HHS's ICD-10 component of its HIPAA regulations is sweeping legislation that requires strong project management to focus on changes to documentation, coding/charging, billing/claims, and information systems and processes.

E-cognosys has developed specific methodologies, tools, and procedures that are designed to guide and assist organizations in achieving ICD-10 compliance as quickly and as cost efficiently as possible. Given the short timeframe established by HHS, an aggressive effort is required in order to ensure compliance by the effective date of October 1, 2013.

Despite the substantial civil and criminal penalties that HIPAA covered entities face, many organizations are still not fully compliant with the HIPAA rules leading up to ICD-10. Unlike the Privacy and Security Rules, the Transaction and Code Sets Rule poses business risks that far exceed civil and criminal penalties. The short-term implications of a failure to comply with ICD-10 legislation include the inability of providers to bill, submit, and receive payment for services and the inability for payers to receive and process claims for payment. Long-term implications include the inability to enjoy some of the strategic advantages anticipated from ICD-10, such as improved automation, better reporting, and enhanced pay-for-performance capabilities.

Delaying compliance efforts will only increase the cost and decrease the availability of knowledgeable, experienced consulting assistance and information systems vendors. In addition, delaying would preclude the competitive advantages associated with early implementation, such as improved operational efficiencies and more powerful data mining capabilities for pricing and pay-for-performance.

E-cognosys work with clients in a structured approach designed to achieve full ICD-10 compliance to meet the mandated effective date. We also assist our clients in optimizing the competitive advantages that the changing marketplace will offer.