CPMA - PowerPoint PPT Presentation

1 / 75
About This Presentation
Title:

CPMA

Description:

... of each process Provides a clear picture of how things work today and can outline how things should work ... Implemented EMR at same time as ... – PowerPoint PPT presentation

Number of Views:303
Avg rating:3.0/5.0
Slides: 76
Provided by: Hur103
Category:
Tags: cpma | outline | process

less

Transcript and Presenter's Notes

Title: CPMA


1
CPMA April 11, 2015 Phill Ward, DPM President,
APMA

2
Whats new for 2015
  • CPT 20600
  • (Descriptor change)
  • Arthrocentesis, aspiration and/or injection,
    small joint or bursa (e.g., fingers, toes)
    without ultrasound guidance

3
Whats new for 2015
  • CPT 20604
  • (New Code)
  • Arthrocentesis, aspiration and/or injection,
    small joint or bursa (e.g., fingers, toes) with
    ultrasound guidance with permanent recording and
    reporting

4
Whats new for 2015
  • CPT 20605
  • (Descriptor change)
  • Arthrocentesis, aspiration and/or injection,
    intermediate joint or bursa (e.g., ankle, wrist,
    elbow) without ultrasound guidance

5
Whats new for 2015
  • CPT 20606
  • (New Code)
  • Arthrocentesis, aspiration and/or injection,
    intermediate joint or bursa (e.g., ankle, wrist,
    elbow) with ultrasound guidance with permanent
    recording and reporting

6
Whats new for 2015
  • CPT 97605
  • (descriptor change)
  • Negative pressure wound therapy (e.g. vacuum
    assisted drainage collection) utilizing durable
    medical equipment (DME), including topical
    application(s), wound assessment, and
    instruction(s) for ongoing care, per session
    total wound(s) surface area less than or equal to
    50 square centimeters
  • Example KCI wound vac

7
Whats new for 2015
  • CPT 97606
  • (New code)
  • Negative pressure wound therapy (e.g. vacuum
    assisted drainage collection) utilizing durable
    medical equipment (DME), including topical
    application(s), wound assessment, and
    instruction(s) for ongoing care, per session
    total wound(s) surface area greater than or equal
    to 50 square centimeters
  • Example KCI wound vac

8
Whats new for 2015
  • CPT 97607
  • (New code)
  • Negative pressure wound therapy (e.g. vacuum
    assisted drainage collection) utilizing
    non-durable medical equipment including
    provision of exudate management collection
    system, topical application(s), wound assessment,
    and instruction(s) for ongoing care, per session
    total wound(s) surface area less than or equal to
    50 square centimeters
  • Example Snap

9
Whats new for 2015
  • CPT 97608
  • (New code)
  • Negative pressure wound therapy (e.g. vacuum
    assisted drainage collection) utilizing
    non-durable medical equipment including
    provision of exudate management collection
    system, topical application(s), wound assessment,
    and instruction(s) for ongoing care, per session
    total wound(s) surface area greater to 50 square
    centimeters
  • Example Snap

10
Whats new for 2015
  • -59 modifier change (only for CMS so far)
  • -XE (separate encounter)
  • -XS (separate structure)
  • -XP (separate practitioner)
  • -XU (unusual overlapping service)
  • CMS has been less than clear in their notices
    about how/when to use these modifiers
  • MLN article dated Feb 2015 still doesnt clarify
    the usage of these modifiers

11
Whats new for 2015
  • Examples
  • -XE
  • Patient was seen in the morning and returned in
    the afternoon for another service
  • -XS
  • Services were provided on nails and lesions or
    bunion and hammertoe

12
Whats new for 2015
  • Examples
  • -XP
  • Bone graft harvested by 1 surgeon and used by
    another surgeon on the same patient in the same
    encounter
  • -XU
  • 2 lesions present in the same code set and are
    excised separately

13
Ongoing Controversy
  • Nerve injections
  • Other peripheral nerve 64450
  • Neuroma Steroid 64455
  • Neuroma Sclerosing 64632
  • Other sclerosing 64640
  • Other misc nerve 64999

14
What About Globals?
  • 10 day global
  • 2017
  • 90 day global
  • 2019
  • CPT Assistant March 2015 revision of global
    package definition/interpretation

15
Meaningful ? Use
  • 50 of eligible providers did not attest for
    Stage I
  • 4 eligible providers successfully attested for
    Stage II in 2014
  • Congressional (in)action
  • Flex It Bill Rep Elmers
  • Jan 30, 2015 CMS comments

16
Sustainable Growth Rate andMedicare Fee Schedule
Reform
  • House passed SGR reform 3/25
  • Senate refused to act before Easter vacation
  • /-21 decrease on April 1, 2015
  • Senate is supposed to act soon
  • Multiple payment models proposals to replace Fee
    For Service model
  • No decisions made yet, likely a testing period
    before implementation

17
(No Transcript)
18
  • If you dont want to use ICD-10
  • then dont
  • ?
  • have a nice day

19
Postponement?
  • It is possible that Congress will once again
    postpone ICD-10 implementation
  • Are you willing to bet your practice on it?

20
The Train has left station!!
  • So what has APMA done to prepare you for ICD-10?

21
APMA News Articles
  • link http//www.apma.org/YourPractice/content.
    cfm?ItemNumber1413
  • There have been more than 20 ICD-10 articles in
    the APMA News
  • All are available for download on the APMA
    website

22
Webinar Series
  • There has been a series of ICD-10 webinars
    presented and recorded and archived on the APMA
    website

23
Coding Resource Center
  • The CRC has been updated with a crossover
    capability to translate ICD-9 codes to ICD-10
    codes

24
ICD-10 Potential negative impacts
  • Decreased productivity
  • Interrupted cash flow
  • Increased amount of rejections
  • Incompatible systems
  • Increased volumes of work
  • Incorrect mapping
  • Increased risk of payer audits
  • Having to run 2 diagnosis coding systems at the
    same time

25
ICD-10 Potential positive impacts
  • Better specificity
  • Better data collection

26
ICD-10 Rules
  • SYMBOLS and CONVENTIONS To get started with any
    new system, one must first understand the rules.
    This webinar will now address the symbols and
    conventions next.
  • Never code from the Alphabetic Index because
    important instructional notes will surely be
    missed.
  • 1) In the text a ? colored dot cautions you to
    make sure you use additional digit(s) to ensure
    greatest specificity.
  • 2) Unspecified The Square before a code
    indicates there are more specific codes without
    the symbol. It is still a valid first line code
    but if possible look for the code with highest
    specificity.
  • 3) OGCR This symbol indicates there is
    Official Guidelines for Coding and Reporting.
    The passage is usually placed near the codes in a
    colored box.

27
ICD-10 Rules
  • SYMBOLS and CONVENTIONS Continued
  • 4) CC Indicates complications and
    comorbidities. MCC indicates Major
    Complications and comorbidities. Published in the
    Federal register these two codes address
    Inpatient Prospective Payment System (IPPS).
  • 5) Z codes that have a number 1 inside a circle
    before them means the code must be listed first.
  • 6) The ½ symbol inside a circle before a Z code
    indicates this code may be the first or second
    listed code.
  • 7) The number 2 inside a circle before Z codes
    means it is listed as a secondary code.

28
ICD-10 Rules
  • SYMBOLS and CONVENTIONS Continued
  • 8) The Excludes 1 is when two conditions can
    not occur together.
  • 9) The Excludes 2 means not included here. This
    is the case where it is acceptable to use both
    the code and the excluded code together.
  • 10) The Code first/Use additional code means when
    there are multiple body system manifestations you
    code the underlying condition first and the
    manifestation second.

29
ICD-10 Rules
  • SYMBOLS and CONVENTIONS Continued
  • 11) In diseases classified elsewhere these
    codes are never permitted to be used as first
    line codes. These codes must be listed after the
    underlying condition.
  • 12) Code also means two codes may be required
    but the sequencing of the codes is discretionary.
  • 13) 7th characters means the applicable 7th
    character must always be used and placeholder x
    used as a 5th character and/or 6th character
    codes to allow for future expansion.
  • 14) and This word is interpreted as either
    and or or.

30
ICD-10 Rules
  • SYMBOLS and CONVENTIONS Continued
  • 15) Includes in a colored box further defines
    or gives examples of the content. This notation
    appears immediately under a code title.
  • 16) Abbreviations NECNot Elsewhere
    Classifiable this is another specified code,
    used when a more specific code is not available.
    NOS Not otherwise specified, this indicates
    an unspecified code.
  • 17) Each ICD-10-CM diagnosis codes are to be
    reported ONCE for an encounter. When bilateral
    conditions exist, this one listed code counts
    when no distinct code for laterality or two
    different conditions are classified.

31
ICD-10 Rules
  • SYMBOLS and CONVENTIONS Continued
  • 18) Documentation for BMI should only report as
    secondary diagnosis codes.
  • 19) The instruction see acts as a cross
    reference and directs the user to look elsewhere.
    This instruction is often found when the term or
    condition may not be the appropriate term. This
    is a mandatory instruction and must be followed
    for proper code selection.
  • 20) See also is a reference instruction note to
    refer to a specific category, subcategory, or
    classification before making a code selection if
    you cannot find the diagnosis listed under a term
    in Volume 2.

32
ICD-10 Rules
  • SYMBOLS and CONVENTIONS Continued
  • 21) Laterality. An unspecified side code is also
    provided should the side not be identified in the
    medical record. The unspecified side is either
    ends with a character 0 or 9 depending on whether
    it is a fifth or sixth character.
  • 22) Dummy Place holders using the character
    x. The x is used as fifth or sixth character
    placeholder to allow for future expansion. Some
    codes in ICD-10-CM require either 6th or 7th
    characters in the code. If the code, for example,
    had 5 characters and a seventh character was
    required based on the instructional notes, dummy
    placeholder would be used in sixth character
    position to allow for the seventh character to be
    reported

33
ICD-10 Rules
  • SYMBOLS and CONVENTIONS Continued
  • 23) Brackets are used in the index and to
    identify manifestation codes.
  • 24) ( ) Parentheses are used in both the Index
    and Tabular List to enclose supplemental words
    that do NOT affect the code number. The terms
    within the parentheses are referred to as
    nonessential modifiers.
  • 25) Colon is used after an incomplete term that
    needs one or more of the modifiers that allow it
    assignable to a given category.

34
ICD-10 Rules
  • SYMBOLS and CONVENTIONS Continued
  • 26) Dash at the end of a code indicates
    additional digits are required to complete the
    diagnostic term.
  • 27) , Comma words following a comma are
    essential modifiers. The term in the inclusion
    note must be present in the diagnostic statement
    to qualify the code.

35
ICD-10 Structure
  • Same as ICD-9
  • Chapters
  • 22 Chapters identifying categories
  • Blocks
  • Subchapters
  • Etiology, anatomical site, severity
  • Rubrics
  • Identify closely related conditions
  • Extensions

36
ICD-10 Chapters
  • Chapter 1 A00-B99 Infectious and Parasitic
    diseases
  • Chapter 2 C00-D49 Neoplasms
  • Chapter 3 D50-D89 Hematological and Immune
    Systems
  • Chapter 4 E00-E90 Endocrine, Nutritional and
    Metabolic Diseases
  • Chapter 5 F01-F99 Mental and Behavioral
    Disorders
  • Chapter 6 G00-G99 Diseases of the Nervous System
  • Chapter 7 H00-H59 Diseases of the Eye and Adnexa

37
ICD-10 Chapters
  • Chapter 8 H-60-H95 Diseases of the Ear and
    Mastoid
  • Chapter 9 I01-I99 Diseases of the
    Circulatory System
  • Chapter 10 J00-J99 Diseases of the Respiratory
    System
  • Chapter 11 K00-K94 Diseases of the Digestive
    System
  • Chapter 12 L00-L99 Diseases of the Skin and

  • Subcutaneous Tissue
  • Chapter 13 M00-M99 Disease of the
    Musculoskeletal
    System and Connective Tissue
  • Chapter 14 N00-N99 Diseases of the Genitourinary
    System

38
ICD-10 Chapters
  • Chapter 15 O00-O99 Pregnancy, Childbirth and
    Puerperium
  • Chapter 16 P00-P96 Certain Conditions
    Originating in the Perinatal Period
  • Chapter 17 Q00-Q99 Congenital Malformations,
    Deformations and Chromosomal Abnormalities
  • Chapter 18 R00-R99 Symptoms, Signs and Abnormal
    Clinical and Laboratory findings, not
    classified elsewhere
  • Chapter 19 S00-T88 Injury, Poisoning and Certain
    other Consequences of External Causes
  • Chapter 20 V00-Y98 External Causes of Disease or
    Morbidity
  • Chapter 21 Z00-Z99 Factors Influencing Health
    Status and Contact with Health Services
  • Chapter 22 Special Purposes

39
How Detailed is ICD-10?
  • Decacodaphobia
  • Definition Fear of ICD-10
  • Z23.670

40
(No Transcript)
41
ICD-9-CM vs. ICD-10-CM
  • ICD-9-CM
  • ICD-10-CM
  • Numeric characters (with exception of some codes
    beginning with V, E, M)
  • 3-5 in length
  • About 13,000 codes
  • Alphanumeric characters always begin with an
    alpha character
  • 3-7 characters in length
  • About 68,000 codes

42
ICD-9-CM ICD-10-CM

43
Other ICD-10 to ICD-9 Differences
  • Laterality (side of the body affected
    right/left) has been added to relevant codes
  • Injuries grouped by anatomic site rather than
    type of injury
  • Expanded use of combination codes
  • Certain conditions and associated common symptoms
    or manifestations
  • Poisonings and associated external causes

44
Format differences
45
Combination Code Examples
  • E11.52 Type 2 diabetes mellitus with diabetic
  • peripheral angiopathy with gangrene
  • E11.621 Type 2 diabetes mellitus with foot ulcer
    Use additional code to identify site of ulcer
    L97.4-,L97.5-
  • I69.144 Monoplegia of lower limb following
  • nontraumatic intracerebral hemorrhage
    affecting
  • left non-dominant side
  • I70.235 Atherosclerosis of native arteries of
    right
  • leg with ulceration of other part of
    foot

46
ICD-9-CM ICD-10-CM
  • V49.71 - Lower limb
  • amputation status,
  • great toe
  • Z89 Acquired absence of limb
  • Z89.4 Acquired absence of toe(s), foot, ankle
  • Z89.41 Acquired absence of great toe
  • Z89.411 - Acquired
  • absence of right great
  • toe

47
ICD-10-CM Structure - Format
  • 3-7 character examples
  • L84 Corn and callosities
  • B95.5 Staphylococcus aureus as the cause of
    diseases classified elsewhere
  • M20.11 Hallux valgus (acquired), right foot
  • T78.01D Anaphylactic shock due to peanuts
    (subsequent encounter)
  • S98.111A Complete traumatic amputation of right
    great toe (initial encounter)

48
ICD-10-CM
  • Fracture codes require a 7th character The
    fracture extensions are
  • A - Initial encounter for closed fracture
  • B - Initial encounter for open fracture
  • D - Subsequent encounter for fracture with
    routine healing
  • G - Subsequent encounter for fracture with
    delayed healing
  • K - Subsequent encounter for fracture with
    nonunion
  • P - Subsequent encounter for fracture with
    malunion
  • S - Sequelae

49
2015 , ready to retire?
  • ICD-10 training and implementation
  • PQRS penalties take effect this year
  • MU2 can you get 5 of your patients to request
    info ?
  • E-Prescribing
  • HIPAA Drs. offices now being looked at
  • Affordable Care Act higher deductibles and
    copays
  • Have you got your line of credit yet?

50
BtwObamacare too
51
ICD-9-CM ICD-10-CM
  • Both ICD-9 and ICD-10 Alphabetic Indexes
  • Recommend beginning your code search in Volume 2
    (alphabetic), then verifying the code in Volume 1
    which is much more detailed
  • (Most EHR will do this automatically after you
    type in an alpha search term)

52
Alphabetic Index (ICD Volume 2)
  • ICD-9 Alphabetic Index
  • ICD-10 Alphabetic Index
  • Hallux 735.9
  • limitus 735.8
  • malleus (acquired) 735.3
  • rigidus (acquired) 735.2
  • congenital 755.66
  • late effects of rickets 268.1
  • valgus (acquired) 735.0
  • congenital 755.66
  • varus (acquired) 735.1
  • congenital 755.66
  • Hallux
  • deformity (acquired) NEC M20.5x
  • limitus M20.5x
  • malleus (acquired) NEC M20.3-
  • rigidus (acquired) M20.2-
  • congenital Q74.2
  • sequelae (late effect) of rickets E64.3
  • valgus (acquired) M20.1-
  • congenital Q66.6
  • varus (acquired) M20.3-
  • congenital Q66.3

53
Tabular List (ICD Volume 1)
  • ICD-9 Tabular Index
  • ICD-10 Tabular Index
  • 735 Acquired deformities of toe
  • Excludes congenital (754.60 - 754.69, 755.65 -
    755.66)
  • 735.0 Hallux valgus (acquired)
  • 735.1 Hallux varus (acquired)
  • 735.2 Hallux rigidus
  • 735.3 Hallux malleus
  • M20.1- Hallux valgus (acquired)
  • Bunion
  • M20.10 Hallux valgus (acquired),
    unspecified foot
  • M20.11 Hallux valgus (acquired), right
    foot
  • M20.12 Hallux valgus (acquired), left foot
  • M20.2- Hallux rigidus
  • M20.20 Hallux rigidus, unspecified foot
  • M20.21 Hallux rigidus, right foot
  • M20.22 Hallux rigidus, left foot
  • M20.3- Hallux varus (acquired)
  • M20.30 Hallux varus (acquired),
    unspecified foot
  • M20.31 Hallux varus (acquired), right foot
  • M20.32 Hallux varus (acquired), left foot

54
Start with Index
  • START WITH INDEX
  • There is a period after the 3rd character and
    often a dash
  • Example Pain
  • M79.
  • NEXT TO TABULAR - Define the site, etiology,
    manifestation or state of the disease or
    condition
  • Example Pain
  • M79. -

55
ICD-9-CM ICD-10-CM
  • Both ICD-9 and ICD-10 Alphabetic Indexes include
  • the Index of Diseases and Injury
  • the Index of External Causes of Injury
  • The Tables of Neoplasm and
  • The Table of Drugs and Chemicals
  • Both ICD-9 and ICD-10 use an indented format
  • Hallux 735.9
  • rigidus (acquired) 735.2
  • congenital 755.66

56
ICD Guidelines
  • Example Volume 2
  • hallux valgus (acquired)

57
ICD Guidelines
  • Example Volume 1
  • M20.1 Hallux valgus (acquired)

58
ICD 10 Changes APMA Submitted for Change 10/1/2015
  • M21.6 Other acquired deformities of foot
  • Excludes deformities of toe (acquired)
  • (M20.1-M20.6)
  • M21.6x Other acquired deformities of foot
  • M21.6x1 Other acquired deformities of right
    foot
  • M21.6x2 Other acquired deformities of left
    foot
  • M21.6x9 Other acquired deformities of
    unspecified foot
  • M21.61 Bunion
  • M21.610 Bunion deformity, unspecified
  • M21.611 Bunion deformity, right foot
  • M21.612 Bunion deformity, left foot
  • M21.62 Bunionette
  • M21.620 Bunionette deformity, unspecified
  • M21.621 Bunionette deformity, right foot
  • M21.622 Bunionette deformity, left foot

59
The X, dummy
  • Dummy 5th Character
  • Just to confuse you even more ?
  • To allow for further expansion some codes have a
    dummy 5th place character so that the 6
    character structure will not be disrupted when
    changes are added
  • Report these codes as they are in the book
    including the dummy5th character x

60
DEFINITION Unspecified
  • Codes in the Tabular Listing that include
    unspecified in their description are to be used
    when the information in the medical record is
    insufficient to assign a more specific code.
  • M20.10 hallux valgus (acquired), unspecified
    foot
  • In other words, in the hallux valgus example,
    the medical record failed to distinguish which
    foot had the hallux valgus deformity.
  • The Alphabetic Index uses NOS not otherwise
    specified for the same designation.

61
DEFINITION Other Unspecified or Other
  • Codes that include other or other specified
    in their description are found in the Tabular
    Listing.
  • Other or other specified codes are to be used
    when the medical record documents a condition for
    which no specific ICD code exists.
  • The corresponding term in the Alphabetic Index
    is NEC (not elsewhere classified).

62
Next
  • 4th Character
  • Define the site, etiology, manifestation or state
    of the disease or condition
  • Numeric
  • Example Pain
  • M79. -
  • M79.6 pain in limb, hand, foot, fingers, toes

63
5
  • 5th Character
  • 5th character identifies a level of specificity
  • Letter or Number (0-9)
  • Example
  • M79. Pain
  • M79.6 pain in limb, hand, foot, fingers, toes
  • M79.60 Pain in limb

64
6
  • 6th character is even more specific
  • Numeric (0-9)
  • Describes specific location or cause
  • For laterality
  • 1 is right
  • 2 is left
  • 3 is unspecified
  • Example Pain
  • M79.-
  • M79.6 pain in limb, hand, foot, fingers, toes
  • M79.60 Pain in limb unspecified
  • M79.671 Pain in right foot

65
7th
  • 7th Character
  • Some codes have a so-called character extension
  • Typically letters, that describe
    conditions/timing of the visit
  • Used to give more information about the events
    related to the reason for the visit or service

66
Non-fracture care A- initial encounter D- subsequent encounter S- sequela Fracture care A- initial encounter (for closed fracture) B initial encounter for open fracture D- subsequent encounter for normal healing fracture G- subsequent encounter for delayed healing fracture K- subsequent encounter for fracture with non-union P- subsequent encounter for fracture with mal-union S- sequela of fracture
67
ICD-10 Look-Up Example
  • Stage III decubitus ulcer of left heel
  • Step 1 - Look up main term in Alphabetic Index
  • Ulcer, ulcerated, ulcerating, ulceration
  • See ulcer by site
  • lower limb (atrophic) (chronic) (neurogenic)
    (perforating) (pyogenic) (trophic)
    (topical)
  • pressure (pressure area) L89-
  • heel L89.6-

68
ICD-10-CM Look-Up Example
  • Stage III decubitus ulcer of left heel
  • Step 2 - Verify in Tabular
  • L89.6- Pressure ulcer of heel
  • L89.62- Pressure ulcer of left heel
  • L89.623 Pressure ulcer of left heel,
    stage III

69
More ICD Guidelines
  • Brackets in the Tabular List enclose
    synonyms, alternative wording, or explanatory
    phrases
  • M21.4 Flat foot pes planus (acquired)
  • Brackets in the Alphabetic Index are used
    to identify manifestation codes
  • Disease, diseased skin L98.9
  • due to metabolic disorder NEC E88.9 L99

70
Code First Use Additional Code
  • An ICD sequencing example
  • Diabetic (type I) heel ulcer
  • Is the underlying condition

71
Code First Use Additional Code
  • The ICD sequencing instruction is to list
  • the underlying condition code first
  • L97 is a
  • manifestation
  • code

72
ICD Guidelines
  • Manifestation code L97.411
  • It is coded after the underlying condition code,
    E10.621 diabetic (type I) heel ulcer

73
At Risk Care and ICD-10
  • ICD- 9
  • ICD- 10
  • 703.8 (onychauxis)
  • L60.2 onychogryphosis, hypertrophic nails
  • L60.3 nail dystrophy
  • L60.8 other nail disorders
  • L60.9 nail disorder, unspecified
  • Q84.5 onychauxis, enlarged nails
  • Q84.6 other cong. Nail dz

74
Lets add PVD
  • ICD-9
  • ICD-10
  • 443.9 PVD, unspecified
  • I70.2- ASO of native arteries of extremities
  • (IMPORTANT!!)
  • The hyphen denotes additional characters required
    specific for ASO disease
  • Need to be SPECIFIC unlike in ICD 9

75
AndDiabetes
  • ICD 9
  • ICD 10
  • 250.60
  • Diabetes with neurological manifestations
  • E10.4- type 1 DM with neuro complications
  • E11.4- type 2 DM with neuro
  • Z79.4- with insulin use
  • E13.4- other specific DM with neuro comps.
  • 13.61- other specified DM with diabetic
    arthropathy and Z79.4- for insulin use

76
Oh yeah, thick nails
  • ICD 9
  • ICD 10
  • 110.1
  • onychomycosis
  • B35.1 onychomycosis

77
Lets add a keratoma
  • ICD 9
  • ICD 10
  • 701.1 keratoderma
  • L85.1
  • L85.2

78
(No Transcript)
79
(No Transcript)
80
(No Transcript)
81
Impact analysis
  • Determine any area in the practice that currently
    utilizes an ICD-9-CM code
  • Ask for input from the various departments
    (clinical and clerical) to ensure that nothing is
    overlooked
  • How are performance measures captured
  • Prior authorizations
  • Research
  • Tracking and trending

82
Impact analysis
  • Create a flow chart to
  • Demonstrate how the action of each individual
    impacts the entire process
  • Identify areas of weakness and quickly create a
    process to strengthen it
  • Clearly illustrates the need for interaction
    between clinical or business areas
  • Generate ownership of each process
  • Provides a clear picture of how things work today
    and can outline how things should work in the
    future

83
  • Strategies for Success
  • The first place to begin in preparing for ICD-10
    implementation is with communication
  • Keep everyone updated on what is happening
  • No delay expected, we need to continue to prepare
    for the transition
  • If you take it seriously, so will the people you
    are leading
  • What form of communication will be most effective
    in your office/institution

84
Build an action plan
  • Build an action plan based on the results of the
    impact analysis
  • Create a preliminary needs assessment
  • Establish timeline parameters to create a roadmap
  • Adhere to the timeline, but be open-minded to
    allow for unexpected circumstances
  • Begin discussion early with vendors to understand
    their timelines

85
Measure productivity
  • Understand where productivity is at prior to the
    implementation of ICD-10
  • Use this as a goal to get back to after the
    official implementation date
  • Canada indicates that their productivity has not
    recovered since implementation
  • Different reimbursement system
  • Implemented EMR at same time as ICD-10
  • Went from DOS system to a windows based claims
    world

86
Questions for Consideration
  • Is your EHR and billing system ICD-10 compatible
  • Are you sure?
  • Has it been tested?
  • Have you tested it?

87
Your take home message isDont be a dinosaur
88
Things that will effect your income in 2015
  • ACA implications
  • Rise of deductibles
  • Decrease in malpractice premiums
  • ICD-10
  • ACOs
  • Retail clinics
  • PCPs, NPs, Pas
  • MU moves from carrot to stick
  • PQRS penalties
  • Reporting payments to physicians

89
QUESTIONS?peward_at_apma.orgTwitter
_at_APMApresident
www.apma.org
Write a Comment
User Comments (0)
About PowerShow.com