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Role-based Model for ICD-10 Implementation: Data Managers

Data Managers

Data managers need to fully grasp the data level differences between ICD-9-CM and ICD-10-CM/PCS so they can assess the impact. To do that, they need to understand the new code sets enough to forecast what they must alter in the database in order to accommodate this change. A fundamental understanding of ICD-10-CM/PCS (code structure, format, length, and hierarchy) is necessary. Data managers also need a thorough understanding of the ICD-10-CM/PCS final rule so they know regulatory compliance dates. Because they will manage the legacy data and comparisons between ICD-9-CM and ICD-10-CM/PCS, data managers must understand what maps are available to translate data between the code systems and understand the use case (where maps are and aren't appropriate to use)

To Do Phase 1:

  1. Review the ICD-10-CM/PCS final rule and define the timelines for compliance.
  2. Learn about the structure, organization, and unique features of ICD-10-CM and ICD-10-PCS.
  3. Begin learning about the general equivalence mappings (GEMs) between ICD-9-CM and ICD-10-CM/PCS.
  4. Begin to assess and communicate the database changes that are required to the technical people (IT or a vendor) who are responsible for re-programming the database application.

Corresponding Resources:

Phase 2:

While four years prior to implementation the focus is on understanding the code sets, three years prior to implementation the focus is on assessing the specific impact to the data and informing those who will modify the database application. It's important for data managers to collaborate with IT to ensure thorough implementation planning.

Data managers understand the nuances and limitations of the data they are using and comparing in reports they produce. This includes ICD-9-CM classification data. We expect these people to be early adopters of ICD-10-CM/PCS.

Data managers will want to learn the new code systems early, so they can look for consistencies and inconsistencies between ICD-9-CM and ICD-10-CM/PCS and begin to forecast how this change will affect their longitudinal data reporting

Steps related to maps are focused on understanding the code sets, though perhaps with a deeper dive. Data managers should begin to use the maps to get a feel for how they will be useful and how they impact the data.

To Do Phase 2:

  1. Learn the fundamentals of the ICD-10-CM and ICD-10-PCS systems.
  2. Learn more about mapping between ICD-9-CM and ICD-10-CM/PCS, and apply the General Equivalence Maps (GEMs).
  3. Take specific steps to collaborate with IT or the database vendor and start asking questions and informing the early planning.

Corresponding Resources:

Phase 3:

Data managers will influence the IT plan for modifying the database to accommodate ICD-10-CM/PCS and will want to be involved in the project planning sequential steps, including decisions about whether to create a dual process, system testing, separate database versions, and similar decisions regarding data management.

 

Phase 4:

The focus for phase 4 is for data managers to collaborate with IT to begin implementing the plan. Action steps include reviewing sample reports, testing, trying to break the application, and evaluating data for accuracy.

Corresponding Resources:

Phase 5:

The new database will go live in Phase 5. This has to be planned out by the end of phase 3, so they can actually begin the steps to make the changes in phase 4 and then implement.

Corresponding Resources: