Embed Size (px)
DESCRIPTION
With the vote to delay ICD-10 implementation to 2015, many in the industry are left to wonder whether to continue with plans to implement in 2014 or not. Our Open Line Friday call with panelists from Mayo Clinic, Secure EDI, Availity and more will explore the implications of the recent decision to delay the implementation of ICD-10, and to rethink YOUR options most effectively.
Citation preview
900-3571-0213
Open Line Friday: ICD-10 Edition
ICD-10 Delayed to 2015:
Now What?
A Discussion with our Program Panelists
April 18, 2014
9:30 a.m. – 10:30 a.m. EST
Dial Toll-Free: (800) 882-3610
Conference Passcode: 6829655#
900-4399-0414
Open Line Friday: ICD-10
Panelists
Deborah Stewart, MD Medical Director
Florida Blue
Gale Scott EDI Regulatory Compliance
Administrator Tampa General Hospital
Laurie Darst Revenue Cycle Regulatory Advisor
Mayo Clinic (MN)
Matthew Ketterman Director, Business Solutions
Availity®1
Joseph Gonzalez VP of Business Development
Secure EDI
Lee Ratliff Clinical Business Technology Consultant
Baptist Health South Florida
Mary Rita Hyland CPO and VP Regulatory Affairs
The SSI Group, Inc.
Diana Brijbag, CMM, CPC, CCP, CMSCS
Office Manager The Springs Family Medical Center
George Vancore Senior Manager, Delivery Systems
Mandates Florida Blue
1 Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit www.availity.com
2
Open Line Friday: ICD-10
ICD-10 Delayed to 2015. Now What?
Agenda
April 18, 2014
3
1. Objectives
2. Healthcare Industry Updates
3. Florida Blue Updates
4. Panel Discussion
5. Next Steps
General Objectives
1. Promote collaboration, communication and coordination between providers, payers
and electronic trading partners.
2. Expand your understanding of the current state of ICD-10, recent regulatory
decisions and industry perspectives.
3. Raise your awareness and understanding of the unique opportunities and challenges
that ICD-10 brings to the entire health care industry including providers, payers and
electronic trading partners.
4. Provide you with tools, techniques, best practices and helpful hints from your peers
that can be used as you continue (or begin) your ICD-10 journey.
**** Please remember that during the call all attendees will be placed on “mute”
except for any guest speakers and all panelists. If you have a question, please
email it to [email protected].
4
Open Line Friday: ICD-10
Today’s Program Objectives
1. Help you to gain an understanding of the implications of the
recent decision to delay the implementation of ICD-10.
2. Influence you to rethink your ICD-10 implementation options most effectively.
5
Open Line Friday: ICD-10
ICD-10 Delayed to 2015. Now What?
R57.9 Shock, Unspecified
• Neurogenic shock caused by extreme emotional
upset due to personal tragedy or disaster.
• Symptoms of shock include cold and sweaty skin,
weak but rapid pulse, irregular breathing, dry
mouth, dilated pupils and reduced urine flow.
6
Open Line Friday: ICD-10
ICD-10 Delayed to 2015. Now What?
Open Line Friday: ICD-10
Health Care Industry & Regulatory Update
April 1, 2014, President Obama signed into law Bill H.R. 4302. Section 212 of this bill states:
Sec. 212. DELAY IN TRANSITION FROM ICD-9 TO ICD-10 CODE SETS. The Secretary of
Health and Human Services may not, prior to October 1, 2015, adopt ICD-10 code sets as
the standard for code sets under section 1173(c) of the Social Security Act (42 U.S.C.
1320d-2(c)) and section 162.1002 of title 45, Code of Federal Regulations.
• Specifically, the ICD-10 content in the bill prohibits CMS from enforcing a mandate to
switch from ICD-9 to ICD-10 until Oct. 1, 2015.
• Small to mid-sized physician practices reported in numerous industry surveys as “slow to
adopt and act toward ICD-10 engagement” are will benefit from the 2015 delay as long as
they start preparing now.
• Many large institutions, practices, payers, technology companies and other stakeholders
who were on schedule for the 2013 implementation date find the delay as a significant
financial and resource disadvantage.
• CMS has yet to comment; they will solicit industry stakeholder feedback for consideration
as to how they respond to the delay; this could take from several weeks or months for any
general guidance for the industry.
7
Open Line Friday: ICD-10
Health Care Industry & Regulatory Update (continued)
• NUCC recently announced changes to the CMS 1500 professional paper claim form to
accommodate ICD-10 (www.nucc.org); the following is the recommended transition timeline:
• January 6, 2014: Payers begin receiving and processing paper claims submitted on the
revised 1500 Claim Form (version 02/12).
• January 6 through March 31, 2014: Dual use period during which payers continue to
receive and process paper claims submitted on the old 1500 Claim Form (version 08/05).
• April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500
Claim Form (version 02/12).
• Industry workgroups (I.e. WEDI) and health care industry trade associations (I.e. HBMA;
AHA; PAHCOM; HFMA; MGMA, etc.) were accelerating their ICD-10 constituent
outreach efforts just prior to the 2015 delay.
• CMS previously announced an ICD-9 and ICD-10 code set freeze which has been in
effect since October 1, 2013. Do these code sets require “unfreezing”?
• It appears that several organizations are leaning toward continuing their ICD-10 testing
efforts. Are you planning to?
8
Florida Blue Update:
• Open Line Friday ICD-10 Edition teleconferences will continue! For those who
may miss a live session, audio recordings will also remain available through the
Podcast link located at www.floridablue.com/icd-10.
• The ICD-10 Testing Edition of Open Line Friday that was scheduled to begin in
April will not launch as planned. This is being reconsidered as part of our ICD-10
re-planning efforts.
• Florida Blue’s ICD-10 initiative is proceeding on plan. We are finalizing our internal
Compliance Level 1 testing and are engaged in Compliance Level 2 testing with
providers and external entities.
• Florida Blue is deploying a full remediation strategy to implement ICD-10.
• ICD-10 Testing with Providers: We are continuing to engage providers in Phase I
and Phase II Testing. Phase III is in beta-test mode and will be generally available
in the late April/May timeframe. Details of our provider testing, including a self-
service option, are now available at www.floridablue.com/icd-10.
• Florida Blue’s ICD-10 Provider Toolkit will be maintained going forward and is
accessible from www.floridablue.com/icd-10. This tool is for you!
Open Line Friday: ICD-10
9
Sec. 212. DELAY IN TRANSITION FROM ICD-9 TO ICD-10 CODE SETS.
The Secretary of Health and Human Services may not, prior to October 1,
2015, adopt ICD-10 code sets as the standard for code sets under section
1173(c) of the Social Security Act (42 U.S.C. 1320d-2(c)) and section
162.1002 of title 45, Code of Federal Regulations.
Panel Questions:
1. Given what you have accomplished to-date in getting prepared for ICD-10
implementation on October 1, 2014, what does this delay mean to you?
2. What do you think this delay means to others across the health care industry?
3. Do you think this delay impacts future regulatory compliance initiatives?
10
Open Line Friday: ICD-10
ICD-10 Delayed to 2015. Now What?
As a direct result of the ICD-10 delay to October 1, 2015, health plans,
providers, clearinghouses and others across the health care industry are
evaluating several implementation options. As an example, two of these
options are “early adoption” and “re-planning for a October 1, 2015
implementation”.
Panel Questions:
1. What are some implementation options that your organization is currently
considering and why?
2. What specific challenges do you see with your implementation options?
11
Open Line Friday: ICD-10
ICD-10 Delayed to 2015. Now What?
.
Send general ICD-10 questions and comments to
12
Open Line Friday: ICD-10
ICD-10 Delayed to 2015. Now What?
2015?
13 13
Next Steps
Next Steps and Contact Information
Access our Open Line Friday podcasts at www.floridablue.com/icd-10
ICD-10 Open Line Friday email list: send us your email by contacting us at
Test ICD-10 with us. Visit www.floridablue.com/icd-10 and select our “Test ICD-10 icon”
for details. Testing questions? Email us at [email protected]
Access Florida Blue’s ICD-10 Provider Toolkit and more at www.floridablue.com/ICD-10
Visit the Availity Learning Center (www.availity.com/learningcenter) to access live and webinars
including information about Ready10 - a popular ICD-10 project management tool (see “There’s
Ready and There’s Ready10”).
Add/update your email address so we can keep you informed via email (Bluemail)
Add, update or delete your email and contact information at any time using Availity's secure website. Log
on to Availity at www.availity.com, select Payer Resources, Florida Blue and Update My Email
Information with Florida Blue then follow the prompts.
Open Line Friday: ICD-10
Follow us on Twitter @FLBlue 14
Addendum
ICD-10 Helpful Resources and Reference Material
• www.cms.gov/ICD10
• www.wedi.org
• www.ama-assn.org
• www.ahima.org/icd10
• www.availity.com
• www.fha.org
• www.hbma.com
• www.mgma.com
• www.floridablue.com/ICD-10
• www.fmaonline.org/HomePage.aspx
• www.cdc.gov/nchs/icd/icd10.htm
For regular CMS ICD-10 email updates, subscribe at:
https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_608
WEDI's Survey on Industry ICD-10 progress:
http://www.wedi.org/docs/comment-letters/2013-wedi-icd-10-survey-results-letter.pdf?sfvrsn=0
FREE CMS and WEDI ICD-10 End-to-End Testing Webinars available for download:
http://www.wedi.org/forms/meeting/MeetingFormPublic/view?id=220AC00000156
HIMSS/WEDI National ICD-10 Pilot Program Update:
http://www.himss.org/library/icd-10/national-pilot-program?navItemNumber=13477
Though not inclusive, the following list includes several public websites that can help increase general awareness
and understanding of the ICD-10 mandate and its impact to the health care industry:
The links below were referenced during this presentation. The actual URLs below are provided for your convenience:
15
Open Line Friday: ICD-10
