Introduction The 5 Phases of the ICD-10 Transition 1. Engaging and - PowerPoint PPT Presentation

Introduction The 5 Phases of the ICD-10 Transition 1. Engaging and educating Physicians and Staff 2. Organizing your implementation effort 3. Creating your Timeline and Transition Plan 4. Implementing your Transition Plan 5. Post Transition Analysis and Reporting Each phase is the prerequisite for the next. Most physician practices are in Phase One!

Why ICD-10? • ICD-9-CM is outdated – Over 30 years old – Many categories full – Not descriptive enough • Coding system needs to be: – Flexible enough to quickly incorporate emerging diagnoses – Exact enough to precisely identify diagnoses

ICD-9-CM and ICD-10-CM Differences ICD-9-CM Diagnosis Codes ICD-10-CM Diagnosis Codes   3-5 numeric digits in length 3-7 Alpha-Numeric characters in length   Approximately 14,000 codes Approximately 69,000 available codes   First digit may be alpha (E or V) or numeric; Digit one is alpha; Digits two and three are  Digits 2-5 are numeric numeric; digits 4-7 are alpha or numeric   Limited space for adding new codes Flexible for adding new codes   Lacks detail Very specific   Lacks laterality Has laterality   Difficult to analyze data due to non-specific Specificity improves coding accuracy and codes rich-ness of data for analysis   Codes are non-specific and do not Detail improves the accuracy of data used adequately define diagnosis needed for for medical research medical research   Does not support interoperability because it Supports interoperability and the exchange is not used by other countries of health data between other countries and the United States

Documentation needs and Responsibility for ICD-10 Success • Create documentation awareness now! • Physician Documentation is the cornerstone for ICD-10 Transition success • This is the primary responsibility physicians have in the move to ICD-10

VII. Tools you will need for the Transition • ICD-10 Transition Software – saves valuable conversion time • Documentation and Coding Training Guides • Do-it-yourself ICD-10 implementation Tool kits - Impact Assessment/Planning Guide • Chart Documentation Reviews • Role Based Training Plan • Budget- Money and time!

Documentation: The KEY to ICD-10 Success With increased dx coding specificity comes a requirement for detailed documentation. Jeri Leong, President, Healthcare Coding Consultants of Hawaii: “…(for current audits), 40% of the time we were unable to assign a specific ICD-10-CM code based on current documentation.” How good is YOUR current documentation?

Increase in Codes? Here’s the Real Story Gastroenterologists: 596 ICD-9 codes and 706 codes in ICD-10 (+110) • Pulmonologists: 255 codes in ICD-9 and 336 codes in ICD-10 (+81) • Urologists: 389 codes in ICD-9 and 591 codes in ICD-10 (+202) • Endocrinologists: 335 codes in ICD-9 and 675 codes in ICD-10 (+340)* • Neurologists: 459 codes in ICD-9 and 591 codes in ICD-10 (+132) • Pediatricians: 702 codes in ICD-9 down to 591 codes in ICD-10 (-111) • Infectious disease: 1,270 in ICD-9 down to 1,056 in ICD-10 (-214) • A few hundred new codes = a few dozen new documentation elements * ICD-10-CM includes more combination codes containing co- morbidities and associated conditions. Example - Diabetes

Do Now: Physician’s Documentation: A Chart Audit 1. Per Doctor: list top 25 diagnoses (by revenue, frequency) 2. Use GEMS to translate ICD-9 to ICD-10 3. Pull patient charts containing those ICD- 9 diagnoses 4. Assess current documentation as sufficient or not 5. Create report for providers 6. Customize training by provider 7. Continue to monitor documentation

Do Now: Create Documentation Coding Tools 1. Make a list of your practice’s top 20 most frequently used ICD-9-CM diagnosis codes 2. Use the GEMs mapping tool to translate the ICD-9 codes to ICD-10 3. For each ICD-10-CM code, highlight unique documentation and coding requirements 4. Create flash cards, one per code, for your providers If providers start now and learn the unique documentation and coding requirements for 1 or 2 diagnoses codes per week, they will be prepared for ICD-10-CM when the Oct. 1, 2014 deadline arrives .

Advice from Other Countries Begin now, take advantage of lead time • Expect significant ICD-9/ICD-10 data comparability issues due to the • fundamental differences in the coding schemes Sharpen anatomy and physiology skills • Keep up coding credentials • Plan for 6 month productivity loss/learning curve • Focus on documentation • Purge bad habits • Vendor readiness is extremely important • Communication is critical •

Questions? Thank you! Suzanne MacEwan ICD-10 Trainer and Implementation Consultant smacewan@emr-hit.com 904-710-7062