ICD-10 Transition Countdown: Ready, Set, Code Your Complete Strategic Readiness Guide

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1 Please stand by There are several attendees still waiting to log in ICD-10 Transition Countdown: Ready, Set, Code Your Complete Strategic Readiness Guide April 4, 2012 To download slides: click on Presentation Assets on the left side of your screen

2 To download slides: click on Presentation Assets on the left side of your screen ICD-10 Transition Countdown: Ready, Set, Code Your Complete Strategic Readiness Guide April 4, 2012

3 Today s Objectives ICD diagnosis and patient care coding changes Transition assessment tools and strategies t Implementation steps, from training to final evaluation Success stories and lessons learned from organizations currently in ICD 10 transition 2

4 Important Webcast Notes If you should need any technical assistance during today s event,,please type your inquiry into the Tech Support box on the left side of your screen and click the Send button. If you are disconnected from the webcast, you can log on again, using the login instructions provided to you. If you cannot log back on with these instructions, please call Technical Support at The ipad drawing will take place at the conclusion of today s program. You may download a copy of today s presentation from the Presentation Assets box on the left side of your screen. 3

5 To Receive CPE Credit Active participation: - NASBA requires that we monitor your participation. - You must answer 75% of all polling questions offered per hour to get credit for that hour. Half credits may be awarded after the first hour, as appropriate. - Your interactions will be tracked through the system. For groups, the proctor s polling answers will be tracked. - Your computer connection will be tracked through the system. You must be connected at least 50 minutes to receive 1 credit. Each 25 minutes after the first hour is worth ½ credit. Polling questions: - Click on appropriate ate radio button to answer the polling question. - You cannot be in full screen mode and answer the polling questions. Please ensure your screen is minimized to answer polling questions. *Failure to follow this policy will result in NO CPE credit. 4

6 To Receive Group CPE Credit Group participation: - Groups should download d the Group Sign-in i sheet from the Presentation Assets box located on left side of the screen - The group proctor must be the person logged into the streaming platform and must answer the CPE polling questions - Group proctors should enter all participant information and sign off at the top of the group sign-in sheet Include actual time in and time out of all participants Verify active participation of all group members - Submit via within 3 days *Failure to follow this policy will result in NO CPE credit for everyone in the group 5

7 Submitting Questions Following the presentation we ll have a Q&A session. We encourage you to ask text questions throughout the presentation. Click the Ask a Question button, type your question in the open area and click Ask Question to submit. 6

8 Today s Presenters Alicia Faust Director, National ICD 10 Lead (office) (cell) alicia.faust@mcgladrey.com Jason Greer Manager, Technology Lead (office) jason.greer@mcgladrey.com g 7

9 Polling Question One Where did you hear about this webcast? - My local l HFMA chapter - McGladrey invitation / contact - McGladrey website - Colleague / friend - Twitter / Facebook - Other 8

10 Polling Question Two What type of organization do you represent? - PPS hospital / health system - Sole community hospital - Critical access hospital - City/county hospital - Physician clinic - Association - Other 9

11 Polling Question Three What role do you hold within your organization? - Board of Directors / Strategic Planning - CEO - CFO - COO/ CIO / CMO - Clinical Leadership - Patient Financial Services - Medical Records / Health Information Management - Reimbursement - Information Technology - Managed Care / Finance - Legal Counsel - Other 10

12 ICD 10 Transition: Background Federal mandate for transition to 5010 software and ICD 10 coding - Improve patient care - Improve diagnosis, coding, billing and reimbursement - Reduce health care cost Original ICD 10 WEDI timeline shows that providers should have been approximately 50%+ through their transition to ICD 10 - Providers should have developed an effective governance structure, completed planning, performed impact analyses and are in the process of identifying performance opportunities; also, training and education initiatives should be underway shortly The Centers for Medicare and Medicaid Services (CMS) original implementation deadline of October 1, 2013 has been delayed. McGladrey continues to advocate to not wait! 11

13 ICD 10: How many codes are affected? Number of Codes and Size of Increase ICD-9 9CM ICD-10 CM and PCS 4.85x 18.98x 68,069 72,589 14,025 Diagnosis 3,824 Procedures ICD 10 CM: Clinical Modification (diagnosis) Across all disciplines ICD 10 PCS: Procedure Coding System (surgical procedures) IP only 12

14 Types of ICD 10 Adopters Late adopter Just getting started with some potential internal/external training initiatives; need rapid assessment approach to assist in catching up to standard timeline Intermediate or mainstream adopter Potentially seeking on-site professional project management resources to lead internal readiness initiatives due to: - Limited project management resources - Formal acknowledgment of the complexities and number of resources, processes and systems impacted by transition - Associated risks indicate a need in your organization for project management support to drive timely completion - Provider more than likely needs a rapid assessment scorecard to determine overall effectiveness Early adopter Evaluating/enabling technology-based tools/solutions; designed to provide advanced, real-time and ongoing data analytics of historical and prospective claims that will provide measurement of claims coded, billed or grouped by ICD 10, DRG/MSDRG, MDC or other frame of reference/relevance 13

15 Polling Question Four What type of adopter would you classify your organization? - Early - Intermediate/mainstream - Late 14

16 Original WEDI Timeline and Catch-up Q1 09 Q2 09 Q3 09 Q4 09 Q1 10 Q2 10 Q3 10 Q4 10 Q1 11 Q2 11 Q3 11 Q4 11 Q1 12 Q2 12 Q3 12 Q4 12 Q1 13 Q2 13 Q3 13 Q4 13 Kick Off * Organize Implementation Effort Impact Assessment Implementation Planning Identify and Implement Process Improvements Training/Education Internal System Design/Development Internal Testing Vendor Code Deployment External Testing Transition/Implementation Post Go Live Timeline Catch-up Necessary 15

17 Hospital Associations: ICD 10 Survey Results About 50% of providers responded that they have not started ICD 10 analyses and are considered to be late adopters Between 10-15% of providers responded that they are in early stages of ICD 10 analyses and are considered to be late adopters Almost 70% of providers responded that they are behind the WEDI timeline For those providers who responded that they were on target, 50% suggested that they were only focusing on I/P issues Over 60% of providers responded that a rapid assessment would benefit their organization We are finding that most hospitals have been slow to begin ICD 10 transition analyses Survey results benchmark consistently between associations/counsels across the country 16

18 Enterprise-Wide Approach Physician Practices ICD 10-CM CPT/HCPCS Other Ambulatory ICD 10-CM CPT/HCPCS Hospital I/P ICD 10-CM ICD 10PCS Hospital O/P ICD 10-CM CPT/HCPCS Emergency Care ICD 10-CM CPT/HCPCS Post-Acute ICD 10-CM CPT/HCPCS 17

19 Enterprise-Wide ICD 10 Risk Areas and Considerations o s Risk Areas Considerations IP/OP/Physician Resources Governance Managed Care / Finance Medical Records / HIM GOVERNANCE: Steering committee, sub workgroups, project charter, communications plan, issues escalation plan, project management office, ICD 10 lead, project plan to include persons responsible, timeframes, milestones and due dates MEDICAL RECORDS/HIM: Number of coders (IP, OP, physicians), current skill levels, credentialing, productivity and accuracy levels, retention, recruitment, out sourcing, system coding staff pool, dual coding, clinical documentation improvement, GEM mapping, education IT: Systems inventory for hardware and software, clinical and financial applications, interfaces, registries, implementations and upgrades, sunsets and replacements, testing storage and back up, dual coding REVENUE CYCLE: Central billing office and key performance indicators i.e. days in AR, days of unbilled, bad debt write off, insurance verification, patient registration, initial denials and denials write offs, etc. Vendors Revenue Cycle Information Systems VENDORS: Vendor inventory, contract negotiations, communications, readiness timelines, testing DOCS: IP Hospitalists, OP, physician practices, GEM mapping, clinical documentation improvement, education RESOURCES: Competing objective: EMR and meaningful use, software implementations, upgrades and training, CDI, CPOE, ICD 10, consolidation and integration, daily operations and tasks MANAGED CARE/FINANCE: MCR and private pay GEM mapping, hold harmless contract provisions ($ neutrality), analysis pre and post ICD 10 (financial impacts), contract negotiation implications i.e. right to audit pre and post impacts, external financial to support operations 18

20 Polling Question Five Looking at all the risk areas, has your organization completed a risk-based assessment for ICD 10? - Yes - No 19

21 ICD 10 Translator Technology Screenshots 20

22 ICD 10 Translator Technology Screenshots (continued) 21

23 ICD 10 Translator Technology Screenshots (continued) 22

24 ICD 10 Translator Technology Screenshots (continued) 23

25 ICD 10 Demo 24

26 ICD 10 Translator Technology Background and platform Demo 25

27 Polling Question Six Have you conducted any type of code translation within your organization from ICD 9 to ICD 10? - Yes - No 26

28 Polling Question Seven How much training time has been built into your ICD 10 project plan to prepare employed physicians? - Less than 15 Minutes - Less than 1 Hour - Less than 4 Hours - Less than 8 Hours 27

29 Lessons Learned from Early Adopters: Why is sas smooth ICD 10 transition so important? Technology Vendor Analysis Education Governance ICD 10 Lessons Learned Coding and Documentation Strategic Performance Managed Care Revenue Cycle Decreased payment due to non-compliant physician documentation Increased compliance risk Decreased payment due to unanticipated changes in commercial, Medicare and Medicaid DRG/MSDRG classifications Increased denials due to ICD 10-revised/dependent national/local coverage determination policies Increased A/R due to log-jammed internal/external claims processing operations Increased claims processing complexities, A/R management challenges due to expected concurrent coding ICD-9/ICD 10 and HIPAA 4010/5010 transmission capabilities due to: Information system complexities/interdependencies Decreased coding productivity it leading to HIM coding under-staffing due to significant unplanned learning curve related to: - Sheer volume of codes increasing - Increased significance of coder competencies in medical terminology and clinical practice variations - Significant number of complex (combination) codes with scenarios and choices - Significant number of ICD-9 clusters that now map to single ICD 10 codes - Significant number of ICD 10 clusters that previously mapped to an ICD-9 code Coding personnel shortages due to increased demand for coding 28

30 Questions? 29

31 Thank You! 30

32 Contact Information Alicia Faust Director, National ICD 10 Lead (office) (cell) Jason Greer Manager, Technology Lead (office) 31

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