Transcript
Page 1: Transition to ICD 10 CM Diagnostic Code Set June 2014

Transition to

ICD 10 CM Diagnostic Code Set

June 2014

Page 2: Transition to ICD 10 CM Diagnostic Code Set June 2014

Workshop Agenda - June 23rd 2014

•Highlights of the Previously Shared ICD10 CM Presentation–http://www.shafafiya.org/Dictionary/Workshops/20140320_IC

D_10_Presentation.pptx•Stakeholder Preparation for Transition•Phases: Transition to ICD 10 CM–http://www.shafafiya.org/Dictionary/Workshops.html •Establishing ICD 10 Transition Working Group.

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Workshop Agenda - June 23rd 2014

Providers and payers were invited to a 2 hour workshop – about 100 members cameHAAD presented the “Transition to ICD 10 Diagnostic Code Set presentation” and answered related questionsHAAD invited volunteers to represent payers and providers to create a working group to facilitate the transitionSupporting material for each of the transition phases is published on Shafafiya http://www.shafafiya.org/Dictionary/Workshops.htm

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Arial Stakeholders’ Transition WorkingGroup Representatives (pending contact emails*)

HAADLina Jichi (Chair)Michelea PeechMarwan Al NaboulsiMohammad Al HajLuis Perfetti

Providers Public Providers:

• Seha• Mubadala Health Care

Private Providers• Al Noor• Ahlia• NMC• Burjeel• Oasis• Advanced Cure Diag.

Ctr.• Western Region??

PayersPublic Payers:

• DamanPrivate Payers

• ADNICTPANAS

Vendors and others

• 3M• Accumed • Abu Dhabi

Police

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HighlightsIn the US as of 2014ICD-10-CM (Diagnosis)Will affect inpatient and outpatient

ICD-10-PCS ( Procedures)Will only affect inpatient in the U.S.NOT UAE -We have CPT for outpatient & inpatient reimbursement

ICD-10-CM/PCS:• Incorporates much greater

specificity and clinical information, which results in:

• Improved ability to measure health care services;

• Increased sensitivity when refining grouping and reimbursement methodologies;

• Enhanced ability to conduct public health surveillance; and

• Decreased need to include supporting documentation with claims;

• Includes updated medical terminology and classification of diseases;

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In the US as of 2014 All software will be ICD

10 based All certified coders will

be ICD 10 based All RVU’s will be ICD 10

based ICD 9 CM will no longer

be updated after 2012

HighlightsICD-10-CM• Provides codes to allow comparison of mortality and morbidity data; and• Provides better data for:

• Measuring care furnished to patients;

• Designing payment systems;• Processing claims;• Providers making clinical

decisions;• Tracking public health;• Identifying fraud and abuse;

and• Conducting research.

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Upgrade to ICD 10 CM

June 2014 DSP voted to retain 1st October, 2015 Deadline

EncouterStart date 1/10/2015 00:01

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Is it a big change? Comparison

ICD-9-CM

Mechanical complication of other vascular device,

implant and graft

1 code (996.1)

ICD-10-CMMechanical complication of other vascular grafts156 codes, includingT82.310 – Breakdown (mechanical) of aortic(bifurcation) graft (replacement)T82.311 – Breakdown (mechanical) of carotid arterialgraft (bypass)T82.312 – Breakdown (mechanical) of femoral arterialgraft (bypass)T82.318 – Breakdown (mechanical) of other vascular graftsT82.319 – Breakdown (mechanical) of unspecifiedvascular graftsT82.320 – Displacement of aortic (bifurcation) graft(replacement)T82.321 – Displacement of carotid arterial graft (bypass)T82.322 – Displacement of femoral arterial graft(bypass)T82.328 – Displacement of other vascular grafts

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Comparisons

X X X XX X XX X XX X

category etiology,anatomic site,manifestation

category etiology,anatomic site,

severity

extension

ICD-9 Code Format ICD-10 Code Format

ICD-9-CM 14,025

ICD-10-CM 68,069Diagnosis Codes

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Comparisons

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Tentative Timeline

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• Phase 1: Implementation plan development and potential impact assessments– Establish interdisciplinary steering committee to develop

ICD‐10 implementation strategy– Development of potential impact assessments– Implementation budget – Systems inventory – Identifying the impact from vendors and payer contracts– Vendors and Contracts

Make Your Plan to ICD 10 CM

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• Phase 2: Implementation preparation– Training/awareness on Codes and Code uses (data etc)

AND documentation– Education on the available GEM and how to use

• Phase 3: “Go live” preparation– Confirm with systems vendor(s)– Finalize all systems - testing of systems changes, and

provide intensive ICD‐10 education to coding staff.– Complete all in‐house systems changes and testing.– Claims on or after Deadline must use ICD‐10‐CM

Make Your Plan to ICD 10 CM

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ICD-9-CM to data coded under ICD-10-CM due to the differences in the code sets. This will impact reports that compile statistical data for trend analysisDownload GEM from CMS website

http://www.cms.gov/Medicare/Coding/ICD10/2014-ICD-10-CM-and-GEMs.html

Any Questions Please Contact• [email protected]

Make Your Plan to ICD 10 CM


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