ICD-10: Planning for a Successful Implementation Contents 1. - - PowerPoint PPT Presentation

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ICD-10: Planning for a Successful Implementation Contents 1. - - PowerPoint PPT Presentation

Jan 15, 2023 239 likes •434 views

ICD-10: Planning for a Successful Implementation Contents 1. Introduction to ICD-10 2. Implementation Calendar 3. Getting Ready 4. Preparation Checklist 5. Resources 1 What is ICD-10? 10 th revision of the International Classification of

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ICD-10: Planning for a Successful Implementation

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Contents

  • 1. Introduction to ICD-10
  • 2. Implementation Calendar
  • 3. Getting Ready
  • 4. Preparation Checklist
  • 5. Resources

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What is ICD-10?

 10th revision of the International

Classification of Diseases (ICD) method

  • f coding:
  • The patient’s state of health, and
  • Institutional procedures

 Allows for:

  • More information per code
  • Better support for care management and

quality

  • Improved ability to understand risk and

severity

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Transition Facts

 All HIPAA-covered entities must use

new code sets as of October 1, 2015

 CPT coding is not affected by the

transition

 ICD-10 CM/PCS consists of:

  • ICD-10-CM for diagnosis coding
  • ICD-10-PCS for inpatient procedural

coding

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Diagnosis Coding

 Captures more specific data from clinical

documentation: left side v. right side, initial v. subsequent encounter, routine v. delayed healing

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Structure Changes

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Side-by-Side

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Quarterly Calendar

 Quarter 1: Technical Preparedness

  • EHR system updates, Meaningful Use,

CRISP

 Quarter 2: Back Office Preparedness

  • Staff training, vendor contact, A/R cleanup,

coding review, financial planning

 Quarter 3: Full Practice Readiness

  • Implement new tools, review physician and

staff roles, testing

 Quarter 4: Implementation and

Revenue Cycle Management

  • Claims accuracy, payment processing,

monitoring KPIs

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Project Plan

 Develop a comprehensive plan to govern

the transition process

 All personnel must be aware of the

extent of this change

 Assign clear responsibility for each step  Develop a comprehensive, realistic

budget

 Involve all stakeholders (physicians,

vendors, payers, clearinghouses)

 Include a transition timeline and adhere

to it

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Sample Template from the AMA

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Transition Checklist

 Identify current systems/structure/processes that

use ICD-9 codes

 Contact all EHR/PM vendors about updates and

testing

 Develop implementation plans with billing

service and clearinghouse

 Talk to payers about transition and potential

contract changes

 Review changes to workflow  Assess training needs  Budget for time and costs; consider ways to

mitigate financial risk

 Conduct full end-to-end testing

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Impact Assessment

 Analyze how codes are used

throughout the practice

  • Billing/submitting claims, eligibility checks,

referrals

 Identify commonly used ICD-9 codes

and explore related ICD-10 codes

 Identify paper and electronic forms to

accommodate new structure

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Systems Update

 Contact Vendors

  • EHR/PM systems should be updated and

support may be available

  • Clearing house and/or billing service will

need to be reviewed

 Complete Systems Tests

  • Internal and external once all updates are

installed

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Minimizing Challenges

 Eliminate coding backlogs prior to Oct

1, 2015

 Prioritize medical records for coding  Provide refresher training

  • ICD-10 accuracy
  • Practice workflows and new efficiencies

 Pre-determine steps for addressing

errors and vendor issues

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Resources

 MedChi Network Services

  • info@medchiservices.org or 888-507-6024

 Centers for Medicare and Medicaid

Services

  • cms.gov/ICD10

 Maryland DHMH

  • dhmh.maryland.gov/icd10info

 American Medical Association

  • ama-assn.org/go/icd-10

 Specialty Societies  Payors  Vendors

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Questions?

Colleen George Practice Services Administrator MedChi Network Services

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888-507-6024 (phone) 888-507-6034 (fax) cgeorge@medchi.org

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References

 American Medical Association: The Current

State of ICD-10 & Preparing for It

  • http://www.ama-assn.org/ama/pub/physician-

resources/solutions-managing-your- practice/coding-billing-insurance/hipaahealth- insurance-portability-accountability- act/transaction-code-set-standards/icd10-code- set.page

 Centers for Medicare and Medicaid Services:

ICD-10

  • cms.gov/ICD10

 Department of Health and Mental Hygiene,

ICD-10 Transition

  • https://mmcp.dhmh.maryland.gov/SitePages/ICD
  • 10%20Conversion.aspx

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