Method and system for health care coding transition and implementation

A system comprising:

• computer elements receiving at least one transaction in an International Classification of Diseases (ICD) 9 format or an ICD 10 format;
• computer elements determining whether the received transaction is in the ICD 9 format or the ICD 10 format;
• when the received transaction is in the ICD 10 format, means for computer elements identifying at least one transaction in the ICD 9 format that matches the received transaction in the ICD 10 format;
• computer elements processing the identified transaction in the ICD 9 format, wherein processing the identified transaction comprises one of processing an eligibility query, processing a claim, and performing claims management;
• computer elements providing processing results in the ICD 10 format by associating the processed identified transaction in the ICD 9 format with the ICD 10 format;
• and
• computer elements transmitting the processing results of the processed transaction,
• wherein identifying at least one transaction in the ICD 9 format that matches the received transaction in the ICD 10 format further comprises:
• computer elements mapping an ICD 10 code from the received transaction to an ICD 9 code selected from a group of at least one ICD 9 code;
• computer elements identifying whether the group of ICD 9 codes are in a priority order;
• and
• computer elements selecting at least a highest priority code from the group of ICD 9 codes for the ICD 9 format, and
• wherein when the received transaction is in the ICD 9 format, computer elements processing the received transaction, computer elements providing processing results in the ICD 9 format, and computer elements transmitting the processing results of the processed transaction.

A computer program product comprising a non-transitory computer usable medium having control logic stored therein for causing a computer to process transaction, the control logic comprising:

• computer readable program code means for receiving at least one transaction in an International Classification of Diseases (ICD) 9 format or an ICD 10 format;
• computer readable means for determining whether the received transaction is in the ICD 9 format or the ICD 10 format;
• when the received transaction is in the ICD 10 format, computer readable means for identifying at least one transaction in the ICD 9 format that matches the received transaction in the ICD 10 format;
• computer readable program code means for processing the identified transaction in the ICD 9 format, wherein processing the identified transaction comprises one of processing an eligibility query, processing a claim, and performing claims management;
• computer readable program code means for providing processing results in the ICD 10 format by associating the processed identified transaction in the ICD 9 format with the ICD 10 format;
• and
• computer readable program code means for transmitting the processing results of the processed transaction,
• wherein identifying at least one transaction in the ICD 9 format that matches the received transaction in the ICD 10 format further comprises:
• computer readable program code means for mapping an ICD 10 code from the received transaction to an ICD 9 code selected from a group of at least one ICD 9 code;
• computer readable program code means for identifying whether the group of ICD 9 codes are in a priority order;
• and
• computer readable program code means for selecting at least a highest priority code from the group of ICD 9 codes for the ICD 9 format, and
• wherein when the received transaction is in the ICD 9 format, computer readable program code means for processing the received transaction, computer readable code means for providing processing results in the ICD 9 format, and computer readable program code means for transmitting the processing results of the processed transaction.