System and method for ensuring medical benefit claim payment neutrality between different disease classification codes

A system comprising:

• one or more computing devices including:
• a memory having program code stored therein;
• a processor in communication with the memory for carrying out instructions in accordance with the stored program code, wherein the program code, when executed by the processor, causes the processor to perform steps comprising:
• receiving existing claim data including at least one existing healthcare code associated with a first classification system;
• receiving new claim data including a plurality of new healthcare codes associated with a second classification system, wherein the at least one existing healthcare code is mapped to the at least one new healthcare code;
• receiving a plurality of payment codes associated with the at least one existing healthcare code and the at least one new healthcare code;
• based on the received plurality of payment codes, calculating payments of the received existing and new claim data, respectively;
• and
• based on the calculating, selecting a most financially neutral new healthcare code of the plurality of new healthcare codes.

A computer program product comprising non-transitory computer readable medium further comprising:

• code for receiving existing claim data including at least one existing healthcare code associated with a first classification system;
• code for receiving new claim data including a plurality of new healthcare codes associated with a second classification system, wherein the at least one existing healthcare code is mapped to the at least one new healthcare code;
• code for receiving a plurality of payment codes associated with the at least one existing healthcare code and the at least one new healthcare code;
• based on the received plurality of payment codes, code for calculating payments of the received existing and new claim data, respectively;
• and
• based on the calculating, code for selecting a most financially neutral new healthcare code of the plurality of new healthcare codes.