ICD-10 Transition: Q & A Session - Beacon Health...
Transcript of ICD-10 Transition: Q & A Session - Beacon Health...
ICD-10 Transition:
Q & A Session
Beacon Health Options
Today’s Agenda
What’s Changing?
Preparedness
Dialogue
Resources
ICD-10 Transition 2
What’s Changing?
ICD-10 Transition 3
ICD-9 CM Diagnosis Codes ICD-10- CM Diagnosis Codes
3 to 5 digits 7 characters
Alpha “E” or “V” on first character Alpha or numeric for any character
Approximately 14,000 codes Approximately 69,000 codes
Terminology Similar
Severity parameters limited Extensive severity parameters
Source: Health Data Consulting
Code Volume and Behavioral Health
ICD-10 Transition 4
Clinical Area ICD-9 ICD-10
Fractures 747 17099
Brain Injury 292 574
Anxiety Disorders 27 47
Mood Related
Disorders
75 71
Hypertensive
Disease
33 14
Source: Health Data Consulting
Impact not as large as anticipated
How is ICD Changing?
5ICD-10 Transition
Diagnosis Code Change Examples:
• ICD-9 one ICD-10 code
• ICD-9 many ICD-10 codes
…Source: https://www.aapc.com/icd-10/codes/
A few examples…
ICD-10 Transition 6
So what does this mean?
Same content will be in many places
Less than 5% of all ICD-9 and ICD-10 codes crosswalk 1:1
In some cases, a single ICD-9 code could be represented
by multiple ICD-10 codes or a cluster of ICD-10 codes may
be required to describe a single ICD-9 code
Some concepts will be lost when translating between ICD-
9 and ICD-10
• Substance Dependence concept has been removed from ICD-10
• Substance Use is now defined by specific substance
Overall, by using ICD-10, documentation will improve
7ICD-10 Transition
Relationship with DSM-5
Both DSM and ICD codes are used for diagnosis
• Per HIPAA, ICD must be used for billing purposes
DSM-5 utilizes ICD-9-CM and ICD-10-CM coding
depending on the date of service
Authorization requests require the provider to supply the
DSM-5 diagnosis using the correct ICD format depending
on the requested start date
• Prior to October 1, 2015: ICD-9 coding accepted
• Beginning October 1, 2015: ICD-10 codes REQUIRED
ICD-10-CM codes can be found in the DSM-5 manual.
8ICD-10 Transition
Are you Ready?
By now, you have most likely:
• Created a transition team or project manager
• Developed a conversion plan and communicated to staff
• Determined what the overall impact will be on your organization or
practice
• Determined documentation and record changes
• Spoke with your payers, billing and IT staff
• Reached out to trading partners about testing
• Began testing as soon as possible
9
It’s not too late!
Planning assistance is available
through CMS here:
http://www.cms.gov/Medicare/
Coding/ICD10/ProviderResources.
html
ICD-10 Transition
Resources: ICD-10 Spotlight
Conversions – A Hot Topic:
• ValueOptions will use the CMS ICD-10 GEMs/crosswalks as the
standard for mapping ICD-9 to ICD-10. Additional information can
be located on the CMS website:
https://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-PCS-
and-GEMs.html.
CMS ICD-10 Code Lookup
Coding Conversion Tool
For more information, including webinar slide decks,
recordings, our FAQ and additional CMS resources, refer
to our ICD-10 Spotlight Page
Basic PowerPoint Template 10
Time for Dialogue
At this time, we encourage you
to ask questions you have related
to the ICD-10 transition
Please enter questions via the
GoTo Question Box located in the
dropdown on your screen
If prompted, you may unmute your
phone line by pressing *6
• To minimize background noise,
please use your mute button or
press *6 to remain on mute if
you are not speaking
ICD-10 Transition 11
Contact Us
Testing and Technical Questions
EDI Help Desk
Monday through Friday
8 a.m. to 6 p.m. ET
Phone: 888.247.9311
Email:
ICD-10 Transition 12
General Provider Questions
Provider Services Line
Monday through Friday
8 a.m. to 8 p.m. ET
Phone: 800.397.1630
Thank you
13ICD-10 Transition
To help us continue to offer quality training opportunities,
please consider completing the survey when prompted to offer
feedback for today’s session