Stage 2 of the electronic health records meaningful use program begins in October 2013 for hospitals and January 2014 for eligible professionals, and right after that comes the October 2014 compliance date for the ICD-10 code sets. A session during the ICD-10 Symposium on March 3 before HIMSS13 in New Orleans, “ICD-10 and Meaningful Use: When Worlds Collide,” will explore the coming convergence of the two initiatives.

ICD-10 by itself will be a major challenge for all stakeholders, but those participating in meaningful use also will face a transition in diagnostic-driven meaningful use quality measures from ICD-9 to ICD-10, says Stephen Spain, M.D., the session presenter, a practicing family physician and CEO at Doc-U-Chart, a Tyler, Texas-based consulting firm.

That means changing the coding and documentation of quality measures in the meaningful use program, possibly sometime during Stage 2 but certainly by Stage 3.  Unlike changes to the HIPAA financial and administrative transactions, providers cannot assume their vendors will do most of the work to be ready for ICD-10, Spain warns. If an EHR system isn’t properly documenting with ICD-10 when required under meaningful use, achieving meaningful isn’t going to happen. For now, providers should ensure that coders and clinicians are well represented on teams to prepare for ICD-10 and meaningful use preparation, as well as overseeing vendor performance. “You can’t count on your EHR vendor to make sure all the processes are done and work properly, he adds.”

As ICD-10 progresses, there will be guidance developed to help providers navigate the necessary tweaks to their meaningful use programs, Spain says. The National Quality Forum, for instance is reviewing meaningful use criteria to assess the needed changes. And medical specialty societies are working to update their quality measures to support the coming convergence of meaningful use and ICD-10, including deciding which of competing codes within ICD-10 would be the most appropriate to measure.

“I want folks to come away with a sense of how to put in place a long-range plan for how ICD-10 will affect their meaningful use reporting,” Spain says.

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