HealthCare Synergy Inc

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Erick Jones
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1 ICD-9 & ICD-10 Implementation (Dual Coding) Unless you ve been hiding under a rock or vacationing on a remote beach without technology, you ve heard about the change to ICD-10 and possibly something called dual coding. This document will provide additional information on ICD-10, OASIS-C1 use, and Dual Coding. After reading, you will understand how this will roll out for HealthCare Synergy clients. ICD-10 is effective on October 1, What does this mean? 1. OASIS-C1 forms will change to use ICD-10 instead of ICD-9 codes. 2. Claims will contain ICD-10 codes instead of ICD-9 codes. HealthCare Assistant is currently scheduled to have ICD-10 coding functionality in mid to late August. The next section is what you can expect in performing data entry between the three versions of the software. ICD-10 Code Entry ICD-10 codes will be entered in two different locations based on the software being used. HealthCare Assistant Client/Server (Legacy) and SITC will have the ICD-10 codes entered into the 485. HealthCare Assistant 485/Plan of Care OASIS-C1 Version Client/Server (Legacy) ICD-10 tab ICD-10 SITC ICD-10 tab ICD-10 Web Edition ICD-10 tab ICD-9 and ICD-10 The 485 is being modified and will have a data grid where the ICD-9 and ICD-10 codes are entered. For episodes that do not require ICD-10, the ICD-10 data grid can be left blank. For all episodes starting on or after October 1, 2015 users will need to enter ICD-10 codes in the ICD-10 diagnosis data grid to successfully populate claims. ICD-9 and ICD-10 codes will be required for all episodes that start before October 1, 2015, but ending on or after October 1, The appropriate OASIS-C1 form will be displayed for all agencies using the Legacy/SITC versions of the software. This will be done automatically based on the M0090 date entered by the user. The Web Edition users will be able to enter ICD-9 and ICD-10 codes into the comprehensive assessment which will then automatically populate the appropriate data grids on the 485.

After reading, you will understand how this will roll out for HealthCare Synergy clients. ICD-10 is effective on October 1, 2015. What does this mean? 1. OASIS-C1 forms will change to use ICD-10 instead of ICD-9 codes.

2 DUAL CODING HealthCare Synergy Inc ICD-10 will be required for any claims submitted with effective dates on or after October 1, 2015 (10/1/15). Dual coding is NOT a Medicare requirement, but it is a preventative measure to speed up the process of coding and preparation for the final claims. If it is not required, why should I do it now? While this is not a requirement by Medicare, it is strongly suggested for the following reasons. 1. Improve accuracy of coding. 2. Practice ICD-10 coding; in case you ve not yet done so. 3. Allow time to obtain additional documentation that may be required. 4. Lighten workload by coding in both ICD-9 and ICD-10 while the case is fresh to the coder. a. Thus preventing the need to review documentation a second time to code in ICD-10 at a later date. 5. Determine possible speed impact of current coding staff. a. Discover whether additional coding staff is required. b. Decide to outsource ICD-10 coding. Dual coding starts on Monday, Aug. 3 for any assessment with a completed (M0090) date from Aug. 3 to Sept. 30. Any claim with a through date of Oct. 1, which can be any claim that starts Aug. 3, will need to be sent with ICD-10 codes for the Final Claim. This will automatically happen in the software without additional work on your part, provided ICD-10 codes are entered on the 485. Dual Coding can be accomplished via the Dual Coding worksheet on the final page of this document until the HealthCare Assistant is capable of storing the ICD-10 codes in the software. OASIS utilization of ICD-10 Understanding when OASIS will be answered and clinician timely completion of OASIS-C1 data will be essential to prevent frustration and additional paperwork. This is because of how ICD-10 is implemented and the fact that Medicare does not have a transitionary or phased in process. It is important to understand that the date the OASIS is completed (M0090) is the one deciding factor on whether ICD-9 or ICD-10 codes are utilized. Since the OASIS-C1 form does not contain both ICD-9 and ICD-10, the form used will be selected based on when the form is expected to be completed. If the clinician expects to complete (M0090) the assessment on or before 9/30/15 the current OASIS-C1 with ICD-9 should be used.

While this is not a requirement by Medicare, it is strongly suggested for the following reasons. 1. Improve accuracy of coding. 2. Practice ICD-10 coding; in case you ve not yet done so. 3.

3 If the clinician does not expect to complete the assessment (M0090) on or before 9/30/15, then they will need to use an OASIS-C1 ICD-10 form. This can lead to frustration by the clinician in the instances when the OASIS-C1 cannot be completed by the expected date, then in some instances the OASIS-C1 will have to be entered on a different form. Thus, it is essential that the agency and clinician properly plan and coordinate on which OASIS-C1 form should be used. The only difference between the two OASIS-C1 forms is the use of ICD-9 or ICD-10 questions. All other OASIS-C1 forms are the same between the two forms. Clients using the Web Edition will benefit from the fact that both ICD-9 and ICD-10 questions will be present on the electronic clinical. Claim Utilization of ICD-10 Date Assessment Completed Certification End Date Assessment Form Version Dual Coding RAP Final Claim On/Before 8/2/15 On/Before 9/30/15 OASIS-C1 ICD-9 No ICD-9 ICD-9 8/3/15 9/30/15 On/After 10/1/15 OASIS-C1 ICD-9 Yes ICD-9 ICD-10 On/After 10/1/15 On/After 10/1/15 OASIS-C1 ICD-10 No ICD-10 ICD-10 Each Medicare claim has a service beginning and ending date. A RAP has the same start and end service dates. A FC has differing start and end service dates; the first and last visits in the episode. Due to the fact that Medicare has no transitionary or phased process for ICD-10 adoption, the dates of service on the claim are the deciding factor of whether the claim is submitted with ICD9 or ICD-10 codes. Any RAP with start/end service dates, on or before 9/30/15 will be sent with ICD-9. A RAP with an SOC date on or after 10/1/15 will be submitted with ICD-10. Any FC with a service date on or before 9/30/15 will be submitted with ICD-9. If the FC service end date is on or after October 1, 2015, then the claim must use ICD-10 instead of ICD-9. The service ending date is the one that determines whether ICD-10 is required on the claim for episodes that start by using ICD-9. Thus any claim where the RAP was submitted with ICD-9 can be submitted with ICD-10. The HealthCare Assistant will automatically submit the claim with the required ICD codes without any user action once ICD-9 and ICD-10 codes, if needed are entered. Users will receive a Claim warning if ICD-10 codes don t exist for a claim that should be submitted with ICD-10 based on the service dates.

form. Thus, it is essential that the agency and clinician properly plan and coordinate on which OASIS-C1 form should be used.

4 Is your agency not prepared? HealthCare Synergy Inc Outsourced ICD-10 Coding may be your solution. In case you are not certain your agency is prepared for the impending ICD-10 implementation, HealthCare Synergy can assist. Our Clinical Technologist Service has been helping agencies outsource OASIS review and diagnosis coding for over 4 years. Utilizing licensed clinicians that are certified in both OASIS and diagnosis coding, we have had the opportunity to assist many agencies improve their documentation and apply better adherence to the OASIS guidance and coding guidelines. The implementation of ICD-10 in Canada and other countries show that the adoption of the new coding system will result in a 20% - 30% decrease in productivity. Assuming that it only results in a 10% - 15% productivity loss many agencies will not be able to retain their current workload without hiring additional staff or considering outsourcing coding. Outsourcing provides considerable savings in employee matching funds, training costs and lost time from vacations and sick time. Months of training for ICD-10 and practice coding has prepared our clinicians to assist both home health and hospice agencies. Our services are prepared to provide short term, long term and overflow coding.

Our Clinical Technologist Service has been helping agencies outsource OASIS review and diagnosis coding for over 4 years.

5 Patient Name / ID Number: Assessment Type: Date: Question/Position M1011 Inpatient diagnosis a. b. c. d. e. f. Question/Position M1017 Diagnoses with change in Past 14 days a. b. c. d. e. f. Primary & Secondary Question & Position M1021 a. M1023 b. M1023 c. M1023 d. M1023 e. M1023 f. g. h. i. j. k. l. m. n. I.E Diabetes I.E Diabetes M1021/M1023 M1021/M1023 I.E. E Diabetes I.E. E Diabetes M1025 Column 3 I.E Diabetes I.E. E13.9 Diabetes I.E Diabetes ICD-10- CM M1025 Column 3 I.E. E Diabetes

M1023 c. M1023 d. M1023 e. M1023 f. g. h. i. j. k. l. m. n. I.E. 250.00 - Diabetes I.E. 250.00 - Diabetes M1021/M1023 M1021/M1023 I.E. E13.

Legislative and Executive Advocacy Response Network (LEARN)

Legislative and Executive Advocacy Network (LEARN) ICD-10 Implementation Study, January 2014 Total Respondents: s were received from over 570 physician group practices in which more than 21,416 physicians