Medical Code Upgrade
Implementing the medical-coding standard known as ICD- 10 could give even data diehards a headache.
Here are a few vital stats on the U.S. upgrade that has been years in the making:
The ICD- 10 is the 10th revision of
the International Statistical Clas-
sification of Diseases and Related
Health Problems by the World
Health Organization (WHO).
Roughly 25 countries use
ICD- 10 for reimbursement and
resource allocation in their
The WHO began work
on ICD- 10 in 1983 and
completed the upgraded
list in 1992.
More than 3,000 comments were made
on the first U.S. proposal for ICD- 10.
Many healthcare providers expressed
concerns about the cost and complexity
of upgrading to the new codes.
The current ICD- 9 includes
around 18,000 codes.
ICD- 10 will have more than
The U.S. adoption deadline—originally
announced in 2009—has been pushed
from 2011 to 2013 to 1 October 2014.
practices into CoreLink’s waterfall approach.
“We asked BCBSNE to break down their requirements into ‘must haves,’ ‘should haves’ and ‘nice to
haves,’” she explains. “This allowed us to focus on
the builds that were crucial to the migration.” She
also implemented timeboxes, creating structure for
the CoreLink staff while making it easier for BCBSNE to schedule their fanned stories.
The blended approach worked. From the first
migration in January 2009 to the last one in June
2012—a month ahead of schedule—the project
came in under budget and without service interruption to BCBS policyholders. As Ms. Courtney
puts it, “Migrations like this are done with some
regularity because systems get old, but it’s rare to
see one this successful—and not uncommon to see
them get ugly.”
Falling Into Agile
The project was so successful, in fact, that
CoreLink is now transitioning to agile. Using
lessons gleaned from the BCBS migration, sev-
eral CoreLink teams have gone through agile
training and use waterfall processes that incor-
porate agile best practices. Ms. Owen reports
that “the teams have established team norms,
they hold daily stand-ups, and many of them
are doing iterative development so that custom-
ers don’t have to wait until the very end of the
project to realize results.” Though CoreLink
was already thinking about a switch to agile,
she says the success of BCBSNE project was a
deciding factor in the decision.
Join the discussion. Visit PMI’s Agile Community
of Practice at agile.vc.pmi.org.