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Transcript of Copyright Gap Consulting, Inc. 2011 A Practical Guide to Navigating the ICD-10 Waters Northeast Ohio...
Copyright Gap Consulting, Inc. 2011
A Practical Guide to Navigating the ICD-10 Waters
Northeast Ohio HFMAJuly 28, 2011
1
Agenda
• Introductions• The Visible Clinical Aspects of ICD-10• ICD-10 Imperative and Call to Action • Impact of ICD-10 Among Stakeholders• Summary• Q&A
2
The Speakers
• Nabil Chehade, MD, MSBS, CPCAssistant Medical Director, Medical SpecialtiesChief Medical Informatics OfficerOhio Permanente Medical Group
• Lynn Eckendorf, MBA, CCPSenior Associate
Gap Consulting
• Gail Kovacs, RN, MBA,CLNCHealthcare Business AdvisorKovacs and Associates
3
The Visible Clinical Aspects of ICD-10
4
Overview of Kaiser Permanente
• Founded 1945• Serves > 8.7 Million Members• 8 Regions Across the United States:
– Colorado,
– Georgia,
– Hawaii,
– Mid-Atlantic States (VA, MD, DC),
– Northern California,
– Northwest (Oregon/Washington),
– Ohio and
– Southern California
• 35 Hospitals• 454 Medical Offices,• 15,129 Physicians,• 64,098 Employees• Total Revenue for 2010 = $44.2B
5Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
According to the American Association of Professional Coders
6Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Kaiser’s Organizational Imperative
• Kaiser Permanente As a Complex Organization:• Insurer, Care Delivery, Hospital System, IT, Vendor Relationship
• Kaiser Permanente as a Leader in Integrated Care Delivery
• Kaiser Permanente As the Largest Non-Governmental Deployment of EMR in the World
Kaiser Permanente Will Have to Take a Multi-Year and Multi-Disciplinary Approach for ICD-10 Readiness
7Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Kaiser Permanente’s Approach Organization Wide
8
2009 2010 2011 2012 2013Assess impact Plan approach Complete
systems readinessExecute plan
10/1/2013 ICD-10 compliance
5010
Systems identified to size impact
Draft systems approachIT
Vendor Readiness survey
Business Review: impacted apps, processes and policies
Bus
ines
s
Refine plan. Remediate, retire, replace applications in line with compliance approach.
Testing/ Deployment / Transition
Coordination with and tracking of vendor readiness activities
Coordinated vendor testing; risk mitigation
Readiness for business-supported apps; revision of policies and procedures; organizational readiness
Pro
gram
Multi-year plan framework
National and RegionalGovernance structures
General awareness, communications and training
Role-specific trainingPrerequisites trainingCoP: Curriculum and approach
Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Example ICD-9 to ICD-10
9Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Comparisons of the Diagnosis Code Sets
ICD-9-CM ICD-10-CM
3-5 Characters in Length 3-7 Characters in Length
Approximately 13,000 Codes Approximately 69,000 Available Codes
First Digit May Be Alpha (E or V) or Numeric; Digits 2-5 Are Numeric
Digit 1 Is Alpha; Digits 2 and 3 Are Numeric; Digits 4-7 Are Alpha or Numeric
Limited Space for Adding New Codes
Flexible for Adding New Code
Lacks Detail Very Specific
Lacks Laterality Has Laterality (i.e., Codes Identifying Right Vs. Left)
10Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
ICD-10 Code Structure
• ICD-10-CM • CM = Clinical Modification of the WHO Diagnostic System for the US
– Characters 1-3 – Category – Characters 4-6 – Etiology, anatomic site, severity, or other clinical
detail – Characters 7 – Extension
• ICD-10-PCS• PCS = Procedural Coding System (Inpatient Hospital Use)• Only the US Uses PCS
– Character 1- Name of Section– Character 2- Body System– Character 3- Root Operation– Character 4- Body Part– Character 5- Approach– Character 6- Device – Character 7- Qualifier
11Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Clinical Example, ICD-10-CM
A Provider Sees a Patient in a Subsequent Encounter for an Age Related Pathological Fracture to Left Humerus with Delayed Healing:•ICD-9-CM Code: One Code 733.11 PATHOLOGICAL FRACTURE OF HUMERUS•ICD-10-CM Takes into Account Several Elements to Get More Granular Code M80.022.G:
– In ICD-10-CM Many Choices for the First 3 Characters Depending on the Category (M80)
• Osteoporosis with current pathological fracture– ICD-10-CM Presents Several Other Choices Dependent on the Clinical
Information (022):• M80.021 Aged related osteoporosis with current pathological fracture, humerus, right• M80.022 Aged related osteoporosis with current pathological fracture, humerus Left• M80.029 unspecified
– ICD-10-CM must identify encounter and healing status, this is the extension code (G)• A) initial encounter for fracture• D) subsequent encounter for fracture with routine healing• G) subsequent encounter for fracture with delayed healing• K) subsequent encounter for fracture with non-union healing• P) subsequent encounter for fracture with malunion healing• S) sequela
12Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
ICD-9-CM Vs. ICD-10-CM
• Prior Example of Age Related Pathologic Fracture Yields 18 codes in ICD-10-CM Vs. One Code Available in ICD-9-CM
• If We Were to Compare and Code for Traumatic Fracture Instead of Pathologic Fracture:– 26 Codes in ICD-9-CM Vs. 966 Codes in ICD-10-CM26 codes (13 closed fracture and 13 open fracture) in ICD-9 - 812.x966 codes (138 codes x 7 alpha extensions includes Initial Open and Initial Closed) in ICD-10 - S42.2xx to
S42.49xx
13Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Impact on Documentation by the Clinician
• How Specific Do We Need to Be When Documenting in ICD-10?
• Is More Specific Better for Patient Care, Quality Initiatives or Revenue Impact?
• Can Extreme Request for Specificity Backfire and Lead to Vague Data and Sometimes Outright Incorrect or Erroneous Data?
What Would the Impact Be on Provider Productivity?
14Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Impact and Optimization of EMR
• Mapping for ICD-10 and Making Display Names and Synonyms Available for Easy Retrieval
• Implementation of New Coding Tools in EMR to Help Selecting Correct Codes
• Remediation and Mapping of:– Structured Data (Problem List, PMH, Decision Support Tools)– Existing Documentation Tools– Quality Reports– Utilization Management Reports– Clinical Protocols– Population Registries
15
Kaiser’s Expectations
• Kaiser Permanente, Kaiser Hospitals and Permanente Medical Group Will Be Ready for an October 2013 Transition to ICD-10– All Impacted Systems Will Be Remediated– People Impact Will Be Minimized– Training and Workflows Will Be Optimized For a Smooth Transition
with a Minimal Disruption
• Progress to Date: – Completed Inventory of Impacted System Program Wide– Significant Progress on People Impact and Training Program Wide– System Remediation, Mapping and Crosswalk of Codes Already in
Progress
16Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
ICD-10 Imperative and Call to Action
17
Where It All Came Together…
18
Timeline/State of Readiness• Key Dates
– 9/30/13: Last date to use ICD-9– 10/1/13: Effective Date ICD-10– Delay potential due to MU Stage 2 delay?
• Coordination with 5010 (Comply with 5010 First)• Preparation / Assessment
– EHR Upgrade Synchronization– Workflow Improvements
• Benefits of ICD-10– Data Precision – Discrete Cost Analysis– Improved Payer / Provider Discussions / Negotiations– Improved Portfolio Management
19
Benefits of ICD-10
• More Specific Coding / More Accurate Reimbursement
• Faster Reimbursement / Fewer Denials (Long-Term)• Able to Accommodate Treatments Post-ICD-9• Better EMR Support• Improved Safety, Medical Management and Quality
of Care• Improved Portfolio Management• Redesign Clinical and Administrative Operations• Enhance Integration with Payers and Providers
20
Source: Accenture: “Preparing Payers for ICD-10”
Industry Benefits of ICD-10
Summary of Estimated Benefits over a Ten-Year Period
Category Benefit ($ Million) Largely Due To
More Accurate Payment for New Procedures
100-1,200 ICD-10 PCS
Fewer Rejected Claims 200-2,500 Both
Fewer Fraudulent Claims 100-1,000 Both
Better Understanding of New Procedures
100-1,500 ICD-10 PCS
Improved Disease Management 200-1,500 ICD-10-CM
21
Source: “The Cost and Benefits of Moving to ICD-10 Code Sets” by Rand Science and Technology
Potential Provider Business Opportunities
22
► Improved portfolio management
► Improvement opportunity - Clinical and Operational Redesign
► Improvement opportunity - Clinical Documentation by Physicians
► Increased patient/provider loyalty
► Improved payer/provider integration
► None to minimal impact to bottom line
BusinessBenefits
Courtesy of: 3M
Source: Trizetto Presentation 2010
Potential Payer Business Opportunities
23
► Improved qualityof care
► Reduced costof claims
► Increased member satisfaction
► Increased provider satisfaction
► Improved administrative cost
BusinessBenefits
Courtesy of: 3M
ICD-10 Projected Impact
The Move to ICD-10 Is Expected to Cost $1.64 Billion Dollars•The Centers for Medicare & Medicaid Services Estimate That the Transition from ICD-9 to ICD-10 Will Cost the Healthcare Industry $1.64 Billion•Also in 2008, Nachimson Advisors, LLC Estimated These Impacts of ICD-10:
– Typical Small Practice: Total Cost Impact $83,290 Per Practice– Typical Medium Practice: Total Cost Impact $285,195 Per
Practice– Typical Large Practice: Total Cost Impact $2.7 Million Per
Practice
24Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Date Impacts
• Claims That Cross the 10/1/13 Boundary• Discharges
– Services Provided Prior to 10/1/13: No Change– Services Provided On or After 10/1/13: All Use ICD-10; Convert
from ICD-9• Code Freezes
– 10/1/11: Last Regular, Annual Updates to Both ICD-9-CM and ICD-10
– 10/1/12: Only Limited Code Updates to Both ICD-9-CM & ICD-10 Code Sets To Capture New Technology And New Diseases
– 10/1/13: Only Limited Code Updates to ICD-10 Code Sets to Capture New Technology And New Diseases
• Define Your Approach Organization-Wide
25
Where Are You with ICD-10 Planning?
• ICD-10 Steering Committee• Comprehensive Assessment
Completed with Issues Identified
– 5010 Readiness – IT Systems-System Inventory– Decision Support– Case Management– Utilization Review– Managed Care/Payer
Contracts– Quality Department– Functional Areas That Use ICD-
9 Codes Today That Need Translation
– Educational Needs Within Organization
– Documentation Assessment
• Claims Analysis to Identify Top Specialties Impacted the Most
• Vendor Readiness– Testing Schedule
• Managed Care/Payer Contract Readiness
• Implemented Education Plan• Implemented Documentation
Improvement Plan for ICD-10– CDI Program w/ I-10 Concepts– Identified Top Specialties and
Education to Physicians• Roadmap Completed for
Implementation
26Courtesy of: 3M
Implementation of ICD-10
• HIMSS ICD-10 Playbook http://www.himss.org/ASP/topics_ICD10Playbook.asp
– Reviews Known Risks—Direct/Avoidable – Reviews Hidden Risks—Indirect and Complex: Can Cause Irreversible Damage
• Payer Readiness Variability• Necessary Payer Conservatism
– Assume Miscoding—Increased Denials– More Diligent In Validating Appeals—Cash Flow Delays– Evaluate Contracts Based on Assumptive Trend Data
• Inevitable Lender Uncertainty– Delays in Cash Flow Will Result in Decreased Net Revenue, Results in More
Scrutiny of Margin– Get Approved Lines of Credit In Place Now
• Payer Will Need Extensive Modeling, Will Adjust Rules as They Gain Experience• Configuration Mistakes Will Lead to Re-Billing
2013 Is Just The Beginning. If You Get Behind, You Stay Behind!
27
What You Need to Be Addressing Today
• Comprehensive Assessment of Functional Areas Impacted – Vendor/Payer Gap Analysis– Identify Functional Areas and Processes That Will be Impacted– Develop Roadmap for Successful Implementation
• Begin Translation Process– Translate Lists of Codes for Appropriate Applications (Software/ Paper)– Assess Payer Contract Implications and Begin Translating/Working with Payer
Regarding Future Contractual Agreement for Transition to ICD-10
• Documentation and Current Claims Assessment– Review of Claim/Code Volume of Codes that Cannot be Translated– Identify High Volume Trends (Codes, Specificity, etc.)– Documentation Review of These Codes for Accuracy and Specificity
• Begin Process of Changing Physician Documentation Behavior– Utilize Trends from Documentation and Claims Assessment to Begin to
Educate and Change Physician Behavior Now
28Courtesy of: 3M,
ICD-10 Implementation: Critical Success Factors
• Knowledge Transfer/Education Provided to Key Leadership/Teams Staged According to Fully Integrated Program Plan Development and Execution.
• Fully Integrated IT And Other Systems Currently Containing ICD-9 Codes Across All Hospital, Vendor, Payer and Other Integrated Systems (Electronic and Other)
• Comprehensive Internal And External Communication Strategy/Plan
• Detailed Contracts with Other Providers, Payers and Vendors with Clear Identification of Timing, Integration and Conversion/Translation Applications
• Comprehensive Modeling and Integrated Functional Testing Plan Across the Continuum of Care
29Courtesy of: 3M
Tools: Conversion / Crosswalk Activities
• General Equivalence Mappings (GEMs) Assist in Converting Data from ICD-9-CM to ICD-10
• Forward and Backward Mappings– Information on GEMs and Their Use –
http://www.cms.gov/ICD10 (Click on ICD-10-CM or ICD-10-PCS to Find Most Recent GEMs)
– Description of MS-DRG Conversion Project http://www.cms.gov/ICD10/17_ICD10_MS_DRG_Conversion_Project.asp
30
Best Methods To Reduce Claims And Coding Errors
Increased Specificity Makes Accurate Documentation Critical Garri Garrison, 3M ICD-10 Could Turn Revenue Cycle Management Upside Down Doug Brilbrey , SSI Group There Are 2 Reasons Mistakes Happen Greg Larson, TriZetto
Info Is Missing or Inconsistent; Diagnosis & Procedural Codes Are Inappropriate for Type/Level of Care
Successful Transition Requires Planning and Collaboration Lisa Nolan, PatientKeeper
Key to Reducing Errors Is Education Ken Bradley, Navicure Control the Accuracy of Coding Where It Matters Kimberly Labow, Navinet Correct Coding Begins with Thorough Documentation Kristen Weinberger,
Edifecs Need to Evaluate the CAC (Computer Assisted Coding) Mark Morsch, A-Life Systems Medical, part of Ingenix Key is Remediation Ray Desrtochers,
HealthEdge Must Have Detailed Contracting Arrangements Ravi Sabharwal, Infosys
Technologies 31
Best Methods To Reduce Claims And Coding Errors
• Mobile Solutions Are Important Paul Adkison, IQMax• Whole Practice Must Embrace the Challenge Rex Stanley, Unicor
Medical • Important to Identify Early Opportunities to Optimize William Shea
Systems Cognizant Business Consulting
• Best Approach Will Start with an Impact Assessment Rob Culbert, Culbert Health Solutions
• Education, Training and Support Are Keys to Avoiding Steve Sabino, DST
Costly Errors Health Solutions• Create an Acceptance Test that Defines the Expected Sal Novin, Health Care
Outcome Productivity Automation
• Education Will Remove Barriers to ICD-10 Success Deborah Nevill, Elsevier
32
Impact of ICD-10 Among Stakeholders
33
According to the American Association of Professional Coders
34Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Steering Committee
• ComponentsExecutive Sponsor : Often the CFO– Governance– Leadership:
• IT / HIM/ CMO / CNO– Broad Stakeholder Participation– PMO Office
• Message: High Level Engagement and Commitment of Senior Management
• Consider: Payer Perspective as a Stakeholder
35
Steering Committee
Role / Responsibilities:• Develop / Implement
– Goals– Schedule / Milestones
• Assign Tasks / Resources• Oversee Organization-Wide Training• Assess Impact/Modify Course
– Of Implementation– On Functional / Other Areas
• Communications (e.g., Awareness, Status)
36
Kaiser Permanente’s Approach National vs. Regional
37
Executive Sponsors (Regional)
Steering Group (Regional)
Executive Sponsors (National)
Steering Group (National)
Org Readiness
National Lead(s)
For Each Functional Area
Compliance PMOReg.
Business Lead(s)
Reg. IT Lead Additional team
structures to bedetermined by each region
Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Sample Organization Structure
38
Physician Impact • Appreciate Time, Complexity, & Level of Difficulty
– Documentation Will Change– Will Take Longer; May Need To Be Repeated; Delinquent Charts– Also Being Impacted At The Office Level AND– Need To Take Care Of Patients!!
• Engage & Train Physicians On Importance Of Changes
– Address Adoption Issues, Training Sessions, Tools
• Conduct Workflow Analysis– Potential Gaps– Redesign Workflows And Documentation Products
• Prepare To Minimize Impact– Consider Preparation Of Billing Under Both Coding Systems
39
Nursing Impact
• Appreciate Time, Complexity, & Level of Difficulty– Same Organizational Change Issues as Physicians– Awareness of Impact Initiative in Other Departments
– Physicians, Utilization & QA Review, Agency Personnel!!– Training Needs– Forms & Orders Will Change; Documentation Will Need to Be More
Specific:• EG. Pressure Ulcers: ICD 9 = 9 codes; ICD 10 > 125 codes
• Don’t Underestimate the Value of a Nurse– Critical to engage: understand A & P, disease process, can read
surgical reports and can explain what happened/how treated– Can serve as translators between Physicians and HIM
• Consider Role for Nursing Specialists/Informaticists, RN-Coders: :http://community.advanceweb.com/blogs/nurses_18/archive/2011/04/25/nursing-s-role-in-icd-10-meaningful-use.aspx
40
Operational / Functional Impact
Productivity will be effected in Real $$•Productivity Decreases Expected, Beyond Transition •Cash Flow Impact Resulting from Lowered Productivity:
– Claims Submissions– Reimbursements– Slowed Revenue Stream– A/R Drop– Audit Impact of Changes in Documentation– Increase in Cost Per Case for a Period of Time– Delays in Chart Completion Secondary to Physician Documentation– Charge capture Processes May Need Modifications
•Utilization Review / Case Management Impact•Stop Loss Initiatives Needed?
– Collaborate with Payers as Well41
Productivity Impact on Coding
Pre 1 Year Post 2 Year Post
Inpatient 4.62 2.15 (47%) 3.75 (81%)
Day Surgery 10.68 3.82 (36%) 8.53 (80%)
Emergency 10.37 6.49 (63%) 8.83 (85%)
• Canada Implemented ICD-10 in 2001 – Coders Did Not Return to Post Implementation
Productivity Levels– Use of Pre-defined Coding Lists Within Ambulatory Care
Settings Mitigated Drop• Sample of Canadian Coding Productivity Pre- and Post-ICD-10
– Expressed as Charts Completed Per Hour
42Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Technology Impact
• Software Programs & Testing Efforts• Clinical Documentation Programs will need Review
– Required to Support Accuracy– Lead to Enhanced Reimbursement and Severity-
Adjusted Clinical Outcome Measures1
• Multiple Sites – May Each Have Locally Customized Software
( Even If Using the Same Applications)• Forms Will Likely Change
43
Who Requires Training?
• Coders• Other HIM• Clinicians
(Physicians, Nurses)• Senior Management• Information
Systems• Quality
Management• Utilization
Management
• Claims Analyst• Performance
Improvement• Compliance• Data Quality
Management• Data Security• Data Analysts
• Accounting• Business Office• Auditors &
Consultants• Patient Access &
Registration• Clinical Department
Managers• Ancillary
Departments
44Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group
Impact on Software Programs
• HIM– DRG Grouper -Encoding Software– Abstract Systems -Compliance Software– Medical Necessity -Support Systems– Case Mix Systems -Utilization Management– Quality Management -Case Management– Performance Management
45
Impact on Software Programs
• Financial– Billing– Financials– Claim Submission– Compliance Checking– National And Local
Coverage– Determinations
• Reporting– Provider Profiling– Quality Management– Utilization Management– Disease Management
Registries / Other Registries
– State Reporting Systems– Fraud Management– Patient Assessment Data– Data Sets– Aggregate Data Reporting– Managed Care Reporting
46
Impact on Software Programs
• Clinical Systems– Clinical Protocols – Test Ordering Systems– Clinical Reminder Systems– Decision Support Systems– Disease Management
Systems
• Internal Home Grown -Systems and Customizations
– Clinical Systems – Pharmacy Systems– Lab System– Radiology Systems– EKG
• Registration– Registration/Scheduling– Advance Beneficiary
Software– Medical Necessity Edits
47
Anywhere a Code or Diagnosis Resides or is Utilized WILL be Effected!!
Ancillary /Other Impact
• Ancillary– Pharmacy (V and E Codes Will Still Be Alphanumeric)– Lab (Codes Change)
• Quality Measures and Reporting• Public Health / Compliance Impact
– Data Is More Clearly Defined– Potential to Improve ACO Data
• Reporting
48
Vendor Interface Impact• Create Inventory of Systems
– Define Those Impacted (Systems, Vendors)• Coding Vendor
– Compliance / Readiness of 5010 & ICD-10– Release / Implementation of System Updates– Costs
• Testing Interfaces (Bidirectional) – Affected Systems and Third-Party Recipients / Providers– Claims, Clearinghouses, Reference Labs, Affiliated
Physicians, Etc.– Costs
49
Payer Impact
Consider:• Testing with Payers and Clearinghouses• Effects That ICD-10 Will Have on Explanation of
Benefits (EOB) Statements• Changes to Submitted Claims• Changes in Communications to Patients
– Handling of Questions / Calls from Patients– Who will they view as the cause of their anxiety
and frustration ?
50
Competition for Essential Resources
Funding•Actual Project Costs•Ongoing Costs
Other Projects•Diversion of Funds & Other Resources to ICD-10 from Other Projects (CMS and Internally-Originated)
– Resistance– Delays Due to Fund Diversion
Time•Project Planning & Timing
People•HIM Staff, Physicians, Nurses, IT, Educators
51
• Budget– Changes and Implementation
• Costs of all Organizational / System Changes, Training, and Lost Productivity Impacts
• Ongoing Costs– Denials and Delayed Payables– Reserves
All Costs Are Higher Than You ThinkThe Longer You Wait, the More It Will Cost You
Financial Impact
52
The Road is Going to Be Bumpy
53
On October 1, 2013, Where Will YOU Be?
Here?
54
On October 1, 2013, Where Will YOU Be?
Or Here?
55
Summary
56
Summary
Critical Success Factors:•Plan•Budget•Train•Obtain Detailed Input Through Work Sessions
– Payers / Providers• Coverage Guidelines, Contracts/Policies, Technology, People
•Create Focus for Strategic Decisions – Leverage ICD-10 As an Enabler to Future Direction– Establish Framework for When to Comply and/or Optimize within a
Business Domain/ Service Line– Establish a Path for Benefit and Reimbursement Strategies (i.e.,
Value Based Benefits/ Reimbursement/ Purchasing) – Identify Drivers for Portfolio Management
•Closely Coordinate•Communicate, Communicate, Communicate
57
Informational Resources / Links
• AHIMA www.ahima.org– ICD-10-CM/PCS Transition: Planning and Preparation
Checklist• HIMSS www.himss.org
– ICD -10 Playbook www.himss.org/ASP/topics_ICD10Playbook.asp
– ICD-10 Task Force: ICD -10 Implementation Cost Prediction Modeling Tool
• Predicts Financial Impact Post Implementation• Covers Incremental Costs vs. Status Quo• Excel Format
– ICD- 10 CM/PSC Tools and Resource Guide– 5010/D.O & ICD-10 Interrelationships (crosswalk table)
58
Informational Resources / Links
• AAPC www.aapc.com– ICD-10 Impact on Productivity
• http://news.aaapc.com/index/2011/03/icd-10-impact on productivity
– ICD-9 to ICD -10 Reference Sheet• CMS https://www.cms.gov/ICD10/04_CMSImplementationPlanning
• AMA www.ama-assn.org -resources for physicians– 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?
59
Informational Resources / Links
• AHIMA www.ahima.org– ICD-10-CM/PCS Transition—Planning and Preparation Checklist
• HIMSS www.HIMSS.org– ICD-10 Initiation & Planning– ICD-10 Implementation– ICD-10 Implementation Cost Prediction Modeling Tool
• Ingenix www.ingenix.com– ICD-10-CM: Diagnostic Coding for the Future
• Experis www.himss.org/content/files/ICD10IdentifiedGenericRisks_Experis.pdf– ICD-10 Identified Generic Risks
• Benchmark www.benchmarkrevenue.com/@api/.../=Benchmark_ICD_10_Checklist.pdf– ICD-10 Checklist
60
Are You Ready?
Now That You’ve Seen What’s Needed:•Are You Prepared?•Have You Started Yet?•Will You Be Able to Do Everything in Time?
61
Questions & Answers
62
Contact Information
• Dr. Nabil [email protected]: 216.362.2770•Lynn [email protected]: 216.789.0041
• Gail [email protected]
Phone: 216.789.1602
63