10/2/2013. Implementing ICD-10 and the New Administrative Simplification Standards: A Step by Step Guide for Medical Groups. Rule Development Timeline
|
|
- Avice Richards
- 8 years ago
- Views:
Transcription
1 Implementing ICD-10 and the New Administrative Simplification Standards: A Step by Step Guide for Medical Groups Robert M. Tennant Senior Policy Advisor MGMA Government Affairs rtennant@mgma.org Step One: Understanding the What and the Why of ICD-10 Rule Development Timeline 1996 HIPAA includes ICD-10 placeholder 2003 NCVHS hearings 2005 Congressional hearing (HR 4157) 2008 NPRM January 16, 2009-Final rule October 1, 2013 Original compliance date for implementation of ICD-10-CM and ICD-10-PCS. October 1, 2014 Revised compliance date for implementation of ICD-10-CM and ICD-10-PCS. No grace period and/or extension per CMS! 1
2 The ICD-10 Challenge ICD-10 is the biggest change in healthcare in over 20 yrs The most significant overhaul of the medical coding system since the advent of computers Implementing ICD-10 will impact every system, process and transaction that contains or uses a diagnosis code Major changes of ICD-10 include: Codes use alphanumeric characters Combination of diagnosis/symptom codes Laterality Expanded potential digits Why Replace ICD-9-CM? Proponents argue that: Almost 30 years old (outdated, obsolete codes) Rapidly running out of space (more so in PCS than CM) Evolving healthcare data needs Comparison with international data is hindered Increased sensitivity when refining grouping and reimbursement methodologies Enhanced ability to conduct public health surveillance Decreased need to include supporting documentation with claims Misconceptions About ICD-10 Implementation Only a back office and coder issue Only an IT issue My PM and CH vendors will take care of this for me The compliance date now Oct 2014 there is no rush ICD-10 will have little impact on my business processes There won t be any impact on productivity or revenue If I ignore it it might just go away 2
3 ICD-9-CM vs. ICD-10-CM ICD-9-CM 3-5 digits or characters 1st character is numeric or alpha (E or V codes) 2 nd 5 th characters are numeric Decimal placed after the first 3 characters 17 Chapters and V & E codes are supplemental ~13,000 codes ICD-10-CM 3-7 digits or characters 1 st character is alpha (all letters used except U ) 2 nd 7 th characters can be alpha or numeric Decimal placed after the first 3 characters 21 Chapters and V & E codes are not supplemental ~69,000 codes Crosswalks Mapping codes between ICD-9-CM and ICD-10-CM CMS General Equivalence Mapping (GEM)-not a 1 to 1 crosswalk from ICD-9-CM to ICD-10-CM Mappings will be used to: Convert and test systems and analyze data before and after Link data in long-term clinical studies Develop application-specific mappings Analyze data collected during transition period and beyond ICD-10: Still in Flux? Of all the HIPAA/HITECH/ACA administrative provisions, ICD-10 is the only one where ROI for medical groups is unproven Provider organizations have consistently raised concerns to CMS regarding cost, timing, alternatives, lack of resources, too much going on Clinical staff will need to be engaged, trained Clearinghouses cannot solve all claim issues Why was the 2013 date moved? Will Congress act? 3
4 Step Two: Determine the Potential Impact of ICD-10 Critical Impact Area: Changes to Software EHR / decision support / other clinical systems Practice management systems Billing systems Encoding software Medical record abstraction systems Scheduling and registration systems Accounting systems Quality management systems Test ordering systems Impact on Practices Statistics / research / historical benchmarking (Longitudinal data captured in ICD-9-CM) Trend analysis / Utilization management Disease management HEDIS Reimbursement and contracting Fee schedules / contracts Proprietary health plan payment policies could require time of service access to plan information 4
5 Impact Areas Redesign of superbills (one AAFP test converted a one page superbill into 11 pages when moving to ICD-10 Form Changes (CMS 1500, UB 92, X12 837, 270) Workflow-data capture, data usage (claims) Increase needed in system storage capacity Impact Areas Need for greater coder understanding of anatomy and physiology by staff Transition period Potential for billing delays due to coding backlogs (internal/external) Dual use of ICD-9 and ICD-10 (WC?) Rejected claims (how can the required data be identified post visit?) 14 Determining the Potential Impact Action plan: Create internal ICD-10 Team (sr management, medical staff, billing/coding, information systems, reporting) Create a spreadsheet/other way of tracking steps/issues Identify the impact areas Prioritize in terms of potential impact to staff, workflow and revenue (consider rating by impact: high, medium, low) Identify internal and external contacts Assign internal staff for specific duties 5
6 Step Three: Build Internal Awareness and Create an Implementation Timeline Building Internal Awareness Expect push back, especially from physicians (AMA HOD votes) Explain new timing from CMS Originally Oct. 1, 2013, now compliance will be Oct.1, 2014 Explain consequences of inaction! Potential of higher cost and/or disruption of claims revenue cycle Potential of not identifying adequate coding support Building Awareness /Establish a Timeline Action plan: Educate practice staff on the reality and impact of ICD-10 Consider peer to peer communication Create a reasonable timeline, include action steps and assign staff Collect tools and resources Include regular updates at staff meetings, internal communications Network with your colleagues to identify and solve problems 6
7 Step Four: Conduct an Internal Systems Assessment Conduct an Impact Assessment Your internal analysis should review: Practice infrastructure Computer systems (core systems, key business area applications, non-essential) All workflow processes that utilize codes Information management (data, extracts, reports, etc) Linkages to other business areas and external entities Documentation issues Code assignment processes Impact Assessment Questions Action plan: ask the critical questions Which vendor applications do we use for these codes? How are ICD-10 codes currently used in each information system? What is the current character length specification? How are the codes entered are they manually entered or pulled in from another system? Do we have or do we need to have the ability to maintain and utilize both ICD-9 and ICD-10 data? Will we have the ability to implement an internal testing process? Do we need outside help? 7
8 Step Five: Create an ICD-10 Budget Estimated costs to move to ICD-10 There are many estimates of the initial and ongoing costs to moving to ICD-10. Rand Study (2002) Conversion $425M to $1.15B $5M to $40M a year in lost productivity BCBSA (2002) Conversion $5.5B to $13.5B $150M to $380M a year in lost productivity Both estimates presented to NCVHS MGMA, AMA, 9 other organizations, commissioned a new study, released in 2008 MGMA Estimated Costs to move to ICD-10 Typical Small Practice (3) Typical Medium Practice (10) Typical Large Practice (100) Education $2,405 $4,745 $46,280 Process Analysis $6,900 $12,000 $48,000 Changes to Superbills $2,985 $9,950 $99,500 IT Costs $7,500 $15,000 $100,000 Increased Documentation $44,000 $178,500 $1,785,000 Cash Flow Disruption $19,500 $65,000 $650,000 Total $83,290 $285,195 $2,728,780 8
9 Cost to upgrade or replace PM/EHR for a 10 FTE Practice = $201,690 Approximately how much will it cost, or did it cost, to upgrade or replace your Practice Management System? Average cost per FTE physician: $10,190 Approximately how much will it cost, or did it cost, to upgrade or replace your EHR? Average cost per FTE physician: $9,979 Additional Areas of Potential Cost Project cost (time NOT spent doing other productive activities) Documentation review (additional person to review? Mapping cost (consultant needed?) Additional staff (temporary or contract) or overtime during learning curve Revenue Impacts of specificity Denials Additional documentation production Loss of productivity rebills, rejections, EOB work, medical necessity rejections/follow up, coder slow down Developing a Comprehensive Budget Action plan: budget for the following: Assessment costs IT infrastructure (software/hardware) Contract revisions (legal) Super bill or other code assignment process Staff time and clinician productivity losses Consulting services Cash flow disruptions and contingencies (line of credit, $ reserves, postponing of capital projects 9
10 Step Six: Understand the Impact on Clinical Documentation Impact of ICD-10-CM on Medical Record Documentation Detailed medical record documentation is required if coders are to code to the highest degree of specificity Non-specific unspecified codes are available to use when detailed documentation is unavailable, but be careful! It is true that a more detailed documentation will result in a more accurate clinical picture and better data but Expect a 15% increase in documentation time (per AAPC) Impact of ICD-10-CM on Medical Record Documentation Documentation issues to consider: Documentation of Additional Symptoms or Conditions Associated and/or Related Conditions Cause of Injury Dominant vs. Non-dominant Side Remember that coders can only code what they see in writing, in front of them (especially critical if you utilize offsite coders) Consider workflow implications (post visit) 10
11 Internal Coding Action Steps Action plan: Evaluate the extent of code changes specific to your specialty Review documentation to assure that it is adequate to support new coding systems Decide what is best approach for code assignment Superbills /book/computer program/app Consider testing options: Use old claims and attempt to assign ICD-10 codes Dual code 31 Step Seven: Clinical and Administrative Staff Training Staff Training-General Plan Implement ICD-10 education for impacted staff Begin by identifying education needs: Who requires training What (type (yp and level) training How should they be trained Key issue when should each group be trained? Too early will require re-training, too late it may be difficult to get a slot recommended timing: 6-9 months before for coders, 3-6 months ahead for physicians 11
12 Training Action Steps Action plan: Wide variety of training opportunities and materials available through professional associations, online courses, webinars, and onsite training If you have a small practice, think about teaming up with other local providers. You might be able to: Train one staff person from the practice, who can in turn train other staff members Hire one trainer for multiple practices Have a super user who can assist multiple clinicians or even practices Step Eight: External System Impact Assessment and Testing Work with your Key Vendors Software action plan questions: Vendor readiness Vendor timeline for installation / testing Modules or interfaces Will YOUR version of the software be upgraded? Will you require any hardware upgrades? Are they offering any training? Expected cost 12
13 Work with your Key Vendors Clearinghouse action plan questions: What ICD-10 services will you provide? Is my submission format appropriate? What will be the cost of the service? When can you accept test claims? Can you run a report of my denied/pended claims? Can you run a report identifying my use of unspecified ICD-19-CM codes Are you offering any training opportunities? Health Plan Questions Action plan, talk to your clearinghouses / plans and ask: When will your upgrades to your systems to accommodate the ICD-10 codes be completed? How can you help me in this transition? What will be the impact of Medicare NOT testing? When can I send claims and other transactions with ICD- 10 codes to you so you can test that they will be accepted? Will you be utilizing the CMS ICD-10 GEMs/crosswalks? When will you let us know coverage/payment changes? Will you provide me a list of the data content changes I need? Step Nine: Ongoing Review and Maintenance 13
14 Outstanding Issues Readiness level of vendors, payers, others If 4010, NPI and 5010 are any indication. What will workers comp do with ICD-10? Resource allocation to manage all requirements: 5010/ICD-10 Quality reporting programs Admin simplification Meaningful use Outstanding Issues Industry cross-walks What will the payers do? Plan payment policies: granularity requirements What will the payers require? How will reimbursement be changed? Could it lead to o Current payment: $100 o Under ICD-10-CM: Unspecified code = $50 Granular code = $100 From BCBSNC: Some impediments to timely reimbursement will be the use of ICD-9 codes after 10/1/2013, the use of truncated codes, and the use of Not Otherwise Specified codes where specificity is available. Ongoing Issues and Maintenance Action plan: Watch for any announcements of/changes to: Compliance dates, federal plan payment/documentation policies Commercial plan payment/documentation policies Vendor announcements Be watchful of variances in clinician productivity Some staff may require additional training and/or monitoring Keep on top the readiness level of your external readiness Identify any issues/roadblocks as early in the process as possible Evaluate issues and assign resolution to staff 14
15 Section 1104 of the ACA Chicken and Egg Issue Solved In 2006 practices spent an average of $68,274 per physician per year (roughly $31 billion) interacting with health plans (Health Affairs, Casalino et al., 2009). Previously-each stakeholder blamed the others for why providers didn t have administrative functionality Providers didn t want multiple proprietary solutions Payers didn t want to offer solution that only small number of providers will adopt With no single approach, no market for vendors HIPAA/ACA/MU etc solves, at least in part, this issue ACA 1104 Wish List Required Operating Rules Eligibility verification and claim status (2013) EFT standards and operating rules (2014) Other HIPAA transactions (2016) Health Plan Identifier Claims attachments (2016) Plan certification and enforcement (2014) 15
16 Eligibility Operating Rules Previously, practices would: Pick up the phone and attempt to verify eligibility Log on a proprietary plan website Employ the submit claim and cross fingers technique Play chase the patient for the outstanding balances With new operating rules practices will receive: Health plan name and coverage dates Static financials (co-pay, co-insurance, base deductibles) Benefit-specific and base deductible for individual and family In/out of network variances Remaining deductible amounts ACA Section 1104 Action Steps Assess your current claims revenue cycle processes Does your current PM system leverage the HIPAA transactions? Which ones now, which ones does it have the capability to? Do you use manual processes for any of these transactions? What staff does what and how efficient are these processes? (Hint, just because your practice has been using them for a long time, doesn t make them efficient.) Do you pay a billing service or clearinghouse for transactions, if so, which transactions and how much? Review your options for increasing your level of automation: PM upgrade PM replacement Web-based vendor solutions ACCESS the AMA-MGMA Selecting a PMSS Toolkit Summary and Key Points 16
17 Summary Implementing ICD-10 is NOT just an IT project it impacts business processes and may impact other systems Keep on top of all industry developments Create internal change team and identify a clinical leader Create a multi-year upgrade and training budget Clinician documentation critical to prevent claim denials Implementation will be heavily dependent on when vendors have upgrades ready and when they can be installed Testing with trading partners is extremely important Look at the ROI with ACA Robert Tennant Senior Policy Advisor MGMA Government Affairs rtennant@mgma.org (202) Questions? Resources Admin Simp Mgma.com/adminsimplify CMS Admin Simp MGMA ICD-10 Mgma.com/icd10 CMS ICD-10 Web Pages _TransactionsandCodeSetsRegulations.asp 17
18 Resources 52 CDC Web Page (General ICD-10 information) ICD-10-CM files, information and GEMs between ICD-10-CM and ICD- 9-CM ICD-10 home page (WHO) NCHS Basic ICD-10-CM information CMS ICD-10-PCS information WEDI ICD-10 Implementation Toolkit Appendix 18
19 New CMS-1500 Claim Form New Features to ICD-10-CM Combination codes for conditions and common symptoms or manifestations E10.21 Type 1 diabetes mellitus with diabetic nephropathy Combination codes for poisonings and external causes T42.4x5A Adverse effect of benzodiazepines, initial encounter Added laterality (left vs. right) M Chrondromalacia, right shoulder Added 7 th character extensions for episode of care S06.01xA Concussion with loss of consciousness of 30 minutes or less, initial encounter Expanded codes (injuries, diabetes, alcohol/substance abuse, postoperative complications F Cocaine dependence with intoxication delirium New to ICD-10-CM Injuries are grouped by anatomic site rather than by type of injury. Diseases of the sense organs (eyes & ears) have their own chapters, no longer part of Nervous System chapter. Inclusion of trimesters in obstetric codes (and elimination of 5 th digits it for episode of care) O Anemia complicating pregnancy, third trimester Change in timeframes specified in certain codes Acute myocardial infarction time period changed from 8 weeks to 4 weeks Full code titles for ALL codes (no reference back to common fourth and fifth digits). Post-op complications have been moved to procedure-specific body system chapters. 19
20 Combination Codes Examples I Atherosclerotic heart disease of native coronary artery with unstable angina pectoris E Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema K71.51 Toxic liver disease with chronic active hepatitis with ascites K Crohn s disease of small intestine with intestinal obstruction N41.01 Acute prostatitis with hematuria ICD-10-CM Specificity Examples S72.044G Nondisplaced fracture of base of neck of right femur, subsequent encounter for closed fracture with delayed healing I Sequelae of cerebral infarction, Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side Z48.21 Encounter for aftercare following heart transplant GEM Examples ICD 9 CM Code Diagnosis ICD 10 CM Code V20.2 Routine infant or child examination V04.81 Need for prophylactic vaccination and inoculation Z (Encounter for routine child exam without abnormal findings). Z (Encounter for routine child exam with abnormal findings). Use additional code(s) to identify abnormal findings. Z23 (Encounter for immunization). At this time in ICD 10 CM there is only one code for immunizations Hypertension, benign I10 (Essential [primary] hypertension). ICD 10 CM does not differentiate between hypertension that is controlled or uncontrolled, benign or malignant and there is only one code Atrial fibrillation I48.0 (Atrial fibrillation) I48.1 (Atrial flutter) Chest pain, unspecified R07.0 (Chest pain, unspecified). ICD 10 CM expands upon chest pain symptoms and unspecified code may no longer be necessary URI J06.9 (Acute upper respiratory infection, unspecified) Lumbago M54.5 (Low back pain) Bronchitis, acute J20.0 (Acute bronchitis, unspecified). ICD 10 CM includes 10 choices for acute bronchitis. Copyright Medical Group Management Limb Association pain(mgma ). All rights reserved. M (Pain in right leg) 20
21 CAQH EFT Enrollment Solution Overview Web-based based data entry for provider EFT enrollment information. Alignment with CORE ERA / EFT Operating Rules for definition of the standard enrollment data set and supporting documents. Web-based access portal for health plan customers. Provider adoption campaigns / integration with UPD to electronically promote the CAQH EFT enrollment utility to UPD provider users. Provider support center. Voided check and other uploaded document processing. Pre-note transactions via ACH partners to validate bank account information. 21
Electronic Health Records Next Chapter: Best Practices, Checklists, and Guidelines ICD-10 and Small Practices April 30, 2014.
Electronic Health Records Next Chapter: Best Practices, Checklists, and Guidelines ICD-10 and Small Practices April 30, 2014 Fallon Health Plan Christine Grondalski, Director Risk Adjustment & Analytics
More informationICD-10 Transition & Implementation Information
ICD-10 Transition & Implementation Information I ICD-10 Implementation Compliance Date: October 1, 2015 ICD-10-CM diagnoses codes will be used by all providers in every health care setting. ICD-10-PCS
More informationHow To Transition From Icd 9 To Icd 10
ICD-10 FAQs for Doctors What is ICD-10? ICD-10 is the 10 th revision of the International Classification of Diseases (ICD), used by health care systems to report diagnoses and procedures for purposes of
More informationICD 10 CM: Presented by:
ICD 10 CM: Presented by: ICD-10-CM Mission 2014 Why ICD-10? Mechanics of ICD-10 Why ICD-10? Why are we doing this? Here is an excerpt taken from the final ruling [T]he ICD-10 code sets provide a standard
More informationCelebrating ICD-10: A New Tradition of Codes.
Celebrating ICD-10: A New Tradition of Codes. Delayed. Now What? Stop training entirely? Continue training as originally planned? Alter the course of training? Important Dates January 16, 2009 February
More informationIntroduction to ICD-10-CM. An Introduction to the Transition from ICD-9-CM to ICD-10-CM
Introduction to ICD-10-CM An Introduction to the Transition from ICD-9-CM to ICD-10-CM 1 Purpose Explain why the transition from ICD-9-CM to ICD- 10-CM is needed Describe the differences between ICD-9-CM
More informationPreparing for ICD-10. Preparing for ICD-10. Preparing for ICD-10
Preparing for ICD-10: What You Should Be Doing Now PHCA November 11, 2014 Presented by: Reinsel Kuntz Lesher LLP Senior Living Services Consulting Stephanie Kessler, Partner Karin Sherman, Senior Consultant
More informationWelcome to ICD-10 CLINICAL CLOSE-UP
Welcome to ICD-10 CLINICAL CLOSE-UP Topics ICD-10 Overview About ICD-10 Why ICD-10 Matters ICD-9 vs ICD-10 Clinical Close-Up ICD-10 Documentation GEMs Mapping Tool GEMS vs Coding Manual Bi-Directional
More informationICD-10 Readiness for Private Practice and Hospitals Presenter Lisa Asbell, RN ICD 10 Specialist
ICD-10 Readiness for Private Practice and Hospitals Presenter Lisa Asbell, RN ICD 10 Specialist 1 Purpose of Today s Seminar #1. To motivate you to fully engage your organization in the ICD-10 transition.
More informationICD-10... What Are You Waiting For?
ICD-10... What Are You Waiting For? What is it? International classification for all general epidemiological, many health management purposes, and clinical use Published by the World Health Organization
More informationICD 10... Ready or Not?
ICD 10... Ready or Not? CAHAM The Lodge at Sonoma Sonoma, CA September 2015 Speaker Gloryanne Bryant, BS, RHIA, RHIT, CCS, CDIP, CCDS, AHIMA Approved ICD 10 CM/PCS Trainer, has more than 30 years of experience
More informationMaking the Transition: ICD-10-CM Diagnosis Codes ICD-10-CM: International Classification of Diseases, 10th Edition, Clinical Modification
1 COA Fact Sheet Making the Transition: ICD-10-CM Diagnosis Codes ICD-10-CM: International Classification of Diseases, 10th Edition, Clinical Modification Mandated Transition to ICD-10 Codes: October 1,
More informationICD-10 Transition Project Planning. Kristen Heffernan MicroMD Director of Prod Mgt and Marketing
ICD-10 Transition Project Planning Kristen Heffernan MicroMD Director of Prod Mgt and Marketing 1 ICD-10 Transition Project Planning Agenda What is ICD-10? Why ICD-10? Realistic expectations Comparing
More informationIntroduction to ICD-10: A Guide for Providers. Centers for Medicare & Medicaid Services
Introduction to ICD-10: A Guide for Providers Centers for Medicare & Medicaid Services 1 Table of Contents Compliance Date: October 1, 2014» What is ICD-10?» Why ICD-10 matters» Why transition to ICD-10»
More informationGuidelines Most Significantly Affected Under ICD-10-CM. May 29, 2013
Guidelines Most Significantly Affected Under ICD-10-CM May 29, 2013 Guidelines Most Significantly Affected Under ICD-10-CM A look at the new system and how it compares to ICD-9-CM Presented by Therese
More informationSarah Hanna President ECS Billing & Consulting North
Presented By: Sarah Hanna President ECS Billing & Consulting North 252 W. Market St. Tiffin, Ohio 44883 419-448-5332 ext. 102 www.ecsbillingnorth.com sarahhanna@ecsbillingnorth.com This presentation was
More informationINTERMEDIATE ADMINISTRATIVE SIMPLIFICATION CENTERS FOR MEDICARE & MEDICAID SERVICES. Online Guide to: ADMINISTRATIVE SIMPLIFICATION
02 INTERMEDIATE» Online Guide to: CENTERS FOR MEDICARE & MEDICAID SERVICES Last Updated: February 2014 TABLE OF CONTENTS INTRODUCTION: ABOUT THIS GUIDE... i About Administrative Simplification... 2 Why
More informationREVISION, PROCEDURE CODING SYSTEM (ICD-10-PCS) VERSION 2.2
NCPDP IMPLEMENTATION TIMELINES AND RECOMMENDATIONS FOR INTERNATIONAL CLASSIFICATION OF DISEASES, 10TH REVISION, CLINICAL MODIFICATION (ICD-10- CM) AND THE INTERNATIONAL CLASSIFICATION OF DISEASES, 10TH
More informationICD 10: Final Steps for Successful Implementation
ICD 10: Final Steps for Successful Implementation Gayle R. Lee, JD Matt Elrod, PT, DPT, MEd, NCS Presenters Gayle Lee, JD, has more than 15 years of experience working on health care issues impacting the
More informationOverview of ICD10 Transition Impact on Physician Practices Presented by Theresa Mendoza Director of Quality, BI and Data Services
Overview of ICD10 Transition Impact on Physician Practices Presented by Theresa Mendoza Director of Quality, BI and Data Services What is ICD10? ICD10 is a diagnostic/procedural coding system implemented
More informationIntroduction to ICD - 10. Andrea Devlin, CPMA, CPC Alta Partners, LLC 2015
Introduction to ICD - 10 Andrea Devlin, CPMA, CPC Alta Partners, LLC 2015 Agenda Introduction Benefits of ICD-10 Features of ICD-10 ICD-9 vs. ICD-10 ICD-10 Structure Question & Answer Introducing ICD-10
More information2/28/2013 ICD-10 AS MANDATED BY ACCME SPEAKERS ARE ASKED TO DISCLOSE ANY REAL OR APPARENT CONFLICT RELATED TO THE CONTENT OF THEIR PRESENTATION
ICD-10 An Overview of the Code Sets with Emphasis on Documentation Requirements & Practice Readiness UMMC Family Medicine Update March 5-8, 2013 Flowood, Mississippi Patty Harper, RHIA AHIMA Approved ICD-CM/PCS
More informationWhat You Need to Know for the Upcoming Transition to ICD-10. Written by the AMA CPT Medical Informatics Department
What You Need to Know for the Upcoming Transition to ICD-10 Written by the AMA CPT Medical Informatics Department W H I T E P A P E R J U N E 2 0 1 2 This white paper is for educational purposes only and
More informationICD-10 in the Provider Newsletter
ICD-10 in the Provider Newsletter ICD-10 CM Code Structure, July 2013 ICD-10 Implementation, April 2013 ICD-10 Manual, January 2013 ICD-10 Back on Track, October 2012 ICD-10 Training, July 2012 ICD-10
More informationICD-10: Prepare, Implement, and Train
ICD-10: Prepare, Implement, and Train Source Medical Solutions, Inc. October 2013 For more information, please visit www.sourcemed.net or call 866-687-2300 1 Executive Summary There are numerous documents
More informationTHE ROAD TO ICD-10: DOES YOUR CHC HAVE AN IMPLEMENTATION STRATEGY IN PLACE?
CPAs & ADVISORS experience perspective // THE ROAD TO ICD-10: DOES YOUR CHC HAVE AN IMPLEMENTATION STRATEGY IN PLACE? AGENDA ICD-10 development Implementation timelines Organizational strategy Project
More informationICD-10 PREPARATION GUIDE. MGMA resources to prepare your practice and work with trading partners on the new code set.
ICD-10 PREPARATION GUIDE MGMA resources to prepare your practice and work with trading partners on the new code set. TABLE OF CONTENTS 3 Implementing ICD-10 in your practice 5 Internal assessment 7 Assessing
More informationForget the Fear and Panic:
ICD-10 White Paper Forget the Fear and Panic: It s Time for a Sensible Approach to ICD-10 Implementation pulseinc.com Forget the Fear and Panic The mere mention of ICD-10 within the healthcare industry
More informationRoad to 10: The Small Physician s Route to ICD-10. Implementation Guide
Road to 10: The Small Physician s Route to ICD-10 Implementation Guide ICD-10 Implementation Guide for Small and Medium Practices 1 Version 2.0 18 August 2014 Table of Contents 1. Introduction... 2 Introduction
More informationICD-10-CM. Objectives
ICD-10-CM What is it? Why? Now What? Debbie Johnson, RHIT, CHP American Health Care Association Webinar September 12, 2013 Objectives Learn what ICD-10-CM is what the main differences in ICD-9 and ICD-10
More informationTransitioning to EDI HIPAA 5010 and ICD-10
Transitioning to EDI HIPAA 5010 and ICD-10 Challenges & Opportunities October 17, 2010 Outline I. HIPAA 5010 EDI Changes HIPAA 5010 Overview Transactions Affected CORE Certification II. III. IV. ICD-10
More informationPreparing for ICD-10. What Your Practice Needs to Know
WRS Health Preparing for ICD-10 2 Executive Summary The healthcare industry is set to undergo an important change on October 1, 2014, when the mandatory adoption of the ICD-10 codes go into effect. The
More informationMolina Healthcare Post ICD 10 FAQ
Molina Healthcare Post ICD 10 FAQ On March 31, 2014, the Senate voted to approve a bill to delay the implementation of ICD-10-CM/ PCS by at least one year. President Obama signed the bill into law on April
More informationPreparing for ICD-10 WellStar Medical Group Toolkit
Preparing for ICD-10 WellStar Medical Group Toolkit Preparing for ICD-10 On Oct. 1, 2015, WellStar will transition from ICD-9 to ICD-10 coding for all medical diagnoses and hospital procedures Systemwide.
More informationSouth Dakota Medicaid ICD-10 Provider Education Series
South Dakota Medicaid ICD-10 Provider Education Series Lori Lawson, Deputy Medicaid Director, DSS Jane Beth Turner, RHIA, AHIMA ICD-10 Approved Trainer, Cognosante 1 Agenda Brief overview of transition
More informationICD-10 Frequently Asked Questions
ICD-10 Frequently Asked Questions ICD-10 General Overview... 3 What is ICD-10?... 3 Why are we adopting ICD-10?... 3 What are the benefits of the ICD code expansion?... 3 What does ICD-10 compliance mean?...
More informationMedical Billing and ICD-10 - Know Your Patients
AHLA N. ICD-10 Transition: What Health Lawyers Need to Know Julie E. Chicoine Senior Assistant General Counsel OSU Wexner Medical Center Columbus, OH Denise J. Hall PYA Atlanta, GA Institute on Medicare
More informationICD-10 Post Implementation: News from the Front Lines
ICD-10 Post Implementation: News from the Front Lines Presented by: Paula Kleiman, RHIA, CPC, AHIMA ICD-10-CM Trainer CEO/President, Creatively HIM Consulting Services, Inc. Agenda ICD-10 Post Implementation
More informationWelcome to AlohaCare s ICD-10 Information Session
Welcome to AlohaCare s ICD-10 Information Session 1 Overview AlohaCare Introduction ICD-10 Primer AlohaCare & ICD-10 ICD-10 Coding Workflow Considerations for Outpatient Orders Questions/Comments This
More informationCountdown to ICD-10. Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CPCD, COBGC, CCS-P, CDIP Senior Manager. AMA Author
Countdown to ICD-10 Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CPCD, COBGC, CCS-P, CDIP Senior Manager AMA Author ICD-10 Implementation Guide, Make the Transition Manageable Principles of ICD-10-CM
More informationASDIN 8th Annual Scientific Meeting
WHO World Health Organization Developed in 1994 AN INITIAL UNDERSTANDING OF Sarah Reed, CPC Coding and Compliance Coordinator Meritas Health Corporation Implementation 138 countries mortality 99 countries
More informationFinancial Disclosure. Teri Thurston does not have any relevant financial relationships with any commercial interests
Financial Disclosure Teri Thurston does not have any relevant financial relationships with any commercial interests Transitioning to ICD-10 Planning the Journey for Implementation 2 Brief History of ICD-10
More informationThe Road to ICD-10 Transition Success
The Road to ICD-10 Transition Success 1.888.MEDIWARE Mediware.com Table of Contents Executive Summary 3 Business Challenges Associated with the ICD-10-CM Transition 4 Preparing to Address the Challenges
More informationICD-10 Readiness for Public Health
ICD-10 Readiness for Public Health Debbie Widener Sr. Implementation & Training specialist Sonali Luniya, PhD VP, Customer Experience ICD-10 Webinar: Goals ICD-10 Overview and Impacts ICD-9 vs. ICD-10
More informationICD-10 Preparation for Non- Coders in the Revenue Cycle
ICD-10 Preparation for Non- Coders in the Revenue Cycle September 24, 2015 Arkansas HFMA Revenue Cycle Seminar Susan Wallace, MEd, RHIA, CCS, CCDS, CDIP, FAHIMA Program Objectives Explain the impact of
More informationICD-10 Action Plan: Your 12-Step Transition Plan for ICD-10. Written by the AMA CPT Medical Informatics Department
ICD-10 Action Plan: Your 12-Step Transition Plan for ICD-10 Written by the AMA CPT Medical Informatics Department P R A C T I C E T O O L S E P T E M B E R 2 0 1 2 This resource is for educational purposes
More information10-Step ICD-10 Planning Guide for Chiropractors
10-Step ICD-10 Planning Guide for Chiropractors ICD-10 Education is necessary till Oct 1st. -Pick a Team Leader Consider: Articles, Should test ICD-10 readiness: -Explain ICD-10 Goals Websites, Webinars,
More informationThe Transition to Version 5010 and ICD-10
The Transition to Version 5010 and ICD-10 An Overview Denise M. Buenning, MsM Director, Administrative Simplification Group Office of E-Health Standards and Services Centers for Medicare & Medicaid Services
More informationThe Transition to ICD-10. Topics to Be Covered. Compliance Date 9/13/2013
The Transition to ICD-10 AAPC 2013 Dallas Regional Conference September 26, 2013 1 Topics to Be Covered ICD-10 compliance date ICD-10 overview Why the transition to ICD-10 Making the switch to ICD-10 CMS
More informationCoding for ICD-10-CM: More of the Basics
Centers for Medicare & Medicaid Services MLN Connects Video Transcript 12/1/14 Nguyen Intro Coding for ICD-10-CM: More of the Basics I am Nguyen, from the Provider Communications Group here at CMS. I would
More informationCoding for ICD-10-CM: More of the Basics. December, 2014
Coding for ICD-10-CM: More of the Basics December, 2014 How to Obtain a Code Book Free ICD-10-CM pdf ftp://ftp.cdc.gov/pub/health_statistics/nchs/publications/icd10cm/2015 Code books and associated tools
More informationICD-10 CM. Presented to Maryland AAHAM May 20, 2011. Basic Overview & Comparison
ICD-10 CM Presented to Maryland AAHAM May 20, 2011 The ICD-10 code sets are not a simple update of the ICD-9 code set. The ICD-10 code sets have fundamental changes in structure and concepts that make
More informationICD-10: Navigating the Change. Presented by: Shelley Garrett, CPC, CMC, CMOM, CMIS
ICD-10: Navigating the Change Presented by: Shelley Garrett, CPC, CMC, CMOM, CMIS A journey of a thousand miles begins with a single step -Confucius 5010 Conversion January 1, 2012 5010 Conversion Version
More informationFrequently asked questions: ICD-10
Frequently Asked Questions Frequently asked questions: ICD-10 To help health care providers and payers prepare for ICD-10, Optum has prepared the following answers to frequently asked questions. ICD-10
More informationREVISION, PROCEDURE CODING SYSTEM (ICD-10-PCS) VERSION 2.Ø
NCPDP IMPLEMENTATION TIMELINES AND RECOMMENDATIONS FOR INTERNATIONAL CLASSIFICATION OF DISEASES, 10TH REVISION, CLINICAL MODIFICATION (ICD-10- CM) AND THE INTERNATIONAL CLASSIFICATION OF DISEASES, 10TH
More informationGetting Ready for ICD-10. Part 1: The Basics
Getting Ready for ICD-10 Part 1: The Basics Introduction In the United States, on October 1, 2015 the ICD 9 code set used to report medical diagnoses and inpatient procedures will be replaced by the International
More informationWebinar sponsored by Gateway EDI
Webinar sponsored by Gateway EDI Agenda Overview of changes Where you should be focused now Changes needed for coders and clinicians Documentation changes Successful implementation Overview 2014 Implementation
More informationBest Practices for Transitioning to ICD-10
Best Practices for Transitioning to ICD-10 Nearly 20 years after it was first proposed, the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) for diagnosis coding
More informationInternational Classification of Diseases (ICD)-10: Are You Ready? Note! Contents are subject to change and are not a guarantee of payment.
International Classification of Diseases (ICD)-10: Are You Ready? Note! Contents are subject to change and are not a guarantee of payment. Objectives Provider community ICD-10 compliance What you can expect
More informationICD-10 FROM A NURSE PERSPECTIVE. Learning Objectives 4/22/2015. Adoption of ICD-10 Classification of Diseases CD-10-CM Diagnostic Codes
ICD-10 FROM A NURSE PERSPECTIVE Learning Objectives 1. New ICD-10-CM diagnostic system for Dermatology. 2. Impact of new codes on nursing and clinical support staff. 3. Education and resources available.
More informationHow To Get A Blue Cross Code Change
OVERVIEW 1. What is an ICD Code? The International Classification of Diseases (ICD) code set is used primarily to report medical diagnosis and inpatient procedures. ICD codes are mandated by the Centers
More informationImpact of ICD-10-CM on Your Practice
Impact of ICD-10-CM on Your Practice From Apprehension to Comprehension Presented by Kelley Lipsey Today s Goal Brief overview of recent ICD-10-CM webinar series for providers Discuss ICD-10s impact on
More informationGetting Ready for ICD-10. Part 2: ICD-10 Coding
Getting Ready for ICD-10 Part 2: ICD-10 Coding Introduction In the United States, on October 1, 2015 the ICD 9 code set used to report medical diagnoses and inpatient procedures will be replaced by International
More informationBasic ICD-10-CM Documentation and Coding. Effective date: October 1, 2015. Presented by: Jenna Glenn, CPC May 6, 2015 1
Basic ICD-10-CM Documentation and Coding Effective date: October 1, 2015 Presented by: Jenna Glenn, CPC May 6, 2015 1 Objectives Overview on what is ICD-10-CM Changes from ICD-9-CM to ICD-10-CM Importance
More informationICD-10 and Its Impact on the Healthcare Industry
Point of View ICD-10 and Its on the Healthcare Industry Written by Stacy Swartz, RHIA, CCS, CPC Vice President of Coding for Sutherland Healthcare Solutions On January 16, 2009, the U.S. Department of
More informationCountdown to Change. DSM-5 and ICD-10. Sharon A. Shover, CPC, CEMC sshover@blueandco.com 502.992.3511
Countdown to Change DSM-5 and ICD-10 Sharon A. Shover, CPC, CEMC sshover@blueandco.com 502.992.3511 Today s Discussion Differences between DSM and ICD Specificity of the code sets Financial Impacts Implementation
More informationHow to Avoid an Office Meltdown: Find Out the Facts about ICD-10-CM. Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Appendix
How to Avoid an Office Meltdown: Find Out the Facts about ICD-10-CM Table of Contents Chapter 1 Why Is ICD-9 Being Replaced?... 3 How Is ICD-10-CM Different?... 4 How Does the New Format Compare?....5
More informationPreparing for the Conversion from ICD-9 to ICD-10: What You Need to Be Doing Today
Preparing for the Conversion from ICD-9 to ICD-10: What You Need to Be Doing Today Currently in the United States, ICD-9 is the code set used to report diagnoses and inpatient procedures. ICD-9 stands
More informationPreparing Your Revenue Cycle for ICD-10. Carrie Aiken, CHC Compliance and Consulting Manager
Preparing Your Revenue Cycle for ICD-10 Carrie Aiken, CHC Compliance and Consulting Manager Today s Presenter Carrie Aiken SVA Healthcare Services, LLC 608.826.2451 aikenc@sva.com 1 Objectives Seeing Revenue
More informationDial-In: (800) 933-2547
GE Healthcare Dial-In: (800) 933-2547 Coding in ICD-10 Planning and Executing for Success 2011 General Electric Company All rights reserved. This does not constitute a representation or warranty or documentation
More informationICD-10-CM Training Module for Dental Practitioners. Presented by Workgroup for Electronic Data Interchange
ICD-10-CM Training Module for Dental Practitioners Presented by Workgroup for Electronic Data Interchange Disclaimer This presentation is for discussion and educational purposes only and is not intended
More informationHome Health Care ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Home Health Care and Top 20 codes
Home Health Care ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Home Health Care and Top 20 codes Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E99) ICD-10-CM diabetes mellitus
More informationICD-10-CM Transition
KY HFMA Spring 2014 Annual Meeting ICD-10-CM Transition Heather Greene, MBA, RHIA, CPC, CPMA Vice President, Compliance Services AHIMA Approved ICD-10 CM/PCS Trainer Myth # 1 Implementation planning should
More informationICD-10 Transition ROLES AND RESPONSIBILITIES
Welcome to ICD-10 Transition ROLES AND RESPONSIBILITIES Training Spotlight for Physicians and Other Providers Topics for Discussion ICD-10 Transition: Roles and Responsibilities ICD-10 Overview A few facts
More informationICD-10 PREPARATION GUIDE PART II
ICD-10 PREPARATION GUIDE PART II More resources to prepare your physicians and staff, and to help work with your vendors to successfully implement the new code set. TABLE OF CONTENTS 3 Working with your
More informationICD-10-CM: Training. Presented by: Anna M. Cruz CCS, CCS/P,CPC-A ICD10CM/PCS AHIMA Approved Trainer & Sonya Shebala CPC, CPC-H
1 ICD-10-CM: Training Presented by: Anna M. Cruz CCS, CCS/P,CPC-A ICD10CM/PCS AHIMA Approved Trainer & Sonya Shebala CPC, CPC-H Partial Freeze of Revisions to ICD-9-CM and ICD-10-CM/PCS CDC.gov 2 October
More informationENGAGING PHYSICIANS FOR ICD-10: ALL ABOARD Engaging Physicians for ICD-10: All Aboard
ENGAGING PHYSICIANS FOR ICD-10: ALL ABOARD Engaging Physicians for ICD-10: All Aboard ICD-10 Lisa Kozakoff Principal Consultant Siemens Healthcare Lisa Kozakoff Principal Consultant Agenda Introduction
More information3/5/2015. Mike Denison Senior Director of Regulatory Programs Emdeon. Andrea Cassese Director, PTOS Software Patterson Medical
Presented by PTOS and Emdeon March 3, 2015 Andrea Cassese, Director, PTOS Rachael McWhorter, Product Manager, PTOS Mike Denison, Senior Director Regulatory Programs, Emdeon Mike Denison Senior Director
More informationICD-10 Update* Mental and Behavioral Health ICD-10-CM Codes Blue Cross Blue Shield of Michigan 2014
ICD-10 Update* Mental and Behavioral Health ICD-10-CM Codes Blue Cross Blue Shield of Michigan 2014 *NOTE: The information in this document is not intended to impart legal advice. This overview is intended
More informationProvider Information Exchanges April 16 th through 24 th 2012
Provider Information Exchanges April 16 th through 24 th 2012 Electronic Data Interchange (EDI) Presenter: Christol Green, Sr. EDI Business Consultant christol.green@anthem.com This presentation contains
More informationICD-10-CM TRANSITION WORKBOOK
ICD-10-CM TRANSITION WORKBOOK The Next Generation of Coding Preparation is the key to success when transitioning your practice from ICD-9 to ICD-10. The federally mandated compliance date is October 1,
More informationICD-10 IS COMING OCTOBER 1, 2014
ICD-10 IS COMING OCTOBER 1, 2014 WHAT IS THE IMPACT ON THERAPY PRACTICES? CHET DESHMUKH, MBA, OTR/L, CPC, CHDA Overview Understanding the language of clinical diagnosis What is ICD? About ICD-9 CM Good
More informationICD 10 Transition: What You Don t Already Know
ICD 10 Transition: What You Don t Already Know and How to Prepare for It! Jennifer Keiser, B.S., A.L.M. General Manager, Alternate Care Solutions Mediware Information Systems, Inc. Cranston, RI CE Credit
More informationICD-10-CM and ICD-10-PCS Frequently asked questions for HIM and Patient Financial Services Leaders
ICD-10-CM and ICD-10-PCS Frequently asked questions for HIM and Patient Financial Services Leaders Executive questions What is the current status of ICD-10? The U.S. Department of Health and Human Services
More informationICD-10 CD-10 AND ONCOLOGY: WHAT YOU NEED TO DO NOW AND IN THE NEAR FUTURE
ICD-10 CD-10 AND ONCOLOGY: WHAT YOU NEED TO DO NOW AND IN THE NEAR FUTURE ION Community Counts Practice Effectiveness Web Series April 10, 2014 Risë Marie Cleland, Oplinc Inc. www.oplinc.com Important
More informationRoad Map to ICD-10 CM ( (Alternate Route Required) Disclosures. Topics for Discussion. No relevant relationships were disclosed
Road Map to ICD-10 CM ( (Alternate Route Required) Presented by Teresa Thompson, CPC TM Consulting, Inc TMConsultingfirm@icloud.com Disclosures No relevant relationships were disclosed Topics for Discussion
More informationCODING CHANGESICD-10!! Presented by: Colleen Grope CPC, CCS-P
CODING CHANGESICD-10!! Presented by: Colleen Grope CPC, CCS-P 1 AGENDA Differences between ICD-9 and ICD-10 Basic ICD-10 Coding Guidelines Implementation Strategies Potential Revenue Ramifications 2 ICD-9
More informationAHLA. HH. Introduction to Medical Coding for Payment Lawyers
AHLA HH. Introduction to Medical Coding for Payment Lawyers Robert A. Pelaia Senior University Counsel University of Florida Jacksonville Jacksonville, FL Institute on Medicare and Medicaid Payment Issues
More informationThe Impact of Implementing ICD 10 on Physician Practices and Clinical Laboratories
The Impact of Implementing ICD 10 on Physician Practices and Clinical Laboratories A Report to the ICD 10 Coalition October 8, 2008 Nachimson Advisors, LLC Nachimson_Advisors@verizon.net 1 Scope of ICD
More information2015 HIM Educational Summit ICD-10-CM Discussion Panel
2015 HIM Educational Summit ICD-10-CM Discussion Panel PRESENTED BY Karen Scott, MEd, RHIA, CCS-P, CPC, FAHIMA AHIMA Approved ICD-10-CM/PCS Trainer KScottSeminars@Comcast.net Brian Boyce, BSHS, CPC, CPC-I,
More information* Dignity Health. Success
* Dignity Health. Tools for Success Table of Contents ICD 10 Overview Physician Practice Checklist Financial Planning for ICD 10 ICD 10 Education for Physicians ICD 10 Education for Staff ICD 10 Impacts
More informationICD-10 An Introduction to the New Diagnosis Coding The Untold Story
ICD-10 An Introduction to the New Diagnosis Coding The Untold Story Charles Jarvis, Senior Manager Health Reform cjarvis@cokergroup.com 610-811-4015/848-992-0281 Agenda Brief Overview of ICD-10 ICD-10
More informationBelow are some frequently asked questions that may assist your practice.
Dear Providers: With the recent announcement in the delay for the implementation for ICD-10-CM/PCS we wanted to provide an update on Blue Cross and Blue Shield of Vermont s (BCBSVT) implementation. We
More informationICD 10 Breakout Session
ICD 10 Breakout Session Conducting the Technology & Practice Impact Assessment Slide 1 Your Presenter Today Hank Mayers, MCP, PMP, CPHIMS President www.reliatechconsulting.com Slide 2 Content Of This Session
More informationPreparing for ICD-10 Expected Impact on Prospective Payment Systems. HSCRC ICD-10 Information Exchange April 2011
Preparing for ICD-10 Expected Impact on Prospective Payment Systems HSCRC ICD-10 Information Exchange April 2011 Agenda ICD-10: A Brief Overview The HSCRC ICD-10 Preparation Process MHA ICD-10 Planning
More informationBreeze Your Way To ICD - 10. Presented by Fred Melroy
Breeze Your Way To ICD - 10 Presented by Fred Melroy Disclaimer The materials and the information contained in the webinar are provided as is, and CureMD makes no express or implied representations or
More informationICD-10 FAQ. How Long Has ICD-9-CM Been In Use?
ICD-10 FAQ How Long Has ICD-9-CM Been In Use? What Code Set Does ICD-9-CM Define? What Code Set Does ICD-10 Define? When was ICD-10-CM Created? What agency maintains ICD-10? Why is ICD-10 better than ICD-9?
More informationICD 10 ESSENTIALS. Debbie Sarason Manager, Practice Enhancement and Quality Reporting
ICD 10 ESSENTIALS Debbie Sarason Manager, Practice Enhancement and Quality Reporting October 29, 2015 CHANGING FROM 1CD 9 TO ICD 10 IN 2015 Rest of world has been using ICD 10 for decades World Health
More informationIRF Coding: Changing the Culture to Strengthen the Team
IRF Coding: Changing the Culture to Strengthen the Team Stephanie Johnson, CCS Sr. HIM Coding Specialist 2014. The UDSMR logo is a trademark of, a division of UB Foundation Activities, Inc. Objectives
More informationPlease Bypass The Screen Below For audio call 1-877-669-3239 Event number: 663 841 450 MUTE YOUR PHONE
Please Bypass The Screen Below For audio call 1-877-669-3239 Event number: 663 841 450 MUTE YOUR PHONE ICD-10 August 9, 2013 Presenter: Miki Hoppe, Manager ICD-10 Business Solutions ICD10@HMSA.com Agenda
More information