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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 for nursing and allied health professionals returning to practice.

    An extensive online course designed to teach human anatomy and physiology by specialty. The course also can be used as a re-fresher for nursing and allied health professionals returning to practice.

    This course is designed to help providers identify critical documen-tation requirements based on settings and the type of service provided. Standardized terminol-ogy is presented, e.g. ICD-10-PCS terms. Activities such as correcting entries, identifying present on ad-mission conditions, differentiating between observation and inpa-tient admission, and documenting medical necessity are covered. The focus is on documentation, not coding or reimbursement.

    This course is designed for CDI specialists, HIM professionals, Qual-ity Improvement and Compliance staff responsible for overseeing coding, documentation improve-ment and compliance functions. This course helps learners identify regulatory requirements surround-ing documentation. Highlighted are efforts associated with docu-menting quality measures, seeking clarification through a physician query process, meeting Joint Commission and COP completion standards, and review of documen-tation requirements for evaluation and management services.

    26 lessons (7 systems) each specialty approx 2 hours to complete

    26 lessons each lesson ap-prox hour to complete

    9 hours to complete course

    4 hours to complete course

    Curriculum/Course Need Met by Content Estimated Time

  • Part 1: Content and descriptions (continued)

    EduCode Clinical Documentation Improvement: Documentation Topics for CDI and Coding Specialists

    EduCode ICD-10 Essentials: ICD-10-CM Diagnosis Coding Fundamentals

    EduCode ICD-10 Essentials: ICD-10-PCS Procedure Coding Fundamentals

    This course highlights highly visible, difficult to document, highly scrutinized, high-cost, high-volume conditions that pose documentation challenges to the practitioner and coder. This con-tent will help learners understand the clinical presentation, treatment and associated terminology for conditions, while comparing and reconciling clinical terminology with classification terminology. Documentation for conditions impacted most by ICD-10 and national audits are included.

    The ICD-10-CM Diagnosis Coding Fundamentals course is comprised of 21 lessons that provide an overview of ICD-10-CM diagnosis coding including the philosophy and functionality of the system. This course is designed to teach differences and similarities between ICD-9-CM and ICD-10-CM involving characteristics, conven-tions, structure, format, and core knowledge needed for coding with ICD-10. These lessons explain the application of ICD-10-CM codes for patients seen in the hospital as well as in physician offices and other outpatient settings. The les-sons are organized by body system as seen in the code book itself.

    The ICD-10-PCS Procedural Coding Fundamentals course consists of 5 lessons that provide an overview of the structure, characteristics and application of medical, surgical and ancillary services. Learners will gain an understanding of the (draft) ICD-10-PCS coding guide-lines as well. This content takes a first look at comparing the differ-ent coding systems and highlights major changes that learners will need to understand.

    16 lessons, each about 1 hour long

    Approximately 20 hours to complete course

    Approximately 3 hours to complete course

    Curriculum/Course Need Met by Content Estimated Time

  • Part 1: Content and descriptions (continued)

    EduCode Coding: Introduction to ICD-10-CM Diagnosis Coding for Inpatients

    EduCode Coding: Introduction to ICD-10-PCS Procedure Coding for Inpatients

    EduCode Coding: Introduction to ICD-10-CM Diagnosis Coding for Outpatients

    EduCode Coding: ICD-10-CM/PCS Specialty Overview*

    This introductory course offers basic education on using the ICD-10-CM diagnosis coding sys-tem. This is the first step in actu-ally learning how to apply coding system guidelines and conven-tions to assign diagnosis codes for inpatients, following the direction of ICD-10-CM Official Guidelines for Coding and Reporting.

    This introductory course offers basic education on using the ICD-10-PCS inpatient procedure coding system. This is the first step in actually learning how to apply procedure codes for inpatients using standard terminology, fol-lowing the direction of ICD-10-PCS Coding Guidelines from CMS. Les-sons emphasize root operations.

    This introductory course offers basic education on using the ICD-10-CM diagnosis coding system. This is the first step in actually learning how to apply diagnosis codes for outpatients, following the direction of ICD-10-CM Official Diagnosis Coding and Reporting Guidelines for Outpatient Services.

    This content is designed to provide an overview of specialty-specific coding information. Each specialty includes one lesson on specialty-specific diagnosis coding with emphasis on fundamental health science knowledge pertinent to the specialty, and one lesson specific to procedure coding, emphasizing common root opera-tions and character selection for the specialty, where appropriate.

    Approximately 14 hours to complete Course

    19 lessons, approximately 1 hour per lesson

    Approximately 15 hours to complete course

    17 specialties, approximately 2 hours per specialty

    Curriculum/Course Need Met by Content Estimated Time

  • Part 1: Content and descriptions (continued)

    EduCode Coding: ICD-10-CM/PCS Specialty Detail*

    EduCode Reimbursement Essentials

    *draft titles

    This content provides topic-specific detailed ICD-10-CM/PCS coding education within each specialty. Complex, high-volume or high-cost diagnoses and procedures are covered within these lessons.

    This content offers education on the fundamentals of reimbursement systems for inpatient and outpatient services. This detailed education defines the OPPS and IPPS payment systems and associated edits and challenges within each system. Also included are courses on the hospital HAC and HQI programs that affect reimbursement, along with lessons on the various CMS auditing (RAC and CERTS) and medical review programs. The Revenue Cycle is present-ed in an easy to understand format within the Revenue Cycle Orientation Course for those who are unfamiliar with the Revenue Cycle.

    Average of 6 hours per spe-cialty

    Approximately 30 hours for the course (can be divided by area of job responsibility)

    Curriculum/Course Need Met by Content Estimated Time

  • Recommended education from Elsevier

    Part 2: Recommended education by type of learner

    3.2

  • Part 2: Recommended education by type of learner

    Every occupation in the hospital requires different training in preparation for the ICD-10 implementation.

    For example an experienced inpatient cardiology coder:

    2011 > ICD-10 Essentials 6 hours

    > Medical Terminology Plus (7 lessons) 2 hours

    > Mosbys Pathophysiology (8 general & 3 specialty lessons) 5.5 hours

    > EduCode Clinical Documentation Improvement (8 lessons) 8 hours

    2012 > Introduction to ICD-10-CM Diagnosis Coding for Inpatients 14 hours

    > Introduction to ICD-10-CM Procedure Coding for Inpatients 18 hours

    2013 > ICD-10-CM Specialty Overview 2 hours

    > ICD-10-CM Specialty Detail 15 hours

  • Part 2: Recommended education by type of learner

    The following chart breaks down the types of users, with recommended coursework and timing.

    Health Information Management Experienced Coder

    ICD-10 Readiness Assessment

    GEMS (to help with data conversion and reporting)

    ICD-10 Essentials

    Mosbys Medical Terminology Plus

    Mosbys Anatomy & Physiology for Health Professions

    Mosbys Pathophysiology for Health Professionals

    Introduction to ICD-10-CM Diagnosis Coding for Inpatients

    Introduction to ICD-10-PCS Procedure Coding for Inpatients

    Introduction to ICD-10-CM Diagnosis Coding for Outpatients (some duplica-tion between inpatient and outpatient)

    EduCode Clinical Documentation Improvement: Standards and Guidelines

    EduCode Clinical Documentation Improvement: Specialty Classification and Clinical Terminologies

    EduCode Coding: ICD-10-CM/PCS Specialty Overview

    EduCode Coding: ICD-10-CM/PCS Specialty Detail

    2011

    2011-2012

    2011

    2011-2012

    2011-2012

    2011-2012

    2012 (Trainers may take in 2011)

    2012 (Trainers may take in 2011)

    2012 - 2013

    2012-2013

    2011-2013

    2013 (trainers may start in 2012)

    2013 (trainers may start in 2012)

    1 - 2

    4 hours

    23 hours (may select specialty)

    15 min/lesson

    2 hours per specialty

    13 hours

    14 hours

    19 hours

    15 hours

    4 hours

    14 hours (may be taken by specialty or condition)

    2 hours per specialty

    6 hours per specialty

    Date for Estimated

    Type of User Content Education Contact Hours

  • Part 2: Recommended education by type of learner (continued)

    The following chart breaks down the types of users, with recommended coursework and timing.

    Health Information Management Novice or outpatient coder

    ICD-10 Readiness Assessment

    Mosbys Basic Medical Terminology

    Mosbys Medical Terminology Plus

    Mosbys Anatomy & Physiology for Health Professions

    Mosbys Pathophysiology for Health Professionals

    ICD-10 Essentials

    EduCode Clinical Documentation Improvement: Standards and Guidelines

    EduCode Clinical Documentation Improvement: Specialty Classification and Clinical Terminologies (if applicable to job function)

    Introduction to ICD-10-CM Diagnosis Coding for Outpatients

    Introduction to ICD-10-CM Diagnosis Coding for Inpatients (if applicable to job function some duplication with outpatient introduction course)

    Introduction to ICD-10-PCS Procedure Coding for Inpatients (if applicable to job function)

    EduCode Coding: ICD-10-CM/PCS Specialty Overview (if applicable to job function)

    EduCode Coding: ICD-10-CM/PCS Specialty Detail (if applicable to job function)

    2011

    2011

    2011

    2011-2012

    2011-2012

    2011

    2012

    2012

    2012-2013

    2012-2013

    2012-2013

    2013

    2013

    1 - 2

    8 hours

    2 hours per specialty

    2 hours per specialty

    13 hours

    23 hours (may select specialty)

    4 hours

    14 hours (may be taken by specialty or condition)

    15 hours

    14 hours

    19 hours

    2 hours per specialty

    6 hours per specialty

    Date for Estimated

    Type of User Content Education Contact Hours

  • Part 2: Recommended education by type of learner (continued)

    The following chart breaks down the types of users, with recommended coursework and timing.

    Clinical Documentation Improvement Specialist

    ICD-10 Readiness Assessment

    EduCode Reimbursement Essentials, Revenue Cycle Orientation course

    EduCode Coding: MS-DRG Fundamentals and MS-DRG Training

    ICD-10 Essentials

    Mosbys Medical Terminology Plus (if refresher needed)

    Mosbys Anatomy & Physiology for Health Professions

    Mosbys Pathophysiology for Health Professionals

    Introduction to ICD-10-CM Diagnosis Coding for Inpatients

    Introduction to ICD-10-PCS Procedure Coding for Inpatients

    EduCode Clinical Documentation Improvement: Specialty Classification and Clinical Terminologies

    EduCode Clinical Documentation Improvement: Standards and Guidelines

    EduCode Clinical Documentation: Documentation for Clinicians

    EduCode Coding: ICD-10-CM/PCS Specialty Overview*

    2011

    2011

    2011

    2011

    2011-2012

    2011-2012

    2011-2012

    2012 (Trainers may take in 2011)

    2012 (Trainers may take in 2011)

    2011-2013

    2011-2012

    2012

    2013 (trainers may start in 2012)

    1 - 2

    6 hours

    21 hours (may be split by specialty)

    23 hours (may select specialty)

    2 hours per specialty

    2 hours per specialty

    13 hours

    14 hours

    19 hours

    14 hours (may be taken by specialty or condition)

    4 hours

    9 hours

    2 hours per specialty

    Date for Estimated

    Type of User Content Education Contact Hours

  • Part 2: Recommended education by type of learner (continued)

    The following chart breaks down the types of users, with recommended coursework and timing.

    Clinical Documentation Improvement Specialist

    Physicians/clinicians/nursing

    Health Information Technology

    Finance & Revenue Cycle Analysts

    EduCode Coding: ICD-10-CM/PCS Specialty Detail*

    EduCode Clinical Documentation: Documentation for Clinicians

    EduCode Clinical Documentation Improvement: Specialty Classification and Clinical Terminologies

    EduCode Clinical Documentation Improvement: Standards and Guidelines (E/M, completion standards, physician query)

    General Equivalence Mappings (GEMS)

    ICD-10 Essentials: Comparison of ICD-9-CM to ICD-10-CM

    ICD-10 Essentials and introduction courses (Dependent on level of analysis generate & compare data will require more coding knowledge: involvement in mapping strategies will require coding knowledge, possibly by specialty)

    General Equivalence Mappings (GEMS)

    2013 (trainers may start in 2012)

    2011-2012

    2011-2013

    2011-2012

    2011

    2011

    2012-2013 (depends on when paral-lel reporting begins)

    6 hours per specialty

    9 hours - 1 hour/lesson (lessons appropriate for type or site of practice)

    1 hour/lesson (by specialty or condition)

    3 hours

    4 hours

    1 hour

    4 hours

    Date for Estimated

    Type of User Content Education Contact Hours

  • Part 2: Recommended education by type of learner (continued)

    The following chart breaks down the types of users, with recommended coursework and timing.

    Finance & Revenue Cycle Analysts

    Contracting rewriting coverage policies or forecasting

    Administrative support in clinical departments

    EduCode Reimbursement Essentials (job function specific, e.g. inpatient (IPPS)

    General Equivalence Mappings (GEMS)

    EduCode Reimbursement Essentials (IPPS inpatient payment system)

    Medical Terminology (specialty specific)

    Anatomy & Physiology (specialty specific)

    Pathophysiology (specialty-specific)

    Introduction to ICD-10-CM for inpatients

    Introduction to ICD-10-CM for outpatients (some overlap with intro to inpatient)

    Introduction to ICD-10-PCS for inpatients

    ICD-10-CM/PCS Specialty-specific lessons

    Medical Terminology (specialty specific)

    Anatomy & Physiology (specialty specific)

    Pathophysiology (specialty-specific)

    Introduction to ICD-10-CM for inpatients

    Introduction to ICD-10-CM for outpatients (some overlap with intro to inpatient)

    2013

    2011-2012

    2012-2013

    2012

    2012

    2012

    2012-2013

    2012-2013

    2012-2013

    2012-2013

    2012

    2012

    2012

    2012-2013

    2012-2013

    Approx 1 hour/lesson

    4 hours

    9 hours

    15 min/lesson

    30 min/lesson

    30 min/lesson

    14 hours

    1 hour/lesson

    1 hour/lesson

    15 min/lesson

    30 min/lesson

    30 min/lesson

    14 hours

    Date for Estimated

    Type of User Content Education Contact Hours

  • Part 2: Recommended education by type of learner (continued)

    The following chart breaks down the types of users, with recommended coursework and timing.

    Administrative support in clinical departments

    Quality Management

    Health Data Professionals

    ICD-10-CM Specialty-specific lessons

    Anatomy & Physiology (specialty specific)

    Pathophysiology (specialty-specific)

    EduCode Documentation Improvement (specialty-specific)

    EduCode Reimbursement Essentials (Quality Programs Affecting Reimbursement)

    EduCode Coding: MS-DRG Fundamentals and MS-DRG Training

    Introduction to ICD-10-CM for inpatients

    Introduction to ICD-10-PCS for inpatients

    ICD-10-CM/PCS Specialty-specific lessons

    General Equivalence Mappings (GEMS)

    ICD-10 Essentials

    Mosbys Medical Terminology Plus

    Mosbys Anatomy & Physiology for Health Professions

    Mosbys Pathophysiology for Health Professionals

    2012-2013

    2011

    2011

    2011

    2011-2012

    2011

    2012-2013

    2012-2013

    2012-2013

    2011

    2011

    2011-2012

    2011-2012

    2011-2012

    1 hour/lesson

    30 min/lesson

    30 min/lesson

    1 hour/lesson up to 18 hours

    4 hours

    21 hours (may be split by specialty)

    14 hours

    1 hour/lesson

    1 hour/lesson

    4 hours

    23 hours

    15 min/lesson

    2 hours per specialty

    13 hours

    Date for Estimated

    Type of User Content Education Contact Hours

  • Part 2: Recommended education by type of learner (continued)

    The following chart breaks down the types of users, with recommended coursework and timing.

    Health Data Professionals

    Utilization Review and Case Management

    Researchers

    Revenue Cycle Managers

    Introduction to ICD-10-CM Diagnosis Coding for Inpatients

    Introduction to ICD-10-PCS Procedure Coding for Inpatients

    Introduction to ICD-10-CM Diagnosis Coding for Outpatients (some duplica-tion between inpatient and outpatient)

    EduCode Clinical Documentation Improvement: Specialty Classification and Clinical Terminologies

    EduCode Coding: ICD-10-CM/PCS Specialty Overview

    EduCode Coding: ICD-10-CM/PCS Specialty Detail

    EduCode Reimbursement Essentials, Revenue Cycle Orientation course

    EduCode Clinical Documentation Improvement: Specialty Classification and Clinical Terminologies

    EduCode Coding: MS-DRG Fundamentals and MS-DRG Training

    Same as clinicians, unless coding is involved, then Same as Coder

    Same as finance and revenue cycle analysts

    2012

    2012

    2012 - 2013

    2011-2013

    2013 (trainers may start in 2012)

    2013 (trainers may start in 2012)

    2011

    2011-2013

    2011

    14 hours

    19 hours

    15 hours

    14 hours (may be taken by specialty or condition)

    2 hours per specialty

    6 hours per specialty

    6 hours

    14 hours (may be taken by specialty or condition)

    21 hours (may be split by specialty)

    Date for Estimated

    Type of User Content Education Contact Hours

  • Part 2: Recommended education by type of learner (continued)

    The following chart breaks down the types of users, with recommended coursework and timing.

    Auditors and Compliance Staff

    Patient Financial Services and Billing

    Dependent on auditing responsibility, same as coders Also include EduCode Reimbursement Essentials: Audits & Reviews, Quality Programs Affecting Reimbursement; and Revenue Cycle Orientation

    Mosbys Basic Medical Terminology

    Mosbys Medical Terminology Plus

    Mosbys Anatomy and Physiology

    Introduction to ICD-10-CM for Inpatients/Outpatients (based on job function)

    Introduction to ICD-10-PCS for Inpatients (based on job function)

    ICD-10-CM Specialty Overview

    EduCode Reimbursement Essentials (job function specific, e.g. inpatient (IPPS)

    2011-2012

    2011

    2011

    2011

    2012-2013

    2012-2013

    2013

    2013

    15 hours

    8 hours

    15 min/lesson (may split by specialty)

    26 lessons -30 min/lesson (may split by specialty)

    14 hours

    19 hours (split by specialty)

    1 hour/lesson

    Approx 1 hour/lesson

    Date for Estimated

    Type of User Content Education Contact Hours

  • Recommended education from Elsevier

    Part 3: Recommended education timeline based on need

    3.3

  • Part 3: Recommended education timeline based on need

    Identify gaps in knowledge to know where education is necessary

    Basic understanding of the coding system to interpret or understand requests to modify or enhance systems

    Enhance fundamental knowledge to prepare for ICD-10 coding knowledge of

    Enhance fundamental knowledge to prepare for ICD-10 coding primary responsibility coding, trainers, and documentation improvement and quality reporting

    Abstracting and reporting of quality measures (ongoing through 2013)

    Improve clinical documentation

    Identify working DRG, utilization review and discharge planning

    Coders; Clinical Documentation Improvement Specialists

    HIT

    HIT; outpatient coders; billers; PFS;

    HIM/Coding; Clinical Documentation Improvement Specialists: Auditors and Compliance Staff; Quality Management staff

    Quality Management; Coders

    Clinicians; Clinical Documentation Improvement; Coding

    Case Management; nursing; Quality Management

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

    ICD-10 Essentials (course specific to job function)Reimbursement Essentials: Revenue Cycle Orientation

    Mosbys Basic Medical TerminologyMosbys Anatomy & Physiology for Health Professions (specific to specialty)

    Mosbys Anatomy & Physiology for Health Professions (specific to specialty)Mosbys Pathophysiology (specialty-specific)Clinical Documentation Improvement

    EduCode Reimbursement EssentialsClinical Documentation Improvement

    EduCode Clinical Documentation ImprovementEduCode Reimbursement Essentials : QPAR, Revenue Cycle Orientation

    EduCode Coding-MS DRG Fundamentals and MS-DRG Training; EduCode Clinical Documentation ImprovementEduCode Reimbursement Essentials

    Need

    Audience Curriculum/Course

    The following chart anticipates needs that may arise among various learners and provides suggestions for appropriate coursework.

  • Part 3: Recommended education timeline based on need (continued)

    Need Audience Curriculum/Course

    The following chart anticipates needs that may arise among various learners and provides suggestions for appropriate coursework.

    Understand clinical phrases enough to assign a basic code, identify medical necessity statements, respond to request for information, communicate with payers

    Data Base Conversion including parallel reporting capability

    Understand clinical phrases enough to assign a basic code, identify medical necessity statements, respond to request for information, communicate with payers

    Abstracting and reporting of quality measures (ongoing through 2013)

    Rewrite:

    coding and compliance policies and procedures;

    billing records/charge tickets (charge capture processes)

    continue fundamental education (by specialty) through 2012 and begin revisions of charge capture processes late 2012, early 2013 to accommodate parallel coding evaluation

    Patient Financial Services (e.g. admissions, registration, scheduling); billing staff;

    HIT; Analysts; HIM (those responsible for identifying needs of report users)

    Patient Financial Services (e.g. admissions, registration, scheduling); billing staff;

    Quality Management; Coders

    HIM/Coders; Contracting; compliance auditors; Data Quality; clinical department administrative support; coders

    Mosbys Basic Medical TerminologyMosbys A&P

    General Equivalence Mappings (GEMS)

    Mosbys Basic Medical TerminologyMosbys A&PEduCode ICD-10-CM Introductory courses

    EduCode Reimbursement EssentialsClinical Documentation Improvement

    Medical Terminology PlusMosbys A&PMosbys PathophysiologyICD-10-CM/PCS Introductory coursesClinical Documentation ImprovementEduCode specialty-specific courses

    *assign applicable specialty lessons

  • Part 3: Recommended education timeline based on need (continued)

    Need Audience Curriculum/Course

    The following chart anticipates needs that may arise among various learners and provides suggestions for appropriate coursework.

    Analytics (analyze coded data) e.g for reimbursement, profiling, modelling, outcomes, research

    Standardization of clinical documentation for clinicians (reconciling clinical terminology to classification terminology

    Enhance fundamental knowledge to prepare for ICD-10 coding knowledge of

    Enhance fundamental knowledge to prepare for ICD-10 coding primary responsibility coding, trainers, and documentation improvement and quality reporting

    Maintain high level of productivity and accuracy for inpatient coding abstract, code and report (minimize disruption of secondary data use such as payment, research, modeling, etc)

    Rewrite/modify payer contracts

    Parallel reporting and analytics (data users)

    Analysts; Revenue Cycle pro-fessionals;

    Clinicians; Coders; CDI; Quality Management

    HIT; outpatient coders; billers; PFS;

    HIM/Coding; Clinical Docu-mentation Improvement Specialists: Auditors and Com-pliance Staff; Quality Manage-ment staff

    Coders, CDI

    Contracting(anticipate coders and clinicians will be involved with the detail of this process and will have in-depth coding education)

    Finance and Revenue Cycle AnalystsResearchers

    General Equivalence Mappings (GEMS)

    Clinical Documentation Improvement

    Mosbys Basic Medical TerminologyMosbys Anatomy & Physiology for Health Professions (specific to specialty)

    Mosbys Anatomy & Physiology for Health Professions (specific to specialty)Mosbys Pathophysiology (specialty-specific)Clinical Documentation Improvement

    EduCode Specialty-Specific EducationClinical Documentation Improvement(Build on fundamental education from 2011 and 2012)

    EduCode ICD-10 Essentials SEE ALSO full line of coding educationEduCode Reimbursement Essentials : OPPS, IPPSGEMS

    General Equivalence Mappings (GEMS)**unique to user

  • Part 3: Recommended education timeline based on need (continued)

    Need Audience Curriculum/Course

    The following chart anticipates needs that may arise among various learners and provides suggestions for appropriate coursework.

    Learn how to assign codes for ancillary or outpatient settings

    Compile, edit & submit claims, and/or perform denial management, as needed

    Understand clinical phrases enough to assign a basic code, identify medical necessity statements, respond to request for information, communicate with payers

    Rewrite:

    coding and compliance policies and procedures;

    billing records/charge tickets (charge capture processes)

    continue fundamental education (by specialty) through 2012 and begin revisions of charge capture processes late 2012, early 2013 to accommodate parallel coding evaluation

    Outpatient Coders

    Patient Financial Services and Billing

    Patient Financial Services (e.g. admissions, registration, scheduling); billing staff;

    HIM/Coders; Contracting; compliance auditors; Data Quality; clinical department administrative support; coders

    Mosbys Anatomy & Physiology for Health ProfessionsEduCode ICD-10-CM Introduction to Outpatient CodingEduCode Coding: ICD-10-CM Specialty Overview

    Mosbys Pathophysiology for Health ProfessionalsEduCode ICD-10-CM/PCS introductory coursesEduCode Coding: ICD-10-CM/PCS Specialty Overview

    EduCode ICD-10-CM Introductory coursesICD-10 Specialty Overview(Build on fundamental education from 2011 and 2012)

    Medical Terminology PlusMosbys A&PMosbys PathophysiologyICD-10-CM/PCS Introductory coursesClinical Documentation ImprovementEduCode specialty-specific courses

    *assign applicable specialty lessons

  • Contact Elsevier at (866) 429-3067 or visit our website at ICD-10online.com

    Elsevier is committed to helping ease

    the burden of ICD-10 implementation

    with eLearning tools to guide you and

    your staff through the transition process.

    As a proven leader in supporting and

    educating coders for more than 20 years,

    Elsevier has provided guidance through

    a myriad of coding changes in the past

    and has the experience necessary to support

    your organization into the ICD-10 era.

    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.


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