ICD-10 CHANGE AHEAD

1. ICD-10 CHANGE AHEAD Change is HARD ICD-9 CM implemented in 1979 Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000, Australia 1998 Canada has used ICD-10 since 2001

2. More Codes More Detail • Greater specificity • Ability to measure healthcare services • Refinement of grouping and reimbursement methodologies • Enhancement of public health surveillance • Decreased need to include supporting documentation with claims

3. Other Features • Includes updated medical terminology and classification of diseases • Provides codes to allow comparison of mortality and morbidity data • Provides for better data for: Measuring care furnished to patients Designing payment systems Processing claims0

4. Further Enhancements • Making clinical decisions • Tracking public health Worldwide: WHO Identifying Fraud and Abuse Conducting research

5. Implementation • Date extended to October 1, 2014 More time to prepare physicians Staff Vendors Systems

6. Education • Allow at least 12 -15 months for education of coding staff • Recommend review of ICD-10 chapters by body system • Review of rules changes in sequencing of diagnoses

7. ICD-10 Chapters • 21 chapters • From Infectious Disease through factors Influencing Health Status and Contact with Health Services. • Sense Organs, Eye and Ear are separate chapters (7 & 8) Chapter 16 is Conditions originating in the Perinatal Period—Newborn only

8. Other Chapters • Chapter 17 • Congenital malformations, deformations and Chromosomal abnormalities

9. Other Chapters • Chapter 20 External Causes of morbidity Includes transport accidents, Slipping, tripping and falls Exposure (contact with animals causing injury) Drowning, near drowning Smoke, fire, flames

10. Chapter 20 continued • Assault • Legal intervention • Operations of war and Military operations • Terrorism Coders should review all coding guidelines listed for ICD-10, as coding clinics will no longer be applicable.

11. POA Present on Admission • POA Guidelines will be reported. • Inpatient admissions principal and secondary dx as well as external cause of injury.

12. Clinical Documentation Improvement • Concurrent coding • Queries • Involve and Educate other staff: Nursing Case Managers Allied Health Cardiopulmonary Laboratory Pharmacy Rehab staff

13. Concurrent will expedite • Concurrent moves the process more quickly • Education of Medical Staff • New Physicians/New Grads have already used ICD-10 --How do we help the senior members of our Medical Staff?

14. Use Existing Opportunities • Medical Staff Meetings Develop an ICD-10 minute or section for each Medical Staff meeting (just like Safety Moments) The accuracy and specificity will assist the physician/practitioner, as much if not more than the Facility.

15. What Vendors/Programs use Codes • Check systems • Test Systems State Reporting Registries Billing and Collection Systems Testing should be scheduled by the vendor. ASK 2013 or early 2014 to work out bugs!

16. Prepare • Coders should begin to use ICD-10 in actual accounts 1) Use ICD-9 and ICD-10 2) Determine what documentation may be needed in addition to what your physicians are usually documenting 3) Educate as needed

17. Computerized Coding Systems • CAC: Computer assisted coding Electronic record/scanned record Will still need coders to edit

18. Reimbursement • Prediction of some variation in payment Mapping will need further review

19. Websites • AHIMA.org • CMS • WVHIMA.org