Healthcare Solutions | Edifecs ICD-10 Code Management

Supporting The End-to-End Lifecycle of ICD-10 Migration Projects

Code mapping is just one aspect of the entire ICD-10 remediation process. An ideal code-mapping solution should support all phases of the project including remediation, testing and production translation. It should also support the iterative nature of map development.

Most ICD-10 code-mapping products are simple point solutions that don't fit into the iterative nature of ICD-10 code-mapping activities. In contrast, Edifecs ICD-10 Code Management supports the end-to-end lifecycle of an ICD-10 project. It provides greater efficiency, increased mapping accuracy and better map utilization to ensure healthcare entities can take the right approach to ICD-10 code mapping. Using Edifecs ICD-10 Code Management, you can:

Make sure your best analysts are working on your organization's riskiest code mappings

Considering the sheer volume of effort required for the ICD-10 transition, it is imperative that organizations prioritize efforts so they're focusing on the most important mapping activities first. Organizations need to make sure their most capable analysts are mapping the codes with the most financial risk to the organization. Using Edifecs Impact Analytics to identify high-risk ICD-9 codes in historical data, Edifecs ICD-10 Code Management optimizes mapping assignments and priorities.

Avoid relying on GEMs alone to build maps that achieve clinical and financial neutrality

As mapping efforts progress, many payers are discovering that GEMs doesn't provide definitive mappings relevant to their organization's medical policies, disease management programs and adjudication rules. Edifecs ICD-10 Code Management leverages a medical ontology approach that uses the underlying medical concepts in ICD-9 and ICD-10 code definitions to identify and rank mapping options, including those missed in GEMs. The solution allows analysts to generate maps with greater clinical equivalency between ICD-9 and ICD-10—thereby enabling a direct path toward clinical and financial neutrality.

Re-use your code maps across the organization

While numerous groups and downstream systems need to use ICD-10 code maps, most code-mapping tools only publish maps in proprietary formats that many downstream systems can't use. Edifecs ICD-10 Code Management publishes maps in both human- and non-proprietary, machine-readable formats, which means organizations can remediate a wide range of systems without having to recreate any maps for downstream purposes. Edifecs ICD-10 Code Management also serves as an online mapping reference resource for users throughout your organization.

Easily incorporate customizable business logic in your code maps

Most organizations have their own approach to benefit administration, medical policies and disease management and will likely need the ability to define business rules to govern how codes are translated to support different process areas. Edifecs ICD-10 Code Management allows definition as well as customization of business rules — the only code-mapping product to offer this capability.

Edifecs ICD-10 Code Management provides the additional information on code risks and improvements in code mapping processes to both accelerate and improve the accuracy of ICD-10 code mapping efforts.