ICD 10 Readiness New Jersey ICD-10 Task Force April 22, 2013

1. ICD 10 Readiness New Jersey ICD-10 Task ForceApril 22, 2013 Innovating Language the Health of

2. AGENDA Introduction                         ICD 10 Overview                         Grouper Readiness (MS DRGs, AP DRGs, APR DRGs, CodeMapper)   Coding & Reimbursement Readiness                 Contacts and Resources                         Questions        

3. #Health Information Systems • Industry leader for, coding, classification and hospital payment systems used by federal agencies, 35 states, many commercial plans, and by 75% of the nation’s hospitals • Created Medicare DRGs—the original bundled payment system-CMS’ contractor for update of the Medicare inpatient system since 1983 • Developed first outpatient Ambulatory Patient Groups (APGs)- modified into APCs for CMS in 2000-APGs fully upgraded in 2008 • 3M APR Suite (APRs, PPRs, PPCs)is widely used in government and commercial uality based payment programs • Quality Based Payment work expanded beyond inpatient hospital to all major care settings with creation of Potentially Preventable Event suite • Primary CMS Medicare contractor for ICD-10 translation and conversion—developed GEMS and ICD-10 Procedure Coding System

4. 3M ICD-10 Readiness • In the October 2012 release, 3M provided a version of each of the following grouping products that process either ICD-9-CM or ICD-10-CM/PCS code sets: • These products support a variety of methodologies including, but not limited to: CMS MS-DRGs 3MTM AP-DRGs 3MTM APR DRG CMS APCs 3M™ Enhanced APGs • Slide 22 contains links to the 3M ICD-10 Readiness Site

5. MS-DRG: ICD-10 Readiness • Current MS-DRG ICD-10 version available in 3M products is v30 • ICD-10 v30 is a pre-release version based upon replication from MS-DRG v30 ICD-9 • Any future releases of MS-DRG ICD-10 prior to its official release has not been determined • Final replication in ICD-10 is ICD-10 v32 (10/2014) when ICD-10 is made official and the CMS IPPS final rule has been published • ICD-10 v32 will be the official MS-DRG version in 2014

6. Availability of MS-DRG ICD-10 Definitions Manuals • MS-DRG V30.0 ICD-10 Definitions Manual – Available in text and HTML versions • Posted on ICD-10 website at http://www.cms.gov/ICD10

7. AP-DRGs: Continued Maintenance in 2014 • The last updated version of AP-DRGs with new codes and logic was v27.0 - released in January 2010. • Since January 2011, AP-DRGs have been supported with the use of code mapping. • AP-DRGs will not be replicated in ICD-10 • AP-DRGs will continue to be supported with the use of a code mapping bridge from v32 ICD-10 to v31 ICD-9 to v30 ICD-9 etc.

8. APR DRGs: ICD-10 Readiness • ICD-10 v30 and ICD-10 v31 are pre-release versions based upon replication from ICD-9 which is still being refined • Prior to official ICD-10 implementation • Final replication in ICD-10 is ICD-10 v32 (10/2014) when ICD-10 is made official • ICD-9 v30 and ICD-9 v31: intended to be identical except for discharge statues added for ICD-9 v31 • End RESULTS will be the SAME • ICD-9 v30 and ICD-10 v30 will have discharge status mapped • ICD-9 v31 and ICD-10 v31 will have discharge status embedded • ICD-10 v32 is the FINAL replication version of both ICD-9 v30 and ICD-9 v31 w/ discharge status refinements. • ICD-10 v32 will be the official version in 2014

9. CODEMAPPER: ICD-10 Readiness Grouper Readiness V24

10. CODEMAPPER: ICD-10 Readiness • In terms of code mapping between ICD-9 and ICD-10, 3M will: • Support backward mapping from ICD-10 to ICD-9 for the supported methodologies • Not support forward mapping from ICD-9 to ICD-10

11. Coding and Reimbursement Readiness

12. October 2014ICD-10 Implementation Date ICD-10 Milestones for the… … 3M™ Coding and Reimbursement System • October 2012ICD-10 Compliant Coding and Dual Coding • October 20113M Readiness Tools and Interface Today • 2010 – 2011ICD-10 Comparison Report3M Training Software and Training Module

13. Defining the Options for Coding in ICD-10 NOTE: “True” Dual coding will help with productivity as it will streamline the process of getting both ICD-10 and ICD-9 codes on the claim

14. ICD-10 Planning and Decisions • Outline Transition Plan for ICD-10 • What do you want to do? • Financial impact analysis? • Gather document insufficiencies while coding ICD-9? • Coder productivity analysis? • Workflow - double code, dual code, or both? • What is your timing for each activity? For Example…

15. Taking Advantage of 3Ms ICD-10 Coding Options? ICD-10 Will Challenge Your Abstracting System • Customer: Can Your Abstracting System… • …Capture both ICD-9 and ICD-10 Codes Simultaneously? • …Report on the Financial Impact of Coding Under ICD-10? • …Determine Which Coders Can Perform Dual Coding? • …Capture Which Codes Have Insufficient Documentation? • …Identify Which Physician May Need Additional Training on ICD-10? • …Measure the Coder Productivity Under ICD-10? 3M’s Database and Abstracting solutions can!!!

16. ICD-10 Financial Impact Analysis • The hospital’s abstracting system sends the appropriate interface tags to CRS specifying ICD-9 as the primary code set with ICD-10 as secondary • Coder uses existing process to derive ICD-9 codes (Classic or Auto-suggested) • To derive the ICD-10 codes, you can either: • Use the translation tab to see the possible translations from ICD-9 and select the appropriate ICD-10 code, or • Natively code in ICD-10 • Coder computes the DRG for both ICD-9 and ICD-10 • Both code sets and DRGs are interfaced back to the abstracting system • Reporting and analysis in hospital’s abstracting system Hospital’s Abstracting System 3M™ Coding and Reimbursement System (CRS)

17. ICD-10 Productivity Impact Analysis The hospital’s abstracting system sends the appropriate interface tags to CRS specifying ICD-10 as the primary code set and that both ICD-10 and ICD-9 are wanted – Dual Coding Coder uses existing process keyword logic to derive ICD-10 and ICD-9 codes simultaneously. Coder computes the DRG for both ICD-10 and ICD-9 Both code sets and DRGs are interfaced back to the abstracting system Reporting and analysis of productivity in hospital’s abstracting system Hospital’s Abstracting System 3M™ Coding and Reimbursement System (CRS)

18. Augment ICD-10 Training Launch CRS either interfaced or standalone Coder uses the ICD-10 Training button on the button bar to launch a second copy of CRS in ICD-10 (dual coding) mode. Codefinder only. Coder uses existing process keyword logic to derive ICD-10 and ICD-9 codes simultaneously. No computing of DRG’s No interfacing of codes Hospital’s Abstracting System 3M™ Coding and Reimbursement System (CRS)

19. Contacts and Resources

20. Margaret A. McGann, MS | Client Relationship Executive 3M Health Information Systems Northeast Region, Silver Spring, MD 20904 Office: 484 552 8468 | Mobile: 215 237 5769 mamcgann@mmm.com Marjorie C. Sexauer, RHIA | Solutions Sales Executive3M Health Information SystemsNortheast Region , Silver Spring, MD 20904Office: 301 281 8470 | Mobile: 412 498 8909 | Fax: 360 287 6766mcsexauer@mmm.com Robert J. Trocchi | Northeast Regional Director3M Health Information Systems, Inc.3M HIS, Danvers, MA 01923Office: 978 739 1433 | Mobile: 617 513 9330 | Fax: 978 739 1432rjtrocchi@mmm.com | www.3MHIS.com 3M Contact Information

21. Other 3M Products and Services for ICD-10 • ICD-10 Financial Impact Analysis • ICD-10 Documentation Assessment • ICD-10 Web Education – Coder, CDI and Physicians • Coding Translation Tool – Translates I-9 to I-10 and I-10 to I-9 • 3MTM 360 Encompass • Computer Assisted Coding for Coding and CDI

22. ICD-10 Readiness Questionnaire • For information about 3M products' ICD-10 readiness: 1. Launch the customer website: https:\\support.3mhis.com 2. Log in. 3. Click the "Get Ready for ICD-10" link on the home page (Announcements, view all) --this takes you to the ICD-10 Ready page. 4. Select the link to "ICD-10 & 3M HIS Software." 5. Information is sorted by product. There are individual questionnaires for the different products affected by the transition to ICD-10.