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ICD-10 Working Session Building Awareness and Tools/Resources Karen Navarro Claudia Yoakum-Watson April 16, 2010. ICD-10 Working Session Building Awareness and Tools/Resources. Overview Structure and Use Actions and Timeline Tools and Resource. #1Overview of ICD. Who uses ICD-10?. - PowerPoint PPT Presentation
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ICD-10 Working SessionBuilding Awareness and Tools/Resources
Karen Navarro
Claudia Yoakum-WatsonApril 16, 2010
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ICD-10 Working SessionBuilding Awareness and Tools/Resources
1. Overview
2. Structure and Use
3. Actions and Timeline
4. Tools and Resource
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#1 Overview of ICD
What is ICD?
Why are we moving to ICD-10?
When does ICD-10 happen?
Where can I get information?
Who uses ICD-10?
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ICD-10 Working SessionBuilding Awareness and Tools/Resources
2. ICD Structure and Use
3. Actions and Timeline
4. Tools and Resource
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#2 ICD Structure & Use
The patient is in the office for the first visit because of closed greenstick fracture of the right radial shaft.
ICD-9813.21 Fracture of radius and ulna; shaft,
closed radius (alone)
ICD-10S52.311A Greenstick fracture of shaft of radius, right arm, initial encounter for closed fracture
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Diagnosis Code Structure
S52.311A Greenstick fracture of shaft of radius, right arm, initial encounter for closed fracture
Root Root Root Site Severity Etiology Extension
S 5 2 3 1 1 A
Injury, poisoning
and certain other
consequences of external
causes
Injuries to the elbow
and forearm
Fracture of
Forearm
Radial Shaft
Greenstick Right Initial Encounter
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Procedure Code Structure
OTF4ZZZ Lithotripsy
Section Body System
Root Procedure
Treatment Site
Approach Device Qualifier
O T F 4 Z Z Z
Medical Urinary Fragment-ation
Left Renal Pelvis
No Approach Noted
No Device Noted
No Qualifier Noted
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Mapping of 813.21
ICD-9 CM 813.21 can be mapped to
??? ICD-10 CM Codes.
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#3 Action Overview ICD-10 Awareness Budget Strategy Business Assessment Internal System assessment External (Vendor) System assessment Implementation Education Testing Maintenance and Ongoing Support
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ICD-10 Awareness
• Provide information on ICD usage and format• Identify why we need ICD-10• Determine what needs to be done• Identify who needs to be involved• Discuss a time line for maximum benefit• Collect needed tools and resources
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Building Awareness
Outline benefits and challenges of ICD-10 Identify where ICD is currently used Identify how ICD-10 could be used
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Benefits and Challenges Mandatory Will cost – time and money Learning something different Documentation requirements Improve business practices Improve reporting Reduce costs Increase efficiency Improve timely claim processing
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Education
Coder System users Business users Management Physicians
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Actions
Identify a timeline
Develop a plan
Establish a budget
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Timeline
April 16, 2010 – October 1, 2013
Years – 3.5 Calendar months – 42.5 Working weeks – 166 Working days – 830
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Not Just Information Systems
InternalSystems
External Systems
BusinessFunction
1. Assessment2. Implementation3. Testing4. Maintenance
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Interdisciplinary Team
Senior management Medical staff Financial management Information systems Reporting Coding or HIM Project manager
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Business Impact Assessment Operational processes Reports Procedures Charge Master or Super bills Pre-authorizations Coding changes
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Business Impact Assessment Budget impact Cash flow Contract revisions Fee schedule changes/revisions Pay for performance initiatives Productivity losses
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Internal System Impact Assessment
• Electronic record• Decision support and reporting systems • Billing and Claim systems • Utilization management • Case mix systems • Accounting systems • Disease management systems • Provider profiling systems • Performance measurement systems • Medical necessity software
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External System Impact Assessment
Vendor Readiness Vendor Timeline Interfaces Cost System changes/upgrades Testing
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Business Implementation
Work flow Processes Education Update resources Productivity variances
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Internal System Implementation
Data structure differences Field structure Programs Maintain both ICD-9 and ICD-10 data Implement and test systems changes.
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External System Implementation
Keep abreast of external readiness Identify any issues Evaluate and assign resolution
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Maintenance Business Internal System External System
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#4 Resources
HIPAA COW – http://www.hipaacow.org AHIMA – http://www.ahima.org/icd10 AAPC – http://www.aapc.com/ICD-10 CMS – http://www.cms.gov/ICD10 WHO – http://www.who.int/classifications/icd CDC – http://www.cdc.gov/nchs/icd.htm AMA – http://www.ama-assn.org
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Summary
• ICD Structure and Use
• Actions and Timeline
• Tools and Resource
• Discussion and Questions
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Discussion and Questions?
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Notes
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HIPAA COW – http://www.hipaacow.org
AHIMA – http://www.ahima.org/icd10
CMS – http://www.cms.gov/ICD10
WHO – http://www.who.int/classifications/icd
CDC – http://www.cdc.gov/nchs/icd.htm
AMA – http://www.ama-assn.org/
Karen Navarro Claudia Yoakum-Watson, CPC [email protected] [email protected] 608.662.0817
