Preparing for the true risks of ICD-10

Rice Memorial Hospital assessed its financial risk posed by the transition to ICD-10 by reviewing records, analyzing subsets of claims in all risk categories, and ten-coding at-risk claims to identify documentation deficiencies. An important step was an in-depth review and validation of the original ICD-9 coding and resulting DRG assignment for each of the 250 inpatient medical records included in the assessment. Through the assessment, Rice Memorial identified opportunities for clinical documentation improvement (CDI) and developed a CDI road map.