LEAP I-10 is an affordable, scalable solution that simplifies the transition to ICD-10-CM/PCS.

The ICD-10 conversion presents a considerable challenge for healthcare organizations because it involves a significant amount of “unknowns”.  There are no “one size fits all” solutions and insurance providers must evaluate the needs of all of their business units to create a customized conversion approach.  The migration from 18,000 ICD-9-CM codes to more than 140,000 ICD-10-CM/PCS codes will affect almost every department within your organization and an in-depth, systematic analysis is required to ensure clinical accuracy and revenue neutrality.

Expose areas of potential risk

Using historical claims data (or any other list of ICD-9 codes) and the GEMs Reimbursement maps, LEAP I-10 can simulate MS DRG assignments in ICD-10-CM/PCS. The system allows users to filter claims by high-cost, high-frequency diagnoses and procedures so that payers can prioritize their conversion plans accordingly. The system also flags MS DRG assignment variances between the code sets, further indicating where payers should focus their attention.  

Compare clinical concepts

LEAP I-10 features a user-friendly interface that displays the forward and backward ICD-10-CM GEMs mappings for any given ICD-9 code.  The system’s robust “drill down” and search capabilities allow payers to efficiently analyze the clinical accuracy of these mappings and modify them to accommodate existing medical policies and benefit plans.

Generate Actionable Business Intelligence    

To realize the full benefits of ICD-10-CM and its increased granularity, payers will need to perform extensive clinical research and analysis. LEAP I-10 supports the needs of distinct business units within your organization (ex. claims, medical policy, care management). Any changes made to the corporate-sanctioned mappings, business rules, and code sets are noted within the application to ensure that existing insurance policies are reviewed and modified to keep pace with a constantly evolving healthcare market.

Enable Enterprise-Wide Terminology Governance

LEAP I-10 builds upon the powerful functionality of the Health Language flagship product, the Language Engine (LE). LE has been in wide production for over a decade, and performs enterprise-wide terminology management functions for a variety of healthcare payers, providers, health information exchanges, and vendors worldwide. It provides centralized access to medical terminology standards and generates mappings to create a common pool of standardized codes and concepts that enhance patient safety, facilitate clinical outcomes analysis, and accelerate reimbursement.

• ICD-10 Countdown
  
• Enable Enterprise-Wide Terminology Governance
• GEMs+ Conversion Solution
  

Request more information about LEAP I-10 for Payers.