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ICD-10-CM and ICD-10-PCS Readiness


The implementation of ICD-10-CM/PCS on October 1, 2014, is one of the most sweeping changes in modern history to affect the entire health care industry, from providers such as hospitals, physicians, laboratory services, etc., to payers, software vendors, clearing houses, and billing services.

The new ICD-10-CM diagnosis coding system and the new ICD-10-PCS procedure coding system for hospital inpatient procedures constitute a vast expansion of the existing ICD-9-CM classification system and cause an urgent need for ICD-10 education for HIM staff, coders, billers, clinicians, and others. Health care organizations’ needs, however, extend far beyond the immediate education requirements. Necessary software system upgrades, financial impact analyses and productivity planning, and compliance concerns – to name a few – will affect the entire health care organization.

To prepare for the ICD-10 conversion and ensure the continued provision of quality patient care as well as the financial viability of the health care organization, Duggan HIM Services possesses the expertise to offer a variety of customizable solutions for health care industry professionals. Read on to learn more about our DRG audit services and other services to help you achieve compliance and meet your financial goals.

DRG, APC, and Coding Validation Audits

Ensuring compliance with reimbursement regulations and coding guidelines has never been as essential for health care providers as it is today. Successful transition to the new ICD-10-CM and ICD-10-PCS coding systems depends on the accuracy of currently existing data as much as defending claims in reviews by Recovery Audit Contractors (RACs) does. Partnering with Duggan HIM Services for MS-DRG, APR DRG, APC, and ICD-9-CM and CPT-4 coding validations is one of the steps to take to reach your health organization’s revenue and compliance goals.

Interested in learning more about our DRG audit services or coding validation? Check out the Services page to learn more.

Coding Training

The complexity of coding classification systems – whether the existing ICD-9-CM, the upcoming ICD-10-CM/PCS, or the outpatient prospective payment system – is ever increasing. The long-standing difficulty to recruit qualified HIM coders and ensure adequate staffing of HIM departments will certainly continue or worsen with the implementation of ICD-10 while at the same time the education needs of seasoned coders need to be addressed. Likewise, clinical documentation requirements to support correct code assignments and subsequent appropriate reimbursement for patient services also creates a dire education need. Duggan HIM Services provides customized education services that meet the diverse education demands of coding and clinical professionals as well as ancillary staff.

Compliance Management

The challenge to accurately apply and use the current ICD-9-CM and CPT-4 and future ICD-10-CM/PCS coding classification systems is not limited to the HIM department and the billing office staff, but instead stretches into various ancillary departments as well. The correct capture of diagnosis and procedure codes during patient registration or on service charge documents as well as an up-to-date and compliant charge description master (CDM) are equally as important to ensure a health care provider’s financial viability and ultimately quality of patient care. Duggan HIM Services takes this complexity into account in its approach to compliance management, offering a comprehensive selection of services.