Health care software developer VitalWare has introduced VitalView, a Web-based project-management tool that provides clinical and financial data to help health care companies adhere to new federally mandated diagnosis codes.
The Department of Health & Human Services requires that all medical claims include ICD-10 codes instead of ICD-9 starting on Oct. 1, 2013. HHS had pushed back this deadline from Oct. 1, 2011.
VitalView's dashboard lets health care facilities perform analytics and compile reports to keep track of ICD-10 timelines and requirements. Hospital IT administrators will be able to view a product readiness indicator, a tool that shows which software used by hospitals may or may not be compliant with ICD-10.
Drawing on its knowledge base and intelligence, VitalView transmits automatic alerts to team members when a vendor or product has missed or completed an ICD-10 milestone or is at risk of missing a claims deadline related to the diagnosis codes.
"It's a system that facilitates communication between all those thousands and thousands of products and vendors that hospitals depend on and gives the hospitals a communication tool that allows them to start planning their testing, which for many hospitals will take six to nine months," Kerry Martin, CEO of VitalWare, told eWEEK.
VitalWare announced VitalView on June 14.
Transitioning financial and clinical software to ICD-10 diagnostic codes could cost large health care organizations $20 million, with the average hospital spending $2 million and $5 million to overhaul or replace its systems, said James Swanson, director of client services at IT consulting firm Virtusa, according to Computerworld.
The transition from ICD-10 to ICD-9 is often considered more complex than the Y2K transition for the date field in databases in 2000.
"Industry analysts characterize ICD-10 as potentially exceeding Y2K with respect to cost and impact, so advance planning is essential," wrote Christine M. Armstrong, a principal at Deloitte Consulting, in a report.
The ICD-10 standard currently has about 69,000 codes compared with about 14,000 in ICD-9. By Oct. 1, 2013, more than 16,000 ICD-9 codes need to convert to more than 154,000 ICD-10 codes.
ICD-10 consists of three to 7 characters compared with the three to five for ICD-9.
An example of an ICD-9 code is 462 for a sore throat and one ICD-10 code is A69.21, signifying meningitis due to Lyme disease.
For physicians, ICD-10 brings challenges of documenting codes based on a significantly revised vocabulary, Martin said.
From a software perspective, the change in diagnosis codes meant a restructuring of data fields in applications like VitalView as ICD-10 brings additional alphanumeric characters and onscreen space issues to fit the additional data.
"Because of ICD-10's complex code structures, implementing associated changes in electronic medical records, billing systems, reporting packages and other decision-making and analytical systems will require either major upgrades of multiple systems, or outright replacement of older systems," Armstrong wrote.
ICD-10 is the main format for diagnosis codes used in inpatient reimbursement, according to Martin. The federal government relies on the diagnosis codes when deciding on reimbursement funds based on quality of care. With ICD-10 compliance, hospitals may avoid an interruption in reimbursement, he said.
Many health care companies remain unprepared for the ICD-10 transition, according to Martin. "There's definitely a significant amount of vendors that haven't done enough and aren't in a good spot right now," he said.