Preparing for ICD-10 Transition Teleconference Hosted by Community Health Association of Mountain/
Plains States (CHAMPS)
January 30, 2013, 12:00 PM – 1:00 PM MT
Presented by Gervean Williams, Director,Community Health Center Finance and Operations,
National Association of Community Health Centers (NACHC)
The NACHC Mission
To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved populations.
ICD – 10 Myths
• It’s not going to happen• My employees are responsible for the changes• It won’t require many operational changes• My software vendor is responsible for the changes• We have plenty of time• We are ready now
ICD-9 History
• World Health Organization
• National Center for Health Statistics Adopts ICD-9 in 1979
• ICD-9 is the International classification of diseases, 9th revision
Why Change to ICD-10
• ICD-9 is over 30 years old
• More specific and accurate capture of data
• Improved ability to measure health care services
• Alignment with WHO
TimelineDate Compliance Step
January 1, 2010
• Payers and providers should begin internal testing of Version 5010 standards for electronic claims
Implemented
December 31, 2010
• Internal testing of Version 5010 must be complete to achieve Level I Version 5010 compliance
Implemented
January 1, 2011
• Payers and providers should begin external testing of Version 5010 for electronic claims
• CMS begins accepting Version 5010 claims
• Version 4010 claims continue to be accepted
Implemented
December 31, 2011
• External testing of Version 5010 for electronic claims must be complete to achieve Level II Version 5010
complianceImplemented
January 1, 2012
• All electronic claims must use Version 5010
• Version 4010 claims are no longer acceptedImplemented
October 1, 2014
• Claims for services provided on or after this date must use ICD-10 codes for medical diagnosis and inpatient
procedures
• CPT codes will continue to be used for outpatient services
Pending
Potential Impact of 5010/ICD - 10
• Information Technology
• Finances
• Providers and Staff
IT Concerns
• Impact of transaction types
• IT Staff
• Electronic Medical Record(EMR)
• Practice Management Software (PMS)
Finances
• Budget considerations–Software and Hardware
–Upgrades
–Testing
–Training
• Will you be able to send claims electronically?
Budget Considerations
• Software and licensing• Hardware• Upgrades• Training• Updating forms• Testing
MGMA Budget Sample
Cost Breakdown 3 physician practice
Education 2,500
Process Analysis (Consultant/Additional Staff Hrs) 7,000
Changes to Super bills (Consultant/Reprinting) 3,000
IT Costs (Upgrades/New Technology) 7,500
Increased Documentation (Dictation/New Technology) 44,000
Cash flow Disruption (Lost Production) 20,000
Total 84,000
Provider and Staff Training
• Who –Providers, Clinical staff, Billing, and Finance
• When–Phase training
• How much– Varies depending on responsibilities
Planning Needs
• Assess your current systems
• Identify your internal and external teams
• Contact your IT and clearinghouse vendors
• Develop an implementation timeline
• Train, Test, Train, and Test
Key Steps
• Organize project team & resources for project completion• Conduct preliminary impact analysis (mission critical issues)• Create implementation timeline (need vs. nice to have)• Develop ICD-10 Implementation Budget (plan more, not less)• Analyze documentation needs (EMR, dictation, hand-written)• Develop communication plan (special news letter, staff meetings, special
sessions, etc.)• Develop training plan (targeted AND integrated training)• Complete information systems design & development• Conduct business process analysis (optimal not perfect)• Conduct needs assessment (Missed anything?)• Complete deployment of system changes (test, test, final)
Note: Based on AMA’s “Implementation of ICD-10…;” Chapter 4, page 45
Community Health Center Issues
• Billing–UB-04 and 1500
• Uniform Data System– Table 6
• Grant Writing• Registry
Resources
• ICD – 10 On Demand Webinar
http://
www.softconference.com/nachc/slist.asp?C=2761#TID17717
• AAFP
http://www.aafp.org/online/etc/medialib/aafp_org/documents/prac_mgt/codingresources/timeline.Par.0001.File.tmp/ICD10Timeline.pdf
• CMS Resources
http://
www.cms.gov/ICD10/02b_Latest_News.asp#TopOfPage
Misc….Medicare Changes
• CR 7038• PAL 2011-04• Enrollment Application Fee (855 form)• Revalidation
Acknowledgements
• CMS ICD-10 Planning• Priority Management Group, Inc. 2011
www.gopmg.com
Contact Information
http://www.nachc.com/complete-list-of-trainings.cfm
Gervean Williams
Director of Finance and Operations
NACHC
• Thank you for your participation!
• Please complete the online evaluation questionnaire. You will receive an email with a link to the evaluation. Your feedback is very valuable in helping CHAMPS develop future training programs.
• There is no continuing education credit available for this event.
• An archive of the event will be made available within one week of the live event on the CHAMPS website at http://www.champsonline.org/Events/DistanceLearning.html#archtele.
• Please contact Shannon Kolman at
[email protected] or 303-867-9583
with any questions.
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