CCHIIM ICD-10 Continuing Education Requirements for AHIMA Certified Professionals (& Frequently Asked Questions for Recertification)

Transcription

1 CCHIIM ICD-10 Cntinuing Educatin Requirements fr AHIMA Certified Prfessinals (& Frequently Asked Questins fr Recertificatin) The transitin t ICD-10-CM and ICD-10-PCS is anticipated t imprve the capture f healthcare infrmatin and bring the United States in step with cding systems wrldwide. Fr thse wh prepare apprpriately, leveraging the ICD-10 investment will allw rganizatins t mve beynd cmpliance t achieve cmpetitive advantage. The fundamental and pervasive nature f cded data n the practice f health infrmatin management makes this transitin is f critical significance t health infrmatin management prfessinals. The value f this transitin will be brad and far-reaching thrughut the healthcare industry, and will result in: Greater cding accuracy and specificity Higher quality infrmatin fr measuring healthcare service quality, safety, and efficiency Imprved efficiencies and lwer csts Greater achievement f the benefits f an electrnic health recrd Recgnitin f advances in medicine and technlgy Alignment f the US with cding systems wrldwide Imprved ability t track and respnd t internatinal public health threats Enhanced ability t meet HIPAA electrnic transactin/cde set requirements Increased value in the US investment in SNOMED-CT Space t accmmdate future expansin When healthcare industry changes affect required cmpetencies f AHIMA Certified Prfessinals, the Cmmissin n Certificatin fr Health Infrmatics and Infrmatin Management (CCHIIM) is cmmitted t prviding assurance fr all industry stakehlders that AHIMA Certified Prfessinals pssess the knwledge, skills, and abilities crrespnding t each AHIMA credential, as necessitated by the afrementined changes. Specifically, implementatin f the ICD-10- CM/PCS classificatin systems represents a majr change frm the current ICD-9-CM system fr the reasns nted abve. AHIMA certificatin represents a high level f achievement and demnstrates prficiency and a brad base f knwledge. AHIMA Certified Prfessinals have passed a rigrus exam and cmmit t nging prfessinal develpment thrugh the CCHIIM recertificatin prcess. The CCHIIM recertificatin (maintenance f certificatin) prgram ensures that CCHIIM-certified prfessinals demnstrate nging cmpetence in the dmain areas in which they are certified thrugh either maintenance r enhancement activities. 1

2 In rder t validate that an AHIMA Certified Prfessinal has gained knwledge f the ICD-10-CM/PCS cding system, CCHIIM has determined that cntinuing educatin hurs with ICD-10-CM/PCS cntent will be required, as applicable and relevant t the specific AHIMA credential(s) held by the individual. AHIMA Certified Prfessinals are emplyed in varius rles acrss multiple healthcare settings, and CCHIIM recgnizes a specific jb functin may require additinal cntinuing educatinal activities related t ICD-10-CM/PCS, abve and beynd the fllwing minimum requirements fr cntinuing educatin credit, t be reprted as cntinuing educatin credits (CEUs), per the CCHIIM recertificatin plicy. ICD-10-CM/PCS Specific CEU Requirements AHIMA Certified Prfessinals are required by CCHIIM t participate in a predetermined number f mandatry baseline educatinal experiences specific t ICD-10-CM/PCS. These ICD-10-CM/PCS specific CEUs will cunt as part f all AHIMA certificants ttal CEU requirements fr the purpse f recertificatin. Stated differently, the fllwing CEU requirements will be included as part f each certificants ttal, required CEUs, by credential, per CEU Cycle. The ttal number f ICD-10-CM/PCS cntinuing educatin units (CEUs) required, by AHIMA credential, is as fllws: CHPS 1 CEU CHDA 6 CEUs RHIT 6 CEUs RHIA 6 CEUs CDIP 12 CEUs CCS-P 12 CEUs CCS 18 CEUs CCA 18 CEUs *6 CEUs = 1 day f training (Please see the explanatin under FAQs) Certificants wh hld mre than ne AHIMA credential will nly reprt the highest number f CEUs frm amng all credentials held. Fr example, if a certificant has bth an RHIA and CCS, the certificant wuld nrmally reprt 40 (30 CEUs fr RHIA and an additinal 10 CEUs fr CCS) CEUs per recertificatin cycle, and 18 f these CEUs will be required t cver ICD-10-CM/PCS. CCHIIM recgnizes that AHIMA Certified Prfessinals have different levels f required cmpetency regarding ICD-10-CM/PCS. These levels may be as fllws: Awareness f ICD-10-CM/PCS which may include general structure f the systems, ptential impact t wrkflw prcesses in rder t prepare fr the systems; Use f ICD-10-CM/PCS which may include analysis, trending r prviding infrmatin that invlves cded data but nt actually apply the cdes in their daily jbs and requires mre indepth knwledge f the systems; and 2

3 Applicatin f ICD-10-CM/PCS which includes assigning cdes n a rutine bases fr varius purpses and requires a mre extensive knwledge f the systems. Therefre, all certificants are encuraged t tailr their educatin specific t their jb rle. Fr example, if yu are an RHIT and perfrm cding as a large percentage f yur daily rutine, yu are encuraged t fllw the requirements set frth fr thse specialized cding credentials. Fr further rle based infrmatin t tailr yur educatinal requirements Timeline fr Accumulating ICD-10-CM/PCS CEUs AHIMA Certified Prfessinals can begin earning ICD-10-CM/PCS specific CEUs during the perid f January 1, 2011 thru December 31, NOTE: All AHIMA Certified Prfessinals wh cmpleted AHIMA s Academy fr ICD-10 prir t January 1, 2011 will be allwed t use thse CEU hurs t fulfill the ICD -10-CM/PCS CE requirement. Frequently Asked Questins (FAQs) What resurce(s) did CCHIIM cnsider when develping the baseline number f required CEUs? ICD10 Final Rule The Department f Health and Human Services nted that estimates f the amunt f time needed fr cder training varied widely between 5-80 hurs. HHS stated that estimates fr cder training invlve five distinct areas f cnsideratin: the training methdlgy; the clinical specialty; the number f inpatient and utpatient cders; the number f hurs fr cder training and the cst per hur f training. HHS increased their estimate f the number f hurs that inpatient cders will need t learn bth ICD-10-CM and ICD-10-PCS frm 40 hurs t 50 hurs, based n industry feedback in respnse t the prpsed rule. Based n similar feedback frm the industry expressing cncern abut the cmplexity f ICD-10-CM due t its size and structural changes, and cder unfamiliarity, the Department f Health and Human Services als increased frm 8 t 10 hurs the time that utpatient cders will need fr ICD-10-CM training. Hwever, based n feedback frm a field testing prject spnsred by AHIMA and the American Hspital Assciatin, it is anticipated that ne t tw days f training will be necessary fr cders nly needing t learn ICD-10- CM and nt ICD-10-PCS. Since ICD- 10-CM has the same hierarchical structure, the same basic rganizatin, and many f the same cnventins as ICD-9-CM, experienced cding prfessinals will nt require the level f extensive training that wuld be necessary fr an entirely new cding system. They will primarily need educatin n the changes and in the classificatin itself as well as guidelines and definitins. It is anticipated that tw days f training will be necessary t learn the ICD-10-PCS system due t its cmplexity and dissimilarity with the ICD-9-CM prcedure cding system. *Hw was 6 hurs determined t be a day f training? 3

4 In the final rule HIPAA Administrative Simplificatin: Mdificatins t Medical Data Cde Set Standards t Adpt ICD-10-CM and ICD-10-PCS days f training were discussed. Six (6) CEU s is equal t a day f training. Hwever, please nte that the unit f measure utilized in categrizing and reprting AHIMA CEU requirements is hurs, nt days. Will these requirements apply t all AHIMA certificants? Yes, ALL CURRENT AHIMA CERTIFICANTS will be required t cmply with this mandatry CEU plicy. Why are there different requirements fr different AHIMA credentials? The credential-specific requirements primarily reflect the cmpetencies assciated with the credential. CCS/CCA certificants will be required t knw hw t apply ICD-10-CM/PCS cdes t demnstrate the cmpetence fr these credentials as utlined in the cntent utline fr these exams. CCS-P credentialed individuals will nt use r apply ICD-10-PCS cdes within their daily duties but are required t knw hw t apply ICD-10-CM cdes. RHIA/RHIT certificants will be required t knw hw t use ICD-10-CM/PCS t demnstrate the verall knwledge f thse psitins that they supervise r perfrm as utlined in the cntent utline f these exams. CHDA and CDIP certificants will be required t knw the differences between the ICD-9- CM and ICD-10-CM/PCS cde sets, fcus n the awareness f the transitin, familiarity with cding cnventins and guidelines, hw the data is cmparable r nt (legacy data), and an understanding f mapping and crsswalks between the classificatin systems. The CDIP exam requires additinal CEUs due t the higher level f ICD-10- CM/PCS cntent n the exam blueprint. CHPS certificants will need t have a generalized awareness f ICD-10 CM/PCS cding systems. What are the baseline ICD-10-CM/PCS CEU requirements if I hld multiple credentials? The requirement will be the credential with the highest number f CEUs. Fr example if a certificant hlds an RHIT and CCS the baseline requirement will be a ttal f 18 CEUs. If I attended an AHIMA Training Academy fr ICD-10 in 2009 r 2010 will thse CEUs meet the requirement? YES, CCHIIM will recgnize CEU s awarded t participants f all AHIMA Academies fr ICD-10. Will the baseline ICD-10-CM/PCS CEU requirements be additinal CEUs frm the established CEU requirements fr a credentialed prfessinal? N, CEU requirements will be included within the ttal number f CEUs required fr a given CEU Cycle. Fr example, if yu hld an RHIA credential, yu will btain 6 CEUs 4

5 that are in relatin t ICD-10-CM/PCS alng with the additinal 24 CEUs t cmplete yur recertificatin cycle. Hw will a credentialed prfessinal reprt the ICD-10-CM/PCS CEUs t AHIMA? Yu can reprt yur ICD-10 specific CEUs any time befre December 31, G nline at ahima.rg and lg int MyAHIMA, and select CEU Center. Next, chse Recrd/Reprt t submit yur CEUs. Make sure t select ICD-10 under the Dmain field. What are the specific types f recmmended training areas /educatinal activities that will qualify fr these required CEUs? Yu are encuraged t tailr yur CEs t the rle yu perfrm in yur daily wrk. Examples f CEs may include: Intrductin t ICD-10-basics Business Impact and Implementatin Cnsideratins Understanding General Equivalence Mappings (GEMs) ICD-10-CM Structure, Guidelines and Cnventins Clinical Dcumentatin Imprvement Strategies using ICD-10 CM Bimedical Science cursewrk such as Anatmy and Physilgy and pathphysilgy refresher curses Data analysis and trending with ICD-10-CM cded data ICD-10-CM and its effect n reimbursement methdlgies Are there stricter guidelines fr the ICD-10 CM CEs than there are fr my nrmal CE requirements fr my credential? N, yu are t be guided by the basic HIM dmains as described in the Recertificatin Guide which can be fund at Will there be any specific mandated activities? N, activities that best supprt the current jb duties shuld be chsen. *Please refer t the chart n the next page fr further infrmatin. 5

6 Example - Training Areas/Educatinal Activities Awareness Examples Usage Examples Applicatin Examples - Intrductin t ICD-10 basics - Business Impact Assessments (HIM Dmain: External Frces) - ICD-10 CM- Structure, Guidelines & Cnventins - Understand Hw I-10 will affect the Infrmatin Flw and Prcesses - Implementatin Cnsideratins & prcess fr ICD ICD-10 -CM by Chapter - Understanding f General Equivalance Mapping (GEMs) - Bimedical Sciences (e.g. anatmy, physilgy, medical terminlgy and pathphysilgy) (HIM Dmain: Clinical Fundatins) - Clinical Dcumentatin Imprvement Strategies - Reimbursement Methdlgies - ICD-10-PCS definitins (rt peratins and appraches) PLEASE NOTE: THE FOLLOWING TOPICS ARE GIVEN AS EXAMPLES ONLY AND ARE NOT INTENDED TO BE AN ALL-INCLUSIVE LIST. (Please refer t the Recertificatin Guide fr specifics n HIM Dmains and general CE requirements). Awareness f the impact f ICD-10-CM/PCS n cding and ther typical health infrmatin management functins and n the healthcare industry in general. This may include an verview f the classificatin system and ptential impact t wrkflw prcesses in rder t prepare fr the system changes. Usage- ICD-10-CM/PCS which may include analysis, trending r prviding infrmatin that invlves cded data but nt actually apply the cdes in their daily jbs and requires mre indepth knwledge f the systems Applicatin- f ICD-10-CM/PCS which includes assigning cdes n a rutine bases fr varius purpses and requires a mre extensive knwledge f the systems. * Certificants are encuraged t tailr their educatin specific t their jb rle. Fr example, if yu are an RHIA but d cding in yur daily rutine fr a large percentage f yur jb tasks, then yu are encuraged t fllw the requirements set frth fr thse specialized cding credentials. Fr further rle based infrmatin click here. **CCHIIM will recgnize CEU s awarded t participants f all AHIMA Academies fr ICD-10 CM/PCS.