ikaSystems Is Ready for the Next Y2K

The flexibility of ikaEnterprise's underlying technology platform makes adapting to industry-wide changes remarkably straightforward. The CMS deadline for HIPAA 5010 compliance is January 1, 2012, and the deadline for ICD-10 compliance is October 1, 2013. ikaSystems expects to be compliant with both by the end of 2010. This will give our clients and other third parties enough time for testing and understanding the structural, front matter, technical improvements and data content changes.

ICD-10 Migration

ikaSystems has separated the ICD-10 migration project into two primary phases:

• Phase 1: ICD-10 PCS Implementation. The first phase has involved designing and structuring the mapping of the ICD-10 Procedure Code System (PCS) with the existing ICD-9-CM. PCS implementation has focused primarily on General Equivalence Mapping (GEM). ikaSystems has projected the linking of existing codes with valid code alternatives in other code sets (in the target system) from which alternate choices can be made, depending on the use to which the code is put. The difference between the codes and structure is then adapted by the adjudication system and the front-end screens. These differences set the rules within the system as well. 
   
• Phase 2: ICD-10-CM Implementation. Clinical Modification Implementation includes system changes (adjudication, front end and back end) due to the increase in code length and the number of codes. In addition, the structure of ICD-10-CM allows for the possibility of greater expansion of code choices. Phase 2 has included the following: 
  
  
  • Logical grouping of codes. 
     
  • Fifth and sixth characters — fifth and sixth characters are incorporated into the code listing rather than having common fifth digits listed at the beginning of a chapter, section or category. 
     
  • Increased specificity — ICD-10-CM offers greatly expanded detail for the various conditions.
     
  • Accommodating the use of extensions — extensions are used in ICD-10-CM to provide additional information. These extensions are most often found in the injury codes. 
     
  • Accommodating the use of post-procedural conditions — there are many more codes added to ICD-10-CM to describe postoperative or post-procedural conditions.

ikaSystems will also provide a crosswalk during the period when some provider practices use ICD-9 and others use ICD-10 until full compliance becomes effective in 2013.

HIPAA 5010 Migration

ikaClaims currently supports ASC X12 4010 A1. We are in the process of converting ASC X12 4010 to ASC X12 5010 for the following EDI transactions:

• ASC X12 834: health plan enrollment
   
• ASC X12 820: premium payments
   
• ASC X12 270/271: eligibility inquiry and response
   
• ASC X12 278: healthcare services — request authorization
   
• ASC X12 837: healthcare claims/encounters (institutional, professional, dental)
   
• ASC X12 276/277: healthcare claim status request and response
   
• ASC X12 835: healthcare claim payment/remittance advice