WMU School of Medicine’s ICD-10 Implementation and Training Practicum

1. WMU School of Medicine’s ICD-10 Implementation and Training Practicum By: Heather Smith, BA, CPC, CPMA, CMOM, CAC AHIMA-Approved ICD-10-CM Trainer August 14, 2013

2. WMU School of Medicine Western Michigan University School of Medicine is a private nonprofit corporation that will welcome it’s first class in August 2014. The new medical school is a collaboration with Western Michigan University and Kalamazoo’s two teaching hospitals, Borgess Health and Bronson Healthcare. The strength of our partners brings more than 40 years of experience in undergraduate and graduate medical education. Western Michigan University School of Medicine. (2013).

3. WMU School of Medicine Previously affiliated with Michigan State University Kalamazoo Center for Medical Studies, our partners, Borgess Health and Bronson Healthcare bring to WMU School of Medicine a history of excellence in education, health care, research and life science exploration. The dream of a medical school in Kalamazoo, Michigan became reality when an anonymous donation of 1.8 million was made in November, 2009. Western Michigan University School of Medicine. (2013).

4. WMU School of Medicine How is WMU School of Medicine Supported? The school is funded through: Private Gifts Clinical Revenue Research Activity Student Tuition Endowment Income

5. WMU School of Medicine Mission To advance the health of humanity through excellence in medical education, clinical care, research, and service. These pursuits are interdependent and together assure optimal care for today and hope for tomorrow. Vision The medical school is distinguished as learner centered, discovery driven, globally engaged, and patient and family focused. Values Compassionate Service Effectively meeting the health needs of our patients and participating in a community-wide effort to meet the health needs of the community.  Commitment to Excellence Pursuing the highest level of performance through evidence-informed medical practice quality standards.   Diversity Understanding, respecting and accepting our culture and the culture of others.   Leadership Inspiring each other through a commitment to accountability, courage, open communication and trust.   Lifelong Learning Promoting continued personal and professional development for all.   Teamwork Attaining the organization's goals by working effectively together. Western Michigan University School of Medicine. (2013).

6. Holly Ramsdell, MPA, CMPE Site Supervisor • Job Title: Director of Clinical Business Services • Background: Holly started with Michigan State University Kalamazoo Center for Medical Studies in 1988 as their Manager of Physician Billing. In 1996, she became the Clinics Administrator and continues her employment today with WMU School of Medicine as the Director of Clinical Business Services. In her current role, she is responsible for the administration and overall management of the organization’s business operations which includes the departments of billing, managed care, and the phone room. She is responsible for the development of the corporate records management program, the practice management education of the physician residents, and the administration tasks related to our Joint Commission Accreditation. In addition, she assists the Associate Dean of Finance and Administration in the monitoring of clinical contracts amongst other miscellaneous job duties.

7. Overview In 1994, the World Health Organization (WHO), created and adopted the 10th revision of the International Classification of Diseases (ICD) known as ICD-10. The WHO directs and coordinates health authority around the world. ICD is the international classification for morbidity and mortality statistics that is used worldwide to compare data, report cause of death on death certificates, and obtain reimbursement. The office of Health and Human Services (HHS) has proposed that the United States transitions from ICD-9 to ICD-10 as of October 1, 2014. AAPC. (2012)

8. Overview Continued Many other countries already use ICD-10 and to improve the quality of our health care data it is imperative for the United States to transition too. Transitioning to ICD-10 is expected to improve patient safety, quality of care, as well as, provide greater coding specificity to hospitals, physicians, payers, and others within the health system to support accurate payment and improve public health. Continuing to use ICD-9 is viewed as dangerous as the code sets are outdated. This could adversely impact the value of health care data due to faulty or imprecise data AAPC. (2012)

9. Objectives • Obtain Administration’s approval to oversee the Implementation of ICD-10 at WMU School of Medicine through Business Plan presentation • Develop a Project Team for implementation • Review Budget Needs • Create a timeline with defined roles and milestones • Obtain AHIMA certification to be able to train the organization on ICD-10 • Identify all areas/systems that will be affected by performing a Gap Analysis • Review clinical documentation to educate providers on documentation needs to meet the coding standards • Develop a training program • Train providers, coders, billing staff, clinical staff, and other staff • Develop a specialty practice specific crosswalk to ICD-10 • Update technology by working with 3rd party vendors • Test with vendors to ensure a successful implementation • Go LIVE, October 1, 2014 • Provide on-site support • Monitor performance/productivity/outcomes

10. Current Status • Successfully introduced Business Plan to Admin • Obtained approval to implement ICD-10 in-house • Developed a Project Team • Obtained Budget Approval • Created timeline with roles and tentative milestones defined • Obtained ICD-10 training and passed certification exam to be able to train and educate our organization • Admin decided documentation and auditing compliance should be part of scope and project objectives • Admin created Billing Change Management Team • Identified audit failures within different departments • Attended Medicare Seminar on Evaluation & Management coding • Took Refresher course on ICD-10 Training • Began to pull practice specific documentation for review and cross-coding from ICD-9 to ICD-10 • Attended education from the IT Dept on eCW functionality and how Providers select their CPT codes • Provided elements on E&M codes for EMR team to build a report to help track and trend code selections based on structured data and coding elements • Started meeting with each individual clinic to discuss audit results, documentation/coding issues and introduced ICD-10 and the changes we foresee that providers will need to make within their documentation to meet the new standards • Attended Strategic Planning sessions for our department and how we plan to move forward short term and long term as an organization • Registered coder’s to begin ICD-10 on-line training course through the AAPC Total Hours Invested to Date = 123 hours

11. Next Steps • Hire 2nd Auditor • Recommend changes in compliance program for audits • Develop ICD-10 training program • Continue meetings with Billing Change Management Team to provide education, discuss deadlines, and communication needs to organization • Continue personal training and education with staff • Coders to complete AAPC ICD-10 training course • Begin cross-coding within billing department • Begin on-site training with Coders/Billers and coding a weekly selection of charts from ICD-9 to ICD-10 • Start Educational and Training Sessions

12. References American Academy of Professional Coders (AAPC). (2012). ICD-10 implementation boot camp. Western Michigan University School of Medicine. (June 10, 2013). Homepage. Retrieved from: http://med.wmich.edu/ Western Michigan University School of Medicine. (June 10, 2013). Mission, vision and values. Retrieved from: http://med.wmich.edu/about-us/mission-vision-and-values