ICD-9 to ICD-10 Detection and Audit

How can my healthcare organization validate current ICD­9 to ICD­10 conversion efforts and ensure compliance with the new standards past October 1, 2015?


The Problem

A large healthcare provider had been working on their ICD-9 to ICD-10 conversion for its EHR, Clinical, Lab, Ambulatory and other applications, which consisted of more than 280 active interfaces, for nearly two years. A lot of time and money had been spent with vendors and on consultants to do the conversion, and everyone was saying they were ready. But the CIO had no way to validate their work, especially on and after the October 1, 2015 deadline. Non-compliance would entail application communication problems within their own distributed environment, and could also result in nonpayment by insurers and the Federal government. If an ICD-9 code was used in a claim it could be delayed, rejected, or just go unacknowledged. The financial risk exposure of non-compliance was enormous.

In order to validate current conversion efforts, the team first planned to use their manual accounting of all interfaces. Based on that information they would run scripts to capture all HL7 messages for a time and dump them into a file for manual analysis. They would then identify the interfaces and applications that were sending either ICD-9 or 10 codes and remediate from there.

However, when the team reviewed its original staging plan to identify dependencies among interfaces, they quickly discovered that their production environment and their manual accounting of the interfaces did not match the staging plan. The only way to identify the non-compliant interfaces would be to manually inspect the traffic from each one.

Desired Outcome

  • Provide an automated, simple and continuous way to discover all applications, their interfaces, message types and code version.
  • Provide dashboards that would pinpoint the HL7 interfaces, their sending and receiving applications, the rate of ICD-9 and 10 messages and their state (acknowledged, rejected, or errors).
  • Hold vendors and consultants accountable for their work and be sure they make the deadline.

The team reviewed its original staging plan to identify dependencies among interfaces but quickly discovered that their production environment did not match the staging plan. The only way to identify the non-compliant interfaces would be to manually inspect the traffic from each one.


The Solution

The healthcare provider's network team, which was already using the ExtraHop Healthcare Edition, recommended that the HL7 / Interface team try the platform for a proof of concept. They downloaded and applied the free ICD 9-10 Detection and Audit bundle, which included a countdown timer to the October 1, 2015 deadline.

ExtraHop automatically discovered all HL7 interfaces within their environment, classified them as either a sending or receiving interface, the volume and rate of messages sent and displayed them in an executive level dashboard. It also identified all individual applications behind the interfaces. The CIO had the dashboard prominently displayed on every flat screen TV in their NOC and on every floor within the IT department showing the real-time state of their ICD 9 to ICD10 conversion effort.

User Impact

For the CIO and the Board, the value of ExtraHop is largely peace of mind. They had already spent so much time and money on this effort that to get it wrong last minute would be a potential financial disaster. For the Director of Applications it has been tremendously helpful in focusing the efforts of her teams and the vendors and consultants they've been working with for the past two years. She used the time comparison feature on the ExtraHop dashboard to track the project week by week and allocate resources more precisely.

The CIO had previously been pitched by a System Integrator selling manual ICD conversion audits starting at $75,000. With ExtraHop, because the hospital already owned the ExtraHop Healthcare Edition, the ICD 9-10 Detection and Audit bundle didn't cost them anything.

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