IBM can help your business to realize optimal business value from ICD-10 adoption with the right investment at the right time. The ICD-10 compliance solution from IBM helps to reduce risk, accelerate implementation and minimize the costs of transformation with a proven SOA framework.

1. IBM Sales and Distribution
Solution Brief
ICD-10 compliance
The Department of Health and Human Services (HHS) has
Highlights mandated that all healthcare providers and health plans implement
the International Statistical Classification of Diseases and Related
● Develop a plan to support your ICD-10 Health Problems, 10th Revision (ICD-10) by October 1, 2013.
adoption business strategy
The Centers for Medicare and Medicaid Services estimate that the
● Create a scorecard for each department industry will spend US$7 billion to comply with ICD-10 requirements.
with specific, actionable business and The choice of implementation approach has potential to differentiate
technical recommendations
your organization.
● Prepare project plans, timelines, staffing
profiles, implementation timelines and
cost estimates Establish an optimal ICD-10 transformation
strategy
● Build an oversight plan with strategies
for future updates Organizations that react to ICD-10 legislation as simply a compliance
mandate risk the possibility of unpredictably large costs and small
value realization. Alternately, they can choose an innovative strategy
and take full advantage of the greater business value offered by
ICD-10 codes to offset anticipated costs. The ICD-10 compliance
solution from IBM includes separate but integrated engagements,
from strategic planning to final execution of the more tactical initia-
tives, to deliver the optimal value for ICD-10 adoption to your
business.
Enabling your transformation
The ICD-10 compliance solution is composed of four integrated
engagements:
● The ICD-10 strategic assessment which is designed to help plan an
ICD-10 adoption strategy by evaluating the current state of the
business.
● The ICD-10 implementation roadmap begins with plans developed
in the strategic assessment to help prepare project plans, timelines,
staffing profiles, implementation timelines and cost estimates.

2. ● ICD-10 business and technical project implementation offerings use
IBM’s experience, technical and business process assets and proven
service oriented architecture (SOA) framework to reduce risk, accel-
erate delivery and minimize the costs of ICD-10 transformation.
● Our ICD-10 shared oversight and roadmap refresh team engages
IBM senior consultants to jointly share responsibility with you for © Copyright IBM Corporation 2009
building a roadmap for future updates, from assessment through IBM Corporation
ICD-10 business value delivery. Route 100
Somers, NY 10589
Engagements can be purchased separately or packaged for joint sharing Produced in the United States of America
December 2009
of responsibility with IBM. Organizations that adopt ICD-10 earlier
All Rights Reserved
will be able to better prepare and optimize plans that outline short-
and long-term budget requests and the supporting business cases. IBM, the IBM logo and ibm.com are trademarks or
registered trademarks of International Business Machines
Corporation in the United States, other countries, or both. If
Align healthcare initiatives with these and other IBM trademarked terms are marked on their
first occurrence in this information with a trademark symbol
ICD-10 adoption (® or ™), these symbols indicate U.S. registered or common
The ICD-10 compliance solution can deliver business, process, people law trademarks owned by IBM at the time this information
was published. Such trademarks may also be registered or
and technology improvements. Compliance with ICD-10 offers the
common law trademarks in other countries. A current list of
opportunity to: IBM trademarks is available on the Web at “Copyright and
trademark information” at ibm.com/legal/copytrade.shtml
● Establish more accurate underwriting and product offerings. Other product, company or service names may be
● Base coverage on condition, not only treatment approach, for cover- trademarks or service marks of others.
age precision.
● Spot high dollar conditions sooner. Please Recycle
● Gain better understanding of medical conditions by member, group
and population.
● Recognize providers that are treating patients with more acute
conditions.
● Enhance pay-for-performance initiatives with significantly more pre-
cision in payment by procedure.
● Reject fewer claims and establish more precise services approval.
● Process fewer fraudulent claims and identifying misdiagnosis
up-coding.
The ICD-10 mandate can be a catalyst to an organization’s transforma-
tion plans. IBM’s fundamental concept is to consider the ICD-10 man-
date as a potential business opportunity, rather than just another
compliance project. Our experience tells us that with an incremental
investment, sufficient business value can be generated to cover compli-
ance cost, as well as deliver a potential return on investment.
For more information
To learn more about the ICD-10 compliance solution, please
contact your IBM representative or IBM Business Partner, or visit:
ibm.com/healthcare.
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