In preparation for the expected transition from ICD-9 to ICD-10 on October 1, 2015, evaluation of the impact that this change will have on NYP’s quality measures data (e.g. – AHRQ Patient Safety Indicators, Value Based Purchasing) used for public reporting, is a critically important undertaking.

ICD-10 has greater specificity and detail for both diagnoses and procedures.   This enhancement provides better data for use in assessing patient severity, outcomes, and quality of care. Understanding the differences in the ICD-9 and ICD-10 definitions is important in assessing changes or shifts in volumes or outcomes observed. Increases or decreases in case volume and case compliance could impact publicly reported data, affect reimbursement, and change how NYP compares to and ranks among other peer organizations. Some measures, because of ICD-10’s impact on the qualifying patient populations could lead agencies to question the original intent of the measure, refinement of the measure, or even lead to some measures becoming obsolete.

Everyone is in a learning phase. NYP is in the process of thoroughly reviewing ICD-10 code set conversions and estimating changes in patient populations and the metric results for approximately 23 different safety and quality indicators. To date, four of those measures appear to be potentially affected by the transition. An example of one those measures, accidental puncture and laceration is included here.

To conceptualize the increase in number of codes, predominately due to specificity, that will occur in moving from ICD-9 to ICD-10 that are utilized in various inpatient quality measures reporting see TJC specification manual reference documents and website.