September 15 2015 A Publication from the Chief of Staff

The Federal Government through the Centers for Medicare and Medicaid Services (CMS) is driving the healthcare industry to upgrade diagnosis coding standards (ICD-10) by October 1 2015 Even though ICD-10-CM will replace the current ICD-9 codes CPT codes will not be impacted Please note there is an additional upgrade that will only impact the hospitalrsquos inpatient coding for procedures This expansion of codes is termed ICD-10-PCS and this will impact the hospital coding only ndash it will not affect the professional CPT procedure billing ICD-10-CM Diagnosis Code structurebull I-9 has approximately 14000 codes to I-10rsquos

approximately 68000 codesbull I-9 codes lack detail I-10 codes will be very specificbull 34250 (50 percent) of all ICD-10-CM codes are related

to the musculoskeletal systembull 17045 (25 percent) of all ICD-10-CM codes are related

to fracturesbull 10582 (62 percent) of fracture codes are to distinguish

lsquorightrsquo vs lsquoleftrsquo

ICD-10-PCS Procedure Code Structure (Inpatient Coding only)bull I-9 has approximately 4000 codes I-10 approximately

72000 available codesbull I-9 lacks description of methodology and approach

I-10 provides detailed descriptions of methodology and approach for procedures

bull I-9 lacks precision to define procedures I-10 precisely defines procedures with detail on body part approach any device used and qualifying information

bull ICD-10-PCS replaces ICD-9-CM Volume 3 (procedure codes) for facility reporting of inpatient cases

Top things you need to know that will affect your officebull The ICD-10-CM diagnosis code set is a full replacement

of the ICD-9-CM code set that will provide additional

specificity and granularity for diagnosis codesbull CPT codes will continue to be used for all outpatient

procedures and professional billingbull One ICD-9 code may be represented by multiple ICD-

10 codesbull Major expansions are coming in coding primary

care encounters external causes of injury mental disorders neoplasms and preventative health

bull Addition of new conditions since last revisionbull More space to accommodate expansionbull Addition of laterality (right left bilateral)bull Expansion of diabetes and injury codesbull New combination codesbull Greater specificity for current conditionsbull Inclusion of trimester in pregnancy codes

Resources and training availableSJO has many mapping tools such as specialty-specific ICD-9 to ICD-10 Crosswalk and General Equivalence Mapping tools (which assist in locating ICD-10 codes from current ICD-9 codes) E-Learning ICD-10 modules in HealthStream offer specialty specific education We encourage your office staff to also complete the modules (using provider log-in information) to prepare for ICD-10 Learn more at these websites1 wwwstjhsorgICD-10aspx2 wwwroadto10org3 wwwaapccomicd-10codes4 wwwfindacodecom5 wwwcmsgovMedicareCodingICD102015-ICD-10-CM-

and-GEMshtml

Contact Robert Vietri ICD-10 Provider Specialist at 210-379-7441 or robertvietristjoeorg for more information to request additional resources or to arrange an individualgroup educational session

October 1rsquos ICD-10 Whatrsquos changing why and what are the biggest changes

In an effort to fast track and streamline our process as well as reduce redundancy for physicians effective immediately any patient referred with an authorization for services to St Joseph Hospital Physical Rehabilitation Services will NOT require an additional prescription to be treated The therapist will fax a plan of care for physician signature after the evaluation and treatment plan is complete

SJO Physical Rehabilitation is a preferred provider for St Joseph Hospital Affiliated Physicians (SJHAP) and St Joseph Heritage Medical Group (SJHMG) Should you have any questions regarding therapy for orthopedic neurologic pulmonary balance pelvic floor oncology-related lymphedema swallowing or speech and hand diagnoses please call 714-771-8222

SJO Physical Rehabilitation Streamlines Authorization Process

The Gooding and Immell Families Celebration 2015 presented by Ron and Marsha Moeller benefitting St Joseph

Hospital will be held on Saturday October 17 at the Newport Beach Marriott Hotel amp Spa Co-Chairs Geoff and Valerie Fearns and Physician Champion Alejandro Ramirez MD invite you to be a sponsor or underwriter in supporting the Innovating for a Healthier Community comprehensive campaign Guests will enjoy dining experiences raffle drawings a KIA raffle silent and live auctions a raise the paddle opportunity and an evening with acclaimed TV late night show host admired stand-up comedian best-selling childrenrsquos book author much-in-demand corporate speaker lovable TV and voice-over artist pioneering car builder mechanic and philanthropist Jay Leno Itrsquos no wonder Jay Leno is widely characterized as ldquothe hardest working man in show businessrdquo The evening will also include the Spirit of St Joseph award presentation to Scot Berlinski Janice Ramsay- Gonzales and Ron and Marsha Moeller Seating is limited To ensure your attendance and support please contact the Foundation for information today at 714-347-7900 or refer to wwwsjoorgcelebration2015

Celebration 2015Clearing Patients of MRSA Labels Swab A simple nose swab improves patient care for patients who have had Methicillin-resistant Staphylococcus aureus (MRSA) You can clear appropriate patients of the MRSA label by per-forming this screening in your office or clinic to determine if they are negative carriers Upon hospital readmission isolation precautions will be taken for unscreened MRSA status patients until screening results become available Hospital policy for MRSA precautions states that any patient with a positive history of MRSA infection or colonization should be placed in contact precautions when re-admitted For isolation clearance the patient must be off all antibiotics for a minimum of 48 hours when the following cultures screening andor other cultures from positive sites are taken Discontinuation of isolation requires MRSA negative results on at least three consecutive sets of cultures taken 24 hours apart Patients who remain colonized with MRSA upon discharge are to be isolated for any subsequent SJO outpatient or inpatient visits Identifying MRSA is critical Thank you for help in prevent-ing transmission and enabling negative carriers to avoid hospi-tal isolation precautions

Condolences for a ColleagueWith heavy hearts we share condolences for surgeon Francis Lee MD whose son Justin was taken in a tragic accident this past August Thank you for your prayers and support for Dr Lee and his family during this very difficult time