The road to ICD-10: case studies of the long awaited transition

The ability to accurately classify and document medical conditions has a significant impact on the ability of healthcare stakeholders to evaluate, measure, and react to changes in cost of care, quality of care, and clinical outcomes. For nearly 35 years, the United States utilized International Classification of Diseases revision 9 clinical modifications, ICD-9-CM, an increasingly antiquated and outdated system to classify diseases and medical procedures. On October 1, 2015, after many delays the Centers for Medicare and Medicaid Services mandated usage of ICD-10-CM and ICD-10-PCS by HIPAA covered entities. The transition process and outcomes of two healthcare delivery organizations located in Western Pennsylvania are profiled and discussed. The use of the most up-to-date coding system has significant positive implications for evaluation of healthcare delivery in a high reform environment where healthcare organizations are held accountable for providing high quality, low cost care with increasing focus on population health. Statement of Public Health Relevance: The ICD has relevance across the fields of public health and healthcare delivery. The implementation of ICD-10 provides significant opportunities to advance public health research, public health policy, and healthcare delivery. ICD-10 provides opportunity for greater specificity in diagnosis and procedures. From this data, there is the potential to address many challenges facing the field of public health and healthcare management