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ICD-10 Delayed to 2015: Now What?
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ICD-10 Delayed to 2015: Now What?

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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 ...

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.

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    ICD-10 Delayed to 2015: Now What? ICD-10 Delayed to 2015: Now What? Presentation Transcript

    • 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 FloridaBlueOpenLineFriday@FloridaBlue.com. 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 floridablueopenlinefriday@floridablue.com. 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 floridablueopenlinefriday@floridablue.com 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 ICD-10Testing@floridablue.com 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