NQF Releases Guidance for ICD-10 Conversion

Report Offers Measure Developers a Resource for Converting Healthcare Quality Measures

WASHINGTON, Oct. 6 /PRNewswire-USNewswire/ -- The National Quality Forum (NQF) has released a guidance report and best practices for converting healthcare quality performance measures from ICD-9-CM to ICD-10-CM/PCS coding standards. The report identifies approaches for the measure conversion process and outlines NQF's measure submission and maintenance process for converting endorsed measures. The full NQF report is a resource to help measure developers convert currently endorsed measures, and outlines NQF's plans for implementing new coding requirements in measure endorsement and maintenance beginning October 2011.  

ICD coding, which stands for International Classification of Diseases, is used for identifying data on claims records, collecting data for use in performance measurement, and reimbursement for Medicare and Medicaid claims. By 2013, the U.S. Department of Health and Human Services (DHHS) is requiring all ICD coding be converted from the current ICD-9-CM codes to ICD-10-CM/PCS for all HIPAA transactions (The Health Insurance Portability and Accountability Act of 1996).  

The NQF guidance document is intended to help measure developers and stewards, as well as NQF, prepare for this change. The guidance document outlines:

• the impact of differences between ICD-9-CM, ICD-10-CM/PCS, and SNOMED CT code sets;
• equivalency of code sets and populations;
• impact of code transitions on measure integrity;
• current practices and required resources for conversion;
• methodologies for converting code sets;
• recommendations for NQF measure submission and maintenance processes involving multiple code sets; and
• implications of additional code sets, coding changes, and coding equivalency on measure development and submission.

"Performance measurement standards and specifications must evolve to reflect the shift in national coding standards and the healthcare system's evolution toward electronic platforms," said Janet Corrigan, PhD, NQF president and CEO. "We know there is much work to be done to convert measures to conform to updated code sets. This guidance is a starting point for both NQF and measure developers in helping prepare for the transition and move smoothly into new and updated measures."

The NQF expert committee that reviewed the Coding Maintenance Operational Guidance was chaired by Patrick Romano, MD, MPH, professor of medicine and pediatrics at the University of California Davis School Of Medicine.

"The developers and stewards of healthcare quality measures face the task of converting several hundred endorsed measures to ICD-10 over the next two years," said Romano. "NQF's guidance can help ensure this conversion is completed in a timely and accurate manner, allowing stakeholders to continue monitoring quality across our healthcare system.  Every American has a stake in making sure that the quality measurement enterprise stays on track during this switchover."

The mission of the National Quality Forum is to improve the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. NQF, a non-profit organization (qualityforum.org) with diverse stakeholders across the public and private health sectors, was established in 1999 and is based in Washington, DC.

SOURCE National Quality Forum