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通往ICD-10-CM/PCS实施之路:预测医疗服务提供者、支付方及其他医疗保健组织的过渡情况。

The road to ICD-10-CM/PCS implementation: forecasting the transition for providers, payers, and other healthcare organizations.

作者信息

Sanders Tekla B, Bowens Felicia M, Pierce William, Stasher-Booker Bridgette, Thompson Erica Q, Jones Warren A

机构信息

University of Mississippi Medical Center's Institute for Improvement of Minority Health and Health Disparities in the Delta Region, Jackson, MS, USA.

出版信息

Perspect Health Inf Manag. 2012;9(Winter):1f. Epub 2012 Jan 1.

Abstract

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.

摘要

本文将探讨美国医疗保健系统即将转换为使用《国际疾病分类第十次修订本,临床修订版/手术编码系统》(ICD-10-CM/PCS)的益处与挑战,并审视这一转变所带来的成本影响。文中讨论了诸多益处,包括医疗质量的提升、因支付准确性提高和未支付索赔减少而可能实现的成本节约,以及在与公共卫生和生物恐怖主义事件相关的医疗数据追踪方面的改善。在规划与实施、转变的财务成本、合格编码员短缺、医疗保健工作人员进一步培训和教育的需求以及转变期间的生产力损失等领域,文中指出了挑战。尽管转变将需要大量实施和转换成本,但在数据完整性、欺诈检测、增强成本分析能力以及改善患者健康结果监测等方面可实现潜在益处,随着时间推移将带来更大的成本节约。讨论最后向医疗保健组织提出了建议,介绍了技术进步以及劳动力培训和发展机会能够缓解向新编码系统转变的方式。

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