Blue Cross Blue Shield of Michigan, Humana, and other payers have joined together to form the ICD-10 Consortium to help smaller providers with the transition to ICD-10, reportsICD-10 Monitor.
ICD-10 Consortium Plans
The consortium members goal is to meet with healthcare provider specialty groups, such as cardiology, dermatology, etc. to prioritize the ICD-9 codes they use most, then map them into ICD-10 codes. By identifying their top 25 ICD-9 codes, these smaller practices can help gauge their potential ICD-10 impact by specialty.
Dennis Winkler
“The framework helps specialties understand how they can map their current ICD-9 codes to the corresponding codes in ICD-10 so they can focus their preparedness activities on their particular book of business,” said Dennis Winkler, technical program director of program management and ICD-10 for Blue Cross Blue Shield of Michigan.
Once the providers have identified their top ICD-9 codes by specialty, they can perform ICD-10 testing with pre-defined scenarios to gauge the accuracy of the coding and potential reimbursement.
“The consortium approach is in response to concerns raised in testimony on Capitol Hill at recent NCVHS hearings that payors may not be able to test with a large number of providers,” said Sid Hebert, director of the ICD-10 implementation team at Humana. “This approach allows for interested providers to evaluate their coding proficiency with real-world examples, keyed to specialties, through a dynamic interchange with cooperating payers.”
Pilot Launch
The consortium plans to launch a small medical specialty pilot for healthcare providers in Michigan and utilize the lessons learned from that pilot before rolling the program out to multiple specialty organizations in other states.
