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ICD-10 Diagnosis Coding

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ICD-10 Diagnosis Coding. In use by majority of developed nations for years Goes into effect in 12 months (Oct. 1, 2014) Will require considerable adjustment in coding Need to start preparation & begin testing. ICD-10 Diagnosis Coding. ICD-10 better provides for improvements in … - PowerPoint PPT Presentation

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  • ICD-10 Diagnosis CodingIn use by majority of developed nations for yearsGoes into effect in 12 months (Oct. 1, 2014)Will require considerable adjustment in codingNeed to start preparation & begin testing

  • ICD-10 Diagnosis CodingICD-10 better provides for improvements inQuality Measurements healthcare successes on specific diagnosesPublic Health worldwide sharing of diagnostic dataResearch analysis using more precise diagnosesReimbursement refined pay for performanceCost containment lower insurance premiums

  • ICD-10 Diagnosis CodingICD-10 captures documentation that ICD-9 omits, such as:Initial vs. Subsequent Encounter vs. SequelaeAcute or Chronic ConditionRight or Left (1/3 of ICD-10 code descriptions are identical except for indicating laterality)Normal Healing, Delayed Healing

  • ICD-10 Diagnosis CodingCMS: No Clear Mapping Between ICD-9-CM and ICD-10-CM Code Sets. There are one-to-one correspondences, one-to-many, many-to-one, many-to-many, or no correspondence at all.

  • ICD-10 Diagnosis CodingCMS: GEMs (General Equivalency Mapping)The GEMs are to assist with converting large ICD-9 databases to ICD-10The GEMs are not a substitute for learning how to use ICD-10-CM Providers coding staff should assign individual codes from the ICD-10 code books

  • Senile CataractICD-9Source

  • ICD-10Senile Cataract

  • ICD-9SourceSenile Cataract

  • ICD-9ICD-10SourceSourcePseudoexfoliation of the lens w/o GLC does not exist in ICD-10Senile Cataract

  • ICD-10SourceSourcePseudoexfoliation of lens capsule convert 366.11 to ICD-10Senile CataractPseudoexfoliation of the lens w/o GLC does not exist in ICD-10

  • ICD-9Currently must file two lines of code for GLC patient

    365.52365.72Glaucoma

  • You only file one code, but you have to chose one of 20 codes

    ICD-10Glaucoma

  • ICD-10 Diagnosis CodingCMS: No Clear Mapping Between ICD-9-CM and ICD-10-CM Code Sets. There are one-to-one correspondences, one-to-many, many-to-one, many-to-many, or no correspondence at all.

  • ICD-10 Diagnosis CodingDoctors and staff will be faced with learning curveLearning curves slow down productionLearning on-the-fly will be disastrousOutline a plan, step by step, your practice intends to follow

  • ICD-10 Diagnosis CodingTo Help Staff Understand the Complexities of the Switch to ICD-10 Make a table of the top 20+ diagnoses currently used by your officeUsing ICD-10*, make a table of these same diagnoses, but with the ICD-10 coding

    * ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2014/

  • ICD-10 Diagnosis CodingEstablishing a transition plan All current use ICD-9 will be affected by the transition.Thus, identify everywhere that your practice uses ICD-9.Decide who needs training, what type of training they need, and when they need it.Schedule staff training on a regular basis for questions and feedback

  • ICD-10 Diagnosis CodingEstablishing a transition plan Share your plan with your EHR vendors and billing services.Set up time for software vendors to train your staff on computer system changes (whether using EHR or non-EHR software systems).Coordinate carefully with Billing Service and Clearinghouse vendors

  • ICD-10 Diagnosis CodingEstablish a training plan Anyone who will test ICD-10 systems before the transition will need training way in advanceOthers who use ICD codes can be trained 6 to 9 months before the October 1, 2014, transitionDoctors and staff should become well versed in the multiple changes in diagnosis coding

  • ICD-10 Diagnosis CodingOther suggestions from CMSCommunicate with your peers, especially those using the same software, clearinghouses, etc.Set aside a contingency fund for preparation costs and for possible unforeseen implementation hang-ups.

  • ICD-10 Diagnosis CodingIn Summary, Educate All PersonnelPrepare for ChangesCommunicate with VendorsTest