Implementation of ICD-10 Joining the Rest of the World in Coding - PowerPoint PPT Presentation

1 / 70
About This Presentation
Title:

Implementation of ICD-10 Joining the Rest of the World in Coding

Description:

IMPLEMENTATION OF ICD-10 JOINING THE REST OF THE WORLD IN CODING Jill Young - CPC, CEDC, CIMC Young Medical Consulting, LLC East Lansing, Michigan – PowerPoint PPT presentation

Number of Views:191
Avg rating:3.0/5.0
Slides: 71
Provided by: ymc84
Category:

less

Transcript and Presenter's Notes

Title: Implementation of ICD-10 Joining the Rest of the World in Coding


1
Implementation of ICD-10Joining the Rest of the
World in Coding
  • Jill Young - CPC, CEDC, CIMC
  • Young Medical Consulting, LLC
  • East Lansing, Michigan

2
Disclaimer
  • This material is designed to offer basic
    information for coding and billing. The
    information presented here is based on the
    experience, training, and interpretation of the
    author. Although the information has been
    carefully researched and checked for accuracy and
    completeness, the instructor does not accept any
    responsibility or liability with regard to
    errors, omissions, misuse, or misinterpretation.
    This handout is intended as an educational a
    guide and should not be considered a
    legal/consulting opinion

3
ICD
  • International
  • Classification of
  • Diseases

4
Purpose of ICD
  • Transforming documentation into numeric or
    alphanumeric designations
  • Diseases
  • Injuries
  • Procedures
  • Designations are grouped into manageable
    categories

5
Purpose of ICD
  • A variety of healthcare reporting functions
  • Not just for reimbursement purposes
  • Intended as a tool to study outcomes and improve
    patient care
  • CDC uses data Need accuracy
  • National Hospital Discharge Survey
  • National Ambulatory Medical Care Survey
  • External Causes of Injury statistics
    (international)

6
ICD in Statistical Reporting
  • The CDC uses clinical information for many of
    their studies
  • Leading cause of deaths for males is heart
    disease 28.7 (2001)
  • In 2003 health care expenditures for heart
    disease and stroke was projected to be 209
    billion
  • Information for consumers and physicians
  • Most prevalent diseases
  • Average length of stay
  • Widely used treatments

7
ICD-9 is obsolete
  • Developed in early 1970s and has been in use
    since 1979
  • Many of the clinical and procedure concepts no
    longer meet todays healthcare needs
  • The U.S. is the only developed country that has
    yet to adopt ICD-10 for morbidity/mortality
    classification
  • No longer supported by the WHO and therefore
    cannot be significantly modified

8
More bad news for ICD-9
  • The system does not comply with
  • HIPAA code set standardization
  • BIPA (Benefits Improvement and Protection Act of
    2000) that outlines new services and technology
    that must be acknowledged in CMS payment systems

9
Details of Implementation
  • October 1, 2013 October 1, 2014
  • Exacting date for physician and ambulatory
    services
  • Date of discharge for inpatient setting
  • ICD-9-CM codes not accepted for new claims for
    dates of service on or after October 1, 2013
    October 1, 2014
  • Except discharge as above
  • ICD-9-CM will still exist to allow claims
    completion
  • Unknown how long ICD-9 allowed

10
Comparison
  • ICD-9-CM
  • 3-5 digits
  • Digits 2-5 are numeric
  • Alpha V and E codes
  • Lacks laterality
  • ICD-10-CM
  • 3-7 digits
  • Digit 1 is Alpha
  • Digit 2 and 3 are numeric
  • Digit 5-7 are alpha or numeric

11
The Need for ICD-10
  • Billing and reimbursement specificity more
    manageable
  • No room for new codes
  • Shortage of rubrics
  • Diagnostic and statistical Manual of Mental
    Disorders
  • DSM IV
  • Chapter 2 (Neoplasms) and morphology codes
    correspond to ICD-O-2
  • Cancer registry programs have used since 1995
  • Misclassifications

12
Misclassifications - Urosepsis
  • Dorlands - a term used imprecisely to denote
    infection ranging from urinary tract infection to
    generalized sepsis which may result from such
    infection
  • Providers UTI with sepsis
  • ICD-9 code- without clarification codes to UTI
  • ICD-10 code to condition

13
ICD-10-CM Guidelines 2013
  • Adherence to these guidelines when assigning
    ICD-10-CM diagnosis codes is required under the
    Health Insurance Portability and Accountability
    Act (HIPAA).
  • The diagnosis codes (Tabular List and Alphabetic
    Index) have been adopted under HIPAA for all
    healthcare settings.

14
ICD-10-CM Guidelines 2013
  • A joint effort between the healthcare provider
    and the coder is essential to achieve complete
    and accurate documentation, code assignment, and
    reporting of diagnoses and procedures.
  • These guidelines have been developed to assist
    both the healthcare provider and the coder in
    identifying those diagnoses that are to be
    reported.

15
1995 1997 EM Guidelines
  • If not documented, the rationale for ordering
    diagnostic and other ancillary services should be
    easily inferred.
  • Appropriate health risk factors should be
    identified.
  • The patient's progress, response to and changes
    in treatment, and revision of diagnosis should be
    documented.
  • The CPT and ICD-9-CM codes reported on the health
    insurance claim form or billing statement should
    be supported by the documentation in the medical
    record.

16
1995 EM
  • For a presenting problem with an established
    diagnosis the record should reflect whether the
    problem is
  • a) improved, well controlled, resolving or
    resolved or,
  • b) inadequately controlled, worsening, or failing
    to change as expected.
  • Comorbidities/underlying diseases or other
    factors that increase the complexity of medical
    decision making by increasing the risk of
    complications, morbidity, and/or mortality should
    be documented.

17
ICD-10-CM Guidelines 2013
  • The importance of consistent, complete
    documentation in the medical record cannot be
    overemphasized. Without such documentation
    accurate coding cannot be achieved.

18
Poor Preparation Consequences
  • Increased delays in processing authorizations and
    reimbursement claims
  • Improper claims payment
  • Coding backlogs
  • Compliance issues
  • Decisions based on inaccurate data
  • Problems can be mitigated with proper advance
    preparation

19
Other Concerns
  • Claims processing
  • Will there be a significant increase in
    rejections, pended or appealed claims
  • Laboratory other testing
  • What specificity is needed on order
  • General symptoms vs specific symptoms
  • Patient concerns
  • Change in covered benefits due to policy changes
  • Perceived change in coverage
  • Is cause the coding systems specificity?

20
The Rand Report
  • Implementation costs include
  • Training
  • Lost productivity during this period
  • System upgrades and changes
  • Future benefits include
  • More accurate payment for new procedures
  • Fewer miscoded, rejected, and improperly
    reimbursed claims
  • Better understanding of the value of new
    procedures and outcomes
  • Improved disease management

21
(No Transcript)
22
AHIMA STUDY COMMENTS
  • Physicians need 5 hours of training to become
    proficient in ICD-10
  • AGREE ? DISAGREE

23
ICD-10-CM Myths or Misnomers
  • Physicians will need to learn new system of
    documentation which may change the way they
    practice
  • Coding and billing staff need to start code set
    training
  • in 2014
  • Now
  • ICD-10 only works with an Electronic Medical
    Record system
  • Practices will need additional staff to handle
    the workload during and after the transition

24
ICD-10 Breaking it Down
  • Disease classifications expanded
  • Health-related conditions
  • Greater specificity to 6 digits with 7th digit
    extension
  • 21 chapters
  • Additional special group chapters
  • 2 new chapters not in ICD-9
  • Diseases of the eye and adnexa
  • Disorders of the ear

25
ICD-10 Breaking it down
  • Alphabetical Index
  • Organized in the same manner as ICD-9
  • Codes listed by main term
  • Cross-references and notes appear
  • Define terms
  • Provide direction
  • Provide coding instructions
  • 3 sections
  • Section I- Index to diseases and nature of injury
  • Section II- External causes
  • Section III- Table of drugs and chemicals

26
ICD-10 Breaking it Down
  • Chapters are further divided into subchapters or
    blocks
  • Contain rubrics identifying closely related
    conditions
  • Each chapter contains a summary subchapter that
    gives an overview of each block

27
New Concepts
  • Excludes1
  • Not coded here
  • Excludes2
  • Not included here

28
Fourth Digit Classification
  • The 4th digit defines site, etiology,
    manifestation, or state of the disease or
    condition
  • Right, left, bilateral
  • Viral vs. bacterial
  • Controlled vs. uncontrolled
  • Primary vs. secondary
  • Malignant vs. benign
  • Congenital vs. acquired

29
Fifth Sixth Digit Classifications
  • Adverse effect, Poisoning or Reaction to improper
    use of medication, Toxic effect
  • Accidental
  • Intentional self harm
  • Assault
  • Undetermined

30
Example
  • A 32 y.o. hiker was bit by a venomous spider
    while hiking through the woods. He began
    experiencing muscle weakness and syncope and was
    rushed to the ED by a fellow hiker, where he was
    diagnosed with spider venom toxicity.

31
Example
  • T63.39 Toxic effect of venom of other spider
  • T63.391 Toxic effect of venom of other spider,
    accidental (unintentional)
  • T63.392 Toxic effect of venom of other spider,
    intentional self-harm
  • T63.393 Toxic effect of venom of other spider,
    assault
  • T63.394 Toxic effect of venom of other spider,
    undetermined

32
New Concepts
  • Placeholder character
  • X
  • Used as 5th and 6th character to allow for future
    expansion
  • Seventh character alpha
  • Burns
  • Initial vs subsequent vs sequela
  • Fractures
  • Initial vs subsequent
  • Healing vs malunion or non union

33
A Seventh character?
  • A seventh character indicates
  • A- the initial encounter
  • First encounter for treatment of the injury
  • D- subsequent encounter
  • May be used for as long as the patient is
    receiving treatment for an injury
  • S- sequelae
  • Complication or condition arising as a result of
    the injury

34
7th Character Example
  • A 25 y.o. male presented to the emergency room
    after accidentally slashing his right arm with a
    sharp knife while cleaning a fish he caught
    during a Key West deep sea fishing trip. The Dx
    reported by the ED is laceration of the ulnar
    artery at the forearm, right arm
  • How to code the dx?

35
Laceration of Ulnar Artery at Forearm Level
  • Laceration - see also Wound open by site
  • No other specific listing
  • Wound
  • Artery see injury, blood vessel, by site
  • Ulnar (artery) (vein) 903.3
  • 903. Injury to blood vessels of upper extremity
  • 903.3 Ulnar blood vessels

36
7th Character Example
  • S55 Injury of blood vessels at forearm level
  • Code also any associated open wound (S51.-)
  • Excludes2 injury of blood vessels at wrist
    and hand level (S65.-)
  • injury of brachial vessels
    (S45.1-S45.2)
  • The appropriate 7th character is to be added to
    each code from category S55
  • A - initial encounter
  • D - subsequent encounter
  • S - sequela injury of ulnar artery at forearm
    level, unspecified arm

37
Example
  • S55.0 Injury of ulnar artery at forearm level
  • S55.00 Unspecified injury of ulnar artery at
    forearm level
  • S55.001 Unspecified injury of ulnar artery at
    forearm level, right arm
  • S55.002 Unspecified injury of ulnar artery at
    forearm level, left arm
  • S55.009 Unspecified injury of ulnar artery at
    forearm level, unspecified arm
  • S55.01 Laceration of ulnar artery at forearm
    level
  • S55.011 Laceration of ulnar artery at forearm
    level, right arm
  • S55.012 Laceration of ulnar artery at forearm
    level, left arm
  • S55.019 Laceration of ulnar artery at forearm
    level, unspecified arm
  • S55.09 Other specified injury of ulnar artery at
    forearm level
  • S55.091 Other specified injury of ulnar artery at
    forearm level, right arm
  • S55.092 Other specified injury of ulnar artery at
    forearm level, left arm
  • S55.099 Other specified injury of ulnar artery at
    forearm level, unspecified arm

38
ICD-10-CM Table of Neoplasms
  • Codes listed with a dash - following the code
    have a required 5th character for laterality or
    other location specificity.
  • The tabular list must be reviewed for the
    complete code.

39
Notes In Chapter Listing
  • The chapter uses the S-section for coding
    different types of injuries related to single
    body regions
  • T-section to covers injuries to multiple or
    unspecified body regions as well as poisoning and
    certain other consequences of external causes

40
Insect Bite ICD-9
  • Insect Bite
  • Non-venomous
  • See injury, superficial, by site
  • 919.4 Insect bite non-venomous, without mention
    of infection
  • 919.5 Insect bite, non-venonomous, infected

41
Insect Bite ICD-10
  • S00.06A Insect bite of scalp Initial
    encounterS00.06D Insect bite of scalp
    Subsequent encounterS00.269A Insect bite of
    unspecified eyelid and periocular area Initial
    encounterS00.269D Insect bite of unspecified
    eyelid and periocular area Subsequent
    encounterS00.36A Insect bite of nose Initial
    encounterS00.36D Insect bite of nose Subsequent
    encounterS00.469A Insect bite of unspecified
    ear Initial encounterS00.469D Insect bite of
    unspecified ear Subsequent encounterS00.561A
    Insect bite of lip Initial encounterS00.561D
    Insect bite of lip Subsequent encounterS00.562A
    Insect bite of oral cavity Initial
    encounterS00.562D Insect bite of oral cavity
    Subsequent encounterS10.16A Insect bite of
    throat Initial encounterS10.16D Insect bite of
    throat Subsequent encounter

42
Insect Bite ICD-10
  • S10.86A Insect bite of other part of neck
    Initial encounterS10.86S Insect bite of other
    part of necks subsequent encounterS10.96A
    Insect bite of unspecified part of neck Initial
    encounterS10.96D Insect bite of unspecified part
    of neck Subsequent encounterS20.161A Insect
    bite of breast, right breast Initial
    encounterS20.161D Insect bite of breast, right
    breast Subsequent encounterS20.162A Insect bite
    of breast, left breast Initial
    encounterS20.162D Insect bite of breast, left
    breast Subsequent encounterS20.169A Insect bite
    of breast, unspecified breast Initial
    encounterS20.169D Insect bite of breast,
    unspecified breast Subsequent encounterS20.361A
    Insect bite of right front wall of thorax
    Initial encounterS20.361D Insect bite of right
    front wall of thorax Subsequent
    encounterS20.361S Insect bite of right front
    wall of thorax Subsequent encounterS20.362A
    Insect bite of left front wall of thorax Initial
    encounterS20.362D Insect bite of left front wall
    of thorax Subsequent encounterS20.369A Insect
    bite of unspecified front wall of thorax Initial
    encounterS20.369D Insect bite of unspecified
    front wall of thorax Subsequent encounter

43
Insect Bite ICD-10
  • S20.461A Insect bite of right back wall of
    thorax Initial encounterS20.461D Insect bite of
    right back wall of thorax Subsequent
    encounterS20.462A Insect bite of left back wall
    of thorax Initial encounterS20.462D Insect bite
    of left back wall of thorax Subsequent
    encounterS20.469A Insect bite of unspecified
    back wall of thorax Initial encounterS20.469D
    Insect bite of unspecified back wall of thorax
    Subsequent encounterS20.96A Insect bite of
    unspecified parts of thorax Initial
    encounterS20.96D Insect bite of unspecified
    parts of thorax Subsequent encounterS30.860A
    Insect bite of lower back and pelvis Initial
    encounterS30.860D Insect bite of lower back and
    pelvis Subsequent encounterS30.861A Insect bite
    of abdominal wall Initial encounterS30.861D
    Insect bite of abdominal wall Subsequent
    encounterS30.862A Insect bite of penis Initial
    encounterS30.862D Insect bite of penis
    Subsequent encounterS30.863A Insect bite of
    scrotum and testes Initial encounterS30.863D
    Insect bite of scrotum and testes Subsequent
    encounterS30.864A Insect bite of vagina and
    vulva Initial encounterS30.864D Insect bite of
    vagina and vulva Subsequent encounterS30.865A
    Insect bite of unspecified external genital
    organs, male Initial encounterS30.865D Insect
    bite of unspecified external genital organs,
    male Subsequent encounterS30.866A Insect bite
    of unspecified external genital organs, female
    Initial encounterS30.866D Insect bite of
    unspecified external genital organs, female
    Subsequent encounter

44
Insect Bite ICD-10
  • S30.867A Insect bite of anus Initial
    encounterS30.867D Insect bite of anus
    Subsequent encounterS40.269A Insect bite of
    unspecified shoulder Initial encounterS40.269D
    Insect bite of unspecified shoulder Subsequent
    encounterS40.869A Insect bite of unspecified
    upper arm Initial encounterS40.869D Insect bite
    of unspecified upper arm Subsequent
    encounterS50.369A Insect bite of unspecified
    elbow Initial encounterS50.369D Insect bite of
    unspecified elbow Subsequent encounterS50.869A
    Insect bite of unspecified forearm Initial
    encounterS50.869D Insect bite of unspecified
    forearm Subsequent encounterS60.369A Insect
    bite of unspecified thumb Initial
    encounterS60.369D Insect bite of unspecified
    thumb Subsequent encounterS60.468A Insect bite
    of other finger Initial encounterS60.468D
    Insect bite of other finger Subsequent
    encounterS60.469A Insect bite of unspecified
    finger Initial encounterS60.469D Insect bite of
    unspecified finger Subsequent encounterS60.569A
    Insect bite of unspecified hand Initial
    encounterS60.569D Insect bite of unspecified
    hand Subsequent encounter

45
Insect Bite ICD-10
  • S60.869A Insect bite of unspecified wrist
    Initial encounterS60.869D Insect bite of
    unspecified wrist Subsequent encounterS70.269A
    Insect bite, unspecified hip Initial
    encounterS70.269D Insect bite, unspecified hip
    Subsequent encounterS70.369A Insect bite,
    unspecified thigh Initial encounterS70.369D
    Insect bite, unspecified thigh Subsequent
    encounterS80.269A Insect bite, unspecified knee
    Initial encounterS80.269D Insect bite,
    unspecified knee Subsequent encounterS90.463A
    Insect bite, unspecified great toe Initial
    encounterS90.463D Insect bite, unspecified great
    toe Subsequent encounterS90.466A Insect bite,
    unspecified lesser toe(s) Initial
    encounterS90.466D Insect bite, unspecified
    lesser toe(s) Subsequent encounterS90.569A
    Insect bite, unspecified ankle Initial
    encounterS90.569D Insect bite, unspecified
    ankle Subsequent encounterS90.869A Insect bite,
    unspecified foot Initial encounterS90.869D
    Insect bite, unspecified foot Subsequent
    encounter

46
Insect Bite ICD-10
47
Diabetes
  • E08 Diabetes due to underlying condition
  • E09 Drug or chemical induced diabetes mellitus
  • E10 Insulin dependent diabetes mellitus
  • E11 Non-insulin dependent diabetes mellitus
  • E12 Malnutrition related diabetes
  • E13 Other specified diabetes mellitus

48
Diabetes Guidelines
  • The diabetes mellitus codes are combination codes
    that include the type of diabetes mellitus, the
    body system affected, and the complications
    affecting that body system.
  • As many codes within a particular category as
    are necessary to describe all of the
    complications of the disease may be used.
  • They should be sequenced based on the reason for
    a particular encounter.

49
Diabetes Guidelines
  • If the documentation in a medical record does not
    indicate the type of diabetes but does indicate
    that the patient uses insulin, code E11, Type 2
    diabetes mellitus, should be assigned.
  • Code Z79.4, Long-term (current) use of insulin,
    should also be assigned to indicate that the
    patient uses insulin.
  • Code Z79.4 should not be assigned if insulin is
    given temporarily to bring a type 2 patients
    blood sugar under control during an encounter.

50
Diabetes Specificity
  • .0 With coma
  • .1 With ketoacidosis
  • .2 With renal complications
  • .3 With ophthalmic complications
  • .4 With neurological complications
  • .5 With peripheral circulatory complications
  • .6 With other specified complications
  • .7 With multiple complications
  • .8 With unspecified complications
  • .9 Without complications

51
Example
  • A 30 year old Type I patient has presented with a
    right foot ulcer due to diabetic atherosclerosis
  • 250.81-Diabetes with other specified
    manifestations, Type I, not stated as
    uncontrolled
  • use additional code to identify manifestation
  • 440.23-Artherosclerosis of the extremities with
    ulceration
  • 707.14-Ulcer, except decubitus, of the heel and
    mid-foot

52
Type I diabetic with right foot ulcer due to
diabetic atherosclerosis
  • E10.621 Type I diabetes mellitus with foot ulcer
  • Use additional code to identify site of ulcer
  • I70.234 Arteriosclerosis of native arteries of
    right leg with ulceration of heel and mid foot
    (other locations)
  • Use additional code to identify severity of ulcer
  • Use additional code to identify
  • Exposure to smoke ?Tobacco dependence
  • Tobacco use ? History of tobacco use
  • Occupational exposure to environmental tobacco
    smoke

53
Example
  • A 30 year old Type I diabetic patient who also
    has
  • atherosclerosis of the right leg extremity,
    presents
  • with a foot ulcer (causal relationship not
    stated)
  • 707.14 - Ulcer heel and mid-foot
  • Diabetes
  • Atherosclerosis
  • 250.01 Diabetes without mention of
    complication Type I, juvenile type, not stated
    as uncontrolled
  • 440.20 Atherosclerosis of extremities,
    unspecified
  • ALTERNATIVE CODES
  • 440.23 Atherosclerosis of extremities with
    ulceration
  • Use additional code for any associated ulceration
  • 250.81-Diabetes with other specified
    manifestations, Type I, not stated as
    uncontrolled use additional code to identify
    manifestation

54
Complications of Care - Guidelines
  • Not all conditions that occur during or following
    medical care or surgery are classified as
    complications.
  • There must be a cause-and-effect relationship
    between the care provided and the condition, and
    an indication in the documentation that it is a
    complication.
  • Query the provider for clarification, if the
    complication is not clearly documented.
  • Guideline extends to any complications of care,
    regardless of the chapter the code is located in

55
Cause Effect Relationship
  • Sepsis
  • Based on providers documentation of the
    relationship between the infection and the
    procedure.

56
Cause Effect Relationship
  • Presume relationship
  • Chronic kidney disease with hypertension
  • as hypertensive chronic kidney disease.
  • Atherosclerosis and angina pectoris
  • Unless the documentation indicates the angina is
    due to something else

57
Acute Exacerbation of Chronic Obstructive
Bronchitis Asthma
  • ICD-10
  • ICD-9
  • The codes in categories J44 and J45 distinguish
    between uncomplicated cases and those in acute
    exacerbation.
  • An acute exacerbation is a worsening or a
    decompensation of a chronic condition. An acute
    exacerbation is not equivalent to an infection
    superimposed on a chronic condition, though an
    exacerbation may be triggered by an infection.
  • The codes for chronic obstructive bronchitis and
    asthma distinguish between uncomplicated cases
    and those in acute exacerbation.
  • An acute exacerbation is a worsening or a
    decompensation of a chronic condition. An acute
    exacerbation is not equivalent to an infection
    superimposed on a chronic condition, though an
    exacerbation may be triggered by an infection.

58
(No Transcript)
59
Asthma
  • v 5th - J45.2 Mild Intermittent asthma
  • J45.20 Mild intermittent asthma,
    uncomplicated
  • Mild intermittent asthma NOS
  • J45.21 Mild intermittent asthma with
    (acute) exacerbation
  • J45.22 Mild Intermittent asthma with
    status asthmaticus
  • v 5th - J45.3 Mild persistent asthma
  • J45.30 Mild persistent asthma,
    uncomplicated
  • Mild persistent asthma NOS
  • J45.31 Mild persistent asthma with
    (acute) exacerbation
  • J45.32 Mild persistent asthma with
    status asthmaticus

60
Asthma
  • v 5th - J45.4 Moderate persistent asthma
  • J45.40 Moderate persistent asthma,
    uncomplicated
  • Moderate persistent asthma NOS
  • J45.41 Moderate persistent asthma with
    (acute) exacerbation
  • J45.42 Moderate persistent asthma with
    status asthmaticus
  • v 5th - J45.5 Severe persistent asthma
  • J45.50 Severe persistent asthma,
    uncomplicated
  • Severe persistent asthma NOS
  • J45.51 Severe persistent asthma with
    (acute) exacerbation
  • J45.52 Severe persistent asthma with
    status asthmaticus
  • J45.9 Other and unspecified asthma

61
Crohns Disease
  • ICD-9
  • 559.x Regional enteritis
  • Large, small, combined, unspecified intestine
  • ICD-10
  • Rubric contains 28 separate codes
  • Site
  • Complications of fistula
  • Obstruction
  • Bleeding
  • Abscess
  • Other
  • None

62
(No Transcript)
63
Converting from ICD-9 to 10
  • A MUST DO
  • Getting everyone on board
  • Physicians, nurses, billing/coding and
    administration
  • Education and training is key

64
AHIMA Preparation
  • Create implementation committee
  • Budget planning
  • Timeline for Implementation
  • Identify training needs
  • Information Management System upgrades and review

65
Challenges per AHIMA
  • Coders Billers
  • Learn new system
  • Forget old system
  • Must understand Coding Guidelines
  • Getting adequate information
  • Physicians
  • Need to understand coding world
  • Need to understand specificity needed
  • Need to write legibly
  • Need to give better documentation

66
What is your offices GAP?
  • Conduct gap analysis of coding professionals
    knowledge and skills
  • Assess coding professionals knowledge in
    sciences (anatomy and physiology,
    pathophysiology), medical terminology, and
    pharmacology
  • Refresh coding staff knowledge as needed on basis
    of assessment results

67
Assess Quality of Medical Record Documentation
  • Evaluate samples of various types of medical
    records to determine whether documentation
    supports level of detail found in ICD-10-CM/PCS
  • Sampling techniques could include random samples,
    most frequent diagnoses or procedures, or
    diagnostic or procedural categories known to
    represent documentation problems with ICD-9-CM
  • Implement documentation improvement strategies
    where needed

68
Determine a Training Plan
  • Who will need education?
  • What type and level of education will they need?
  • How will the education be delivered?
  • When will training be needed?

69
Determine Business Associate Readiness
  • When will upgrades or replacement systems be
    available for testing and implementation?
  • What customer support and training will they
    provide?
  • How will their products/services accommodate both
    ICD-9 and ICD-10?
  • How long will their products accommodate both
    code sets?

70
QUESTIONS???
Thank you !
Jill_at_youngmedconsult.com
Write a Comment
User Comments (0)
About PowerShow.com