出了一些建议,说明技术进步、劳动力培训和发展机会如何能够简化向新编码系统的过渡。
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The road to ICD-10-CM/PCS implementation: forecasting the transition for providers, payers, and other healthcare organizations.

This article will examine the benefits and challenges of the US healthcare system's upcoming conversion to use of the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) and will review the cost implications of the transition. Benefits including improved quality of care, potential cost savings from increased accuracy of payments and reduction of unpaid claims, and improved tracking of healthcare data related to public health and bioterrorism events are discussed. Challenges are noted in the areas of planning and implementation, the financial cost of the transition, a shortage of qualified coders, the need for further training and education of the healthcare workforce, and the loss of productivity during the transition. Although the transition will require substantial implementation and conversion costs, potential benefits can be achieved in the areas of data integrity, fraud detection, enhanced cost analysis capabilities, and improved monitoring of patients' health outcomes that will yield greater cost savings over time. The discussion concludes with recommendations to healthcare organizations of ways in which technological advances and workforce training and development opportunities can ease the transition to the new coding system.

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来源期刊
CiteScore
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期刊介绍: Perspectives in Health Information Management is a scholarly, peer-reviewed research journal whose mission is to advance health information management practice and to encourage interdisciplinary collaboration between HIM professionals and others in disciplines supporting the advancement of the management of health information. The primary focus is to promote the linkage of practice, education, and research and to provide contributions to the understanding or improvement of health information management processes and outcomes.
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