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ICD-10 Working Session Building Awareness and Tools/Resources Karen Navarro

ICD-10 Working Session Building Awareness and Tools/Resources Karen Navarro Claudia Yoakum-Watson April 16, 2010. ICD-10 Working Session Building Awareness and Tools/Resources. Overview Structure and Use Actions and Timeline Tools and Resource. #1 Overview of ICD. Who uses ICD-10?.

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ICD-10 Working Session Building Awareness and Tools/Resources Karen Navarro

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  1. ICD-10 Working SessionBuilding Awareness and Tools/Resources Karen Navarro Claudia Yoakum-WatsonApril 16, 2010

  2. ICD-10 Working SessionBuilding Awareness and Tools/Resources • Overview • Structure and Use • Actions and Timeline • Tools and Resource

  3. #1 Overview of ICD Who uses ICD-10? What is ICD? When does ICD-10 happen? Where can I get information? Why are we moving to ICD-10?

  4. ICD-10 Working SessionBuilding Awareness and Tools/Resources 2. ICD Structure and Use 3. Actions and Timeline 4. Tools and Resource

  5. #2 ICD Structure & Use The patient is in the office for the first visit because of closed greenstick fracture of the right radial shaft. ICD-9 813.21 Fracture of radius and ulna; shaft, closed radius (alone) ICD-10 S52.311A Greenstick fracture of shaft of radius, right arm, initial encounter for closed fracture

  6. Diagnosis Code Structure

  7. Procedure Code Structure

  8. Mapping of 813.21 ICD-9 CM 813.21 can be mapped to ??? ICD-10 CM Codes.

  9. #3 Action Overview • ICD-10 Awareness • Budget Strategy • Business Assessment • Internal System assessment • External (Vendor) System assessment • Implementation • Education • Testing • Maintenance and Ongoing Support

  10. ICD-10 Awareness • Provide information on ICD usage and format • Identify why we need ICD-10 • Determine what needs to be done • Identify who needs to be involved • Discuss a time line for maximum benefit • Collect needed tools and resources

  11. Building Awareness • Outline benefits and challenges of ICD-10 • Identify where ICD is currently used • Identify how ICD-10 could be used

  12. Benefits and Challenges • Mandatory • Will cost – time and money • Learning something different • Documentation requirements • Improve business practices • Improve reporting • Reduce costs • Increase efficiency • Improve timely claim processing

  13. Education   • Coder • System users • Business users • Management • Physicians

  14. Actions Identify a timeline Establish a budget Develop a plan

  15. Timeline April 16, 2010 – October 1, 2013 • Years – 3.5 • Calendar months – 42.5 • Working weeks – 166 • Working days – 830

  16. Not Just Information Systems External Systems Business Function Internal Systems • Assessment • Implementation • Testing • Maintenance

  17. Interdisciplinary Team • Senior management • Medical staff • Financial management • Information systems • Reporting • Coding or HIM • Project manager

  18. Business Impact Assessment • Operational processes • Reports • Procedures • Charge Master or Super bills • Pre-authorizations • Coding changes

  19. Business Impact Assessment • Budget impact • Cash flow • Contract revisions • Fee schedule changes/revisions • Pay for performance initiatives • Productivity losses

  20. Internal System Impact Assessment • Electronic record • Decision support and reporting systems • Billing and Claim systems • Utilization management • Case mix systems • Accounting systems • Disease management systems • Provider profiling systems • Performance measurement systems • Medical necessity software

  21. External System Impact Assessment • Vendor Readiness • Vendor Timeline • Interfaces • Cost • System changes/upgrades • Testing

  22. Business Implementation • Work flow • Processes • Education • Update resources • Productivity variances

  23. Internal System Implementation • Data structure differences • Field structure • Programs • Maintain both ICD-9 and ICD-10 data • Implement and test systems changes.

  24. External System Implementation • Keep abreast of external readiness • Identify any issues • Evaluate and assign resolution

  25. Maintenance   • Business • Internal System • External System

  26. #4 Resources • HIPAA COW – http://www.hipaacow.org • AHIMA – http://www.ahima.org/icd10 • AAPC – http://www.aapc.com/ICD-10 • CMS – http://www.cms.gov/ICD10 • WHO – http://www.who.int/classifications/icd • CDC – http://www.cdc.gov/nchs/icd.htm • AMA – http://www.ama-assn.org

  27. Summary • ICD Structure and Use • Actions and Timeline • Tools and Resource • Discussion and Questions

  28. Discussion and Questions?

  29. Notes

  30. HIPAA COW – http://www.hipaacow.org • AHIMA – http://www.ahima.org/icd10 • CMS – http://www.cms.gov/ICD10 • WHO – http://www.who.int/classifications/icd • CDC – http://www.cdc.gov/nchs/icd.htm • AMA – http://www.ama-assn.org/ • Karen Navarro Claudia Yoakum-Watson, CPC KNavarro@uwhealth.orgcyoakumw@weatrust.com 608.662.0817 608.661.6727 ccrsconsulting@tds.net 608.289.4974

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