To Receive CPE Credit

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1 The Five Ws of ICD-10 Training & How to Develop a Training Plan Presented by Ann Zeisset, RHIT, CCS, CCS-P AHIMA-Approved ICD-10-CM/PCS Trainer February 13, 2013 To Receive CPE Credit Participate in entire webinar Answer polls when they are provided If you are viewing this webinar in a group o Complete group attendance form with Title & date of live webinar Your company name Your printed name, signature & address o All group attendance sheets must be submitted to training@bkd.com within 24 hours of live webinar o Answer polls when they are provided If all eligibility requirements are met, each participant will be ed their CPE certificates within 15 business days of live webinar 2 1

2 The Five Ws of ICD-10 Training & How to Develop a Training Plan Presented by Ann Zeisset, RHIT, CCS, CCS-P AHIMA-Approved ICD-10-CM/PCS Trainer February 13, 2013 Learning Objectives Identify key components of ICD-10 training to allow development of training strategy o Who, what, when, where & why Discuss differences between organizational & coder training Define organizational awareness training Discuss coder-specific training Identify strategies to develop role-based training 4 2

3 = HOW Why Who ICD-10 Training What When Where 5 Why Training Needed Final Regulations Final rule published January 16, 2009 in Federal Register o o Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards (5010) January 1, 2012, compliance date Adoption of ICD-10-CM/PCS October 1, 2013, compliance date Final rule for one-year extension published in Federal Register on September 5, 2012 o Compliance date October 1,

4 Four Phases of Implementation Phase 1 Implementation plan development & impact assessment o 1 st quarter nd quarter 2012 Phase 2 Implementation preparation o 1 st quarter nd quarter 2014 Phase 3 Go live preparation o 1 st quarter rd quarter 2014 Phase 4 Post-implementation follow-up o 4 th quarter th quarter Implementation Phases Involving Training Assess & Plan Training Needs Phase 1 Develop & Implement Training Plan Phase 2 Provide Intense Training Phase 3 8 4

5 Assess Training Needs Multiple categories of users o Require varying types & levels of ICD-10 education o At different times Determine who, what, when & level Determine method (internal or external) Part of Impact Assessment 9 Two Types of Training (Who & What) Organization-Wide Basic awareness training to key stakeholders o Senior management, Information technology, Clinical department managers, Medical staff More intense training on structure & changes o All currently involved with ICD data o HIM & coding professionals 10 Coding Professionals Provide training based on knowledge gaps o Biomedical Sciences o Begin with new structure, definitions, guidelines Hands-on intense training Role-based training model throughout transition Use full implementation time! 5

6 ORGANIZATIONAL TRAINING Include All Key Stakeholders & Data Users ICD Organization-Wide Training 12 ICD-10 awareness on transition & IMPACT Basic awareness training o IT personnel o Clinical department managers o Senior management o Medical staff o HIM & coders 10/09 1/11 6

7 High-Level Awareness Education Senior Management Clinical Department Managers Medical Staff HIM Managers & Coding Staff Regulatory requirements Value of new code sets How ICD-10 fits within other internal & external initiatives: EHR, Meaningful Use, HIE, health care reform, valuebased purchasing, quality measurement & improvement Preparation & transition effects on organizational operations (e.g., systems changes, processes, policies & procedures) Impact on coding productivity & accuracy Budgetary considerations Impact on legacy data & differences between legacy & new coding systems. 13 Source: AHIMA High-Level Awareness Education Senior Management Clinical Department Managers Medical Staff HIM Managers & Coding Staff Impact on each particular department & budgetary considerations Impact on documentation practices & importance of a strategy for documentation improvement Implementation plan & how it can be adapted for use in their own practices Impact on individual physicians & their budgetary considerations 14 Source: AHIMA 7

8 Organization-Wide Training More intense training to data users o All currently involved with ICD data o HIM & coding professionals o Data users 1/11 12/13 15 Provide Education to Data Users Differences in classifications o Definitions o Code composition Data comparability issues & longitudinal data analysis issues o Differences in axis of classification & definitions GEMS 16 8

9 More Intense Awareness Education Differences between ICD-10- CM and ICD-10-PCS & how each is used Key provisions of final rule Anyone Using ICD-9 Now Clinical Department Managers Heavy Data Users HIM Managers & Coding Staff Structure, organization & unique features of ICD-10- C/PCS Data comparability issues & longitudinal data analysis issues GEMS 17 Examples of Categories of Data Users Requiring ICD-10 Education Coders Business office Epidemiologists Other HIM Auditors & consultants Performance improvement Clinicians Patient access & Corporate compliance registration Senior management Other data users Data quality management Information technology Clinical department Data security managers Quality management Ancillary departments Clinical documentation improvement (CDI) staff Utilization management Data analysts Payor contract managers & negotiators Accounting Researchers Registry personnel 18 Source: AHIMA 9

10 Follow CODER Role-Based Training Plan TRAINING 19 Coder Training Encompasses three phases of implementation plan Role-based Training Model 20 10

11 Assess Coding Needs Coders Heavy data users Gap analysis of coder skills Tailor trainings to individuals Identify staff (who) Competence & skill gaps (what) Best approach (where) Optimal timing (when) Webinars Certification courses Community courses Not too early Not too late 21 Provide Education to Coders Preparatory training Provide training based on knowledge gaps o Biomedical Sciences o Anatomy Pathophysiology Medical Terminology Pharmacology Begin with new structure, definitions, guidelines 1/11 12/

12 Role-Based Coder Training Strategy Coding Education Challenge 50 hours of training 16 hours ICD-10-CM 24 hours ICD-10-PCS 10 additional hours of practice 23 AHIMA Role-Based Models Healthcare Providers Others Academic Physicians Inpatient coder Outpatient coder Data Manager Health Plans Long-Term Care Educators Current students Prospective students Physician Champion Group 1 processes Group 2 processes Group 3 processes 24 12

13 Conduct Gap Analysis ( early 2012) Conduct Gap Analysis of current knowledge & skills Knowledge in biomedical sciences Refresh knowledge as needed based on assessment results 25 Assess Training Needs ( mid 2012) Different type of ICD-10 education Multiple categories of users Required at different times Determine who needs education, type & level & when Determine most appropriate & cost-effective method 26 13

14 Assess Training Needs ( mid 2012) Determine method of education Internal External Combination Develop Training Strategy 27 Assess Training Needs ( mid 2012) Assess each coder s strengths & weaknesses Develop individualized plan to address weaknesses Develop rolebased training plan: which coders need to learn which systems 28 14

15 Preparatory Training ( ) Begin studying ICD-10-PCS definitions Learn about the GEMS between ICD- 9-CM & ICD- 10-CM/PCS Provide training on CDI strategies 29 Preparatory Training ( ) Code structure, coding conventions & fundamentals Analyze and practice applying Coding Guidelines Memorize & apply ICD-10-PCS definitions (if applicable) 30 15

16 Preparatory Training ( ) 31 Provide Education to Coders Intense training six to nine months prior to implementation Provide training on ICD-10-CM code sets o Each chapter o All settings Provide training on ICD-10-PCS code sets o Each section o Each root operation o Only hospital inpatients 32 1/14 9/14 16

17 Sources of Training Traditional classroom Distance education Audio or Webbased programs Self-directed learning 33 Intense Coder Training Document in personnel files Test ICD-10 Proficiency Provide Training 34 17

18 Post-Implementation Phase 4 Train new staff Retrain to improve coding productivity & accuracy 35 Key is to be prepared Develop focused training strategy Use every year available Take advantage of full implementation timeframe 36 18

19 References AHIMA o o o ICD-10-CM/PCS Transition: Planning & Preparation Checklist hcsp?dDocName=bok1_ ICD-10 Role-Based Model for ICD-10 Implementation Tips for Successful Training 37 References National Center for Health Statistics CDC ICD-10- CM o Centers for Medicare & Medicaid Services ICD-10- PCS o Medicare Learning Network ICD-10-CM/PCS o viderresources.asp#topofpage 38 19

20 Resources HIMSS ICD-10 Implementation o =473 Developing an ICD-10-CM/PCS Coder Training Strategy o 39 Contact G2N info@g2n.org BKD Sally A. Hardgrove, RHIA Senior Managing Consultant shardgrove@bkd.com 40 20

21 Continuing Education Hours BKD, LLP is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: This webinar has the prior approval of AHIMA for one continuing education hour. 41 CPE & CEU Credit Up to one CPE & CEU credit will be awarded upon verification of participant attendance; however, credits may vary depending on state guidelines For questions or comments regarding CPE, please BKD Learning & Development department at training@bkd.com For questions relating to CEU please visit AHIMA website