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
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
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 http://ahima.rg/icd10/rle.aspx. 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, 2015. 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
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
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, 2015. 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 http://ahima.rg/certificatin/recertificatin.aspx 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
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- 10 - 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.