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  • A Guide to Education and Training for ICD-10 Implementation

  • Chapter One: Phases of implementation

    Chapter Two: Timelines for implementation

    Chapter Three: Recommended education from Elsevier

    Part One: Content and descriptions

    Part Two: Recommended education by type of learner

    Part Three: Recommended education timeline based on need

    Table of Contents

  • With the 2013 implementation date for ICD-10 drawing closer, all healthcare organizations are facing new challenges. How you prepare for these challenges will dramatically impact the ease and success of your transition.

    There are many benefits to the adoption of ICD-10 in the United States, including improvements in patient outcomes and quality measures reporting; revenue cycle analytics and associated reimbursement; better data for research; and consistency with international coding systems.

    But improvements require change and change leads to uncertainty. And uncertainty only adds to the burden of preparing for future requirements while maintaining current workflow.

    There are solutions, however.

    Elsevier has developed a phased, comprehensive ICD-10 transition plan that will position your organization for a smooth implementation allowing you to reap the benefits of ICD-10, while minimizing the pain.

    Introduction

    Copyright 2011 Elsevier, Inc. All rights reserved. Details provided in this document are for information purposes only and, unless specifically agreed to the contrary by Elsevier in writing, are not part of any order or contract.

  • Chapter One: Phases of implementation1

  • PHASE ONE Impact Assessment (Evaluation) Obtain executive sponsorship Assemble an implementation team Identify stakeholders and their unique needs Perform GAP analysis of staff and systems - workflow analysis - data flow analysis - workforce analysis Assess clinician and code set user knowledge Budget for resource and system needs

    Elsevier solutions

    > ICD-10 Readiness Assessment

    > EduCode ICD-10 Essentials

    > ICD-10 Webinar Series

    > ICD-10 White Papers

    PHASE TWO Identify Challenges and Planning Solutions (Planning) Budget and plan for stakeholder education Develop communication plans Define coding education plans Provide fundamental education of coding and CDI professionals Offer introductory ICD-10 courses for trainers Implement information systems changes Assess documentation practices and begin documentation improvement efforts

    Elsevier solutions

    > EduCode Documentation Improvement curriculum

    > Mosbys Medical Terminology

    > Mosbys Human Body Essentials (Anatomy & Physiology, Pathophysiology)

    > GEMS and Introduction to ICD-10-CM/PCS Courses (2011 release date)

    > White Papers such as Two Years and Counting Where You Should Be in Your

    Transition Plan; General Equivalence Mappings (GEMS); A Guide to Preparatory

    ICD-10 Training with appendix.

    > 2011 Webinar Series

    Phases of implementation1Elsevier views the transition to ICD-10 as a longitudinal educational process. The phases identified below may OVERLAP and may be undertaken at different times by different departments/stakeholders based on unique needs.

  • PHASE THREE Go Live Preparation (Action)

    Coordinate educational needs with meaningful use, quality measures, patient outcomes, and clinical decision support requirements Finalization and testing of systems changes Intensive education Monitoring coding accuracy and reimbursement impact Assess payer readiness and model revenue impact - prepare for more appeals Implement comprehensive evaluation to understand quality measures Policy development, trending and projection analysis; change of billing records and templates

    Elsevier solutions

    > Introductory and specialty-specific ICD-10 content

    > General Equivalence Mappings (GEMS) Courses

    > EduCode Clinical Documentation Improvement

    > EduCode Reimbursement Essentials

    > Mosbys Medical Terminology

    > Mosbys Human Body Essentials (Anatomy & Physiology, Pathophysiology)

    > Continuation of webinar and white paper series

    PHASE FOUR Measurement and Milestones (Management) Set milestones for each action item and monitor for compliance Measure coding accuracy and productivity and effect on reimbursement, e.g. Case Mix Index, reimbursement, assignment of MS-DRGs with and without MCCs/CCs Perform parallel reporting and comparison of historical data Monitor documentation improvement and effects of data use, e.g. patient outcomes Continue coding education and documentation education

    Elsevier solutions

    > Competencies used to evaluate knowledge, skills, and ROI

    > ICD-10 Coding education with associated reporting

    > Clinical Documentation Improvement with associated reporting

    > EduCode Reimbursement Essentials with associated reporting

    > Webinar and white paper series

    1Phases of implementation

  • Chapter Two: Timelines for implementation2

  • Timelines for implementation

    As the 2013 implementation date for ICD-10 draws closer, healthcare organizations are facing new and numerous challenges. Not only must they prepare for one of the most impactful changes in healthcare in 30 years, but they must do so with minimal disruption to current operations, workflow and revenue. In addition, theres a lot at stake, as failure to adequately prepare could have serious data quality and economic consequences.

    Along the pathway of the ICD-10 transition, there are concerns that will arise and need to be addressed, including:

    Short-term concerns:

    awareness of ICD-10 and meaningful use requirements; response to external fraud and abuse audits, such as RAC, and gear-up for more intensive fraud audits; system migration to 5010 ; GAP analysis of staff competency

    Mid-term concerns:

    planning and implementation of ICD-10 training; ensuring EHRs meet phase I and phase II meaningful use criteria; correlation of ICD-10, quality measure reporting, meaningful use, and Value-Based initiatives; mapping of data from ICD-9-CM to ICD-10 (data base conversion); standardizing documentation and data for future Health Information Exchange

    Long-term concerns:

    confidence that all staff have sufficient education on ICD-10-CM/PCS; understanding the impact of ICD-10 on reimbursement; quality outcomes and how they drive the new model of consolidated healthcare; Health Information Exchange

    Important Dates: > January 1, 2011 begin testing 5010 with trading partners

    > October 1, 2011 ICD-9/10 code freeze last regular updates to ICD-9-CM and ICD-10-CM/PCS

    > January 1, 2012 full compliance with 5010

    > October 1, 2012 limited code updates for new technologies and diseases

    > October 1, 2013 limited code updates for new technologies and diseases

    > October 1, 2013 ICD-10-CM/PCS is effective

    > October 1, 2014 regular updates to ICD-10-CM/PCS begin

    2

  • Chapter Three: Recommended education from Elsevier3

  • Recommended education from Elsevier 3

    To help your organization address the wide range of challenges it may face during the transition to ICD-10, Elsevier has created comprehensive solutions to meet your specific education needs.

    On average, it takes one hour to complete each Elsevier lesson. This includes reading all screens and sub screens of content, completing interactive knowledge checks, viewing slide shows or animations and completing lesson post tests. Continuing education credit is applicable to all content that promotes learning, including knowledge checks that provide rationale, but excluding tests.

    Recommendations within this document are meant as a guide only, recognizing that organizations will modify their educational plans to meet their individual requirements. Education is evolving and some titles of content are considered draft.

  • 3.1

    Part 1: Content and descriptions

    ICD-10 Readiness Assessment and white paper with appendix A Guide to ICD-10 Preparatory Training

    General Equivalence Mapping (GEMS)

    Mosbys Basic Medical Terminology

    Medical Terminology Plus

    Tools to aid with GAP analysis of fundamental knowledge needs for ICD-10

    Provides an overview of General Equivalence Map-pings and Reimbursement Mappings. Explains how to interpret the data, the dos and donts of using GEMS, and helps the learner to develop their own applied mappings.

    The Basic Medical Terminology course allows learners to develop an understanding of basic medical word structure and medical abbreviations. Audio teaches learners how to correctly pronounce terms.

    Medical Terminology Plus enhances information pro-vided in the basic med term course plus provides in-depth training for specific body systems.

    1 -2 hours

    4 hours to complete course

    8 hours to complete course

    95 lessons 15 min/lesson

    Curriculum/Course Need Met by Content Estimated Time

    Recommended education from Elsevier

  • Part 1: Content and descriptions (continued)

    Mosbys Anatomy & Physiology for Health Professions

    Mosbys Pathophysiology for Health Professionals

    EduCode Clinical Documentation Improvement: Documentation for Clinicians*

    EduCode Clinical Documentation Improvement: Standards and Guidelines

    An extensive online course de-signed to teach human anatomy and physiology by specialty. The course also can be used as a re-fresher