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June 2014 ICD-10 Open Line Friday

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We're pleased to present Rhonda Buckholtz, VP of ICD-10 Education and Training for the American Association of Professional Coders (AAPC), as our June Open Line Friday guest. Rhonda will explain the …

We're pleased to present Rhonda Buckholtz, VP of ICD-10 Education and Training for the American Association of Professional Coders (AAPC), as our June Open Line Friday guest. Rhonda will explain the approach the AAPC has taken with the delay of ICD-10 to 2015. Visit http://www.bcbsfl.com/wps/portal/bcbsfl/w/providers/providerdetails/SA_ToolsResources/SA_ICD10 for your comprehensive list of ICD-10 resources.


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  • 1. 900-3571-0213 Open Line Friday: ICD-10 Edition AAPC’s ICD-10 Delay Approach Rhonda Buckholtz Vice President ICD-10 Education & Training American Association of Professional Coders June 20, 2014 9:30 a.m. – 10:30 a.m. EST Dial Toll-Free: (800) 882-3610 or (412) 380-2000 Conference Passcode: 6829655# 900-4451-0614
  • 2. 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 VP of the Cooperative Exchange Diana Brijbag CMM, CPC, CCP, CMSCS, HITCM-PP Office Manager The Springs Family Medical Center George Vancore Senior Manager, Delivery Systems Mandates and Compliance 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
  • 3. Open Line Friday: ICD-10 June 20, 2014 Special Guest 3 Rhonda Buckholtz CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC Vice President ICD-10 Education & Training Note: Practitioner guests are subject to unforeseen clinical or other emergencies. Should guest(s) become unavailable at the time of our program, Florida Blue will attempt to reschedule guest(s) for a future session.
  • 4. Open Line Friday: ICD-10 AAPC’s ICD-10 Delay Approach 4 Agenda June 20, 2014 1. Objectives 2. Healthcare Industry Updates 3. Florida Blue Updates 4. AAPC’s ICD-10 Delay Approach 5. Next Steps
  • 5. 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. 5 Open Line Friday: ICD-10
  • 6. Open Line Friday: ICD-10 Health Care Industry & Regulatory Update • HHS expects to release interim final rule in near future with a new compliance date requiring the use of ICD-10 beginning Oct. 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through Sept. 30, 2015. • American Health Information Management Association (AHIMA) is recommending the industry “keep its momentum going, continuing to prepare by strengthening clinical documentation improvement programs, working with vendors on transition readiness, training coders and other stakeholders, and proceeding with dual coding.” • CMS ICD-10 Acknowledgement Testing: Providers, suppliers, billing companies, and clearinghouses may submit acknowledgement test claims with CMS anytime up to the anticipated Oct. 1, 2015 implementation date. Submitters should contact their local Medicare Administrative Contractor (MAC) for more information about acknowledgment testing. However, those who submit claims may want to delay acknowledgement testing until after Oct. 6, 2014, when Medicare updates its systems. 6
  • 7. Open Line Friday: ICD-10 Health Care Industry & Regulatory Update • CMS/Medicare ICD-10 Acknowledgement Testing Results from March 2014 were reported as follows: • Approximately5% of all submitters (2600) joined in the testing week. • Over 127k ICD-10 coded claims were sent to the Medicare FFS claims systems and received a “functional acknowledgement”. • Nationally CMS accepted 89% of test claims and some regions reported success rate of 99%; CMS’s normal acceptance rates range from 95% to 98%. • All claims were required to have: • A valid NPI and a valid diagnosis code that must match the date of service. • Claims using ICD-9 or ICD-10 codes had to have a corresponding ICD-10 code qualifier. • CMS has announced that they will be conducting end-to-end testing in 2015 with details and schedules to be released “soon”. • Several organizations are continuing their ICD-10 testing efforts. Are you? 7
  • 8. Open Line Friday: ICD-10 Health Care Industry & Regulatory Update (continued) • NUCC changes to the CMS 1500 professional paper claim form to accommodate ICD-10 (www.nucc.org); the following recommended transition timeline has applied: • 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). • Partial code freeze continues until one year after the implementation of ICD-10: • Only codes for new diagnosis and new technologies will be considered for exception inclusion. • Last regular updates to ICD-9-CM and ICD-10 occurred on October 1, 2011. • Regular ICD-10 updates will begin on October 1, 2016 pending the approval of the October 1, 2015 ICD-10 implementation date. 8
  • 9. Florida Blue Update: • Florida Blue is deploying a full remediation strategy to implement ICD-10. • Florida Blue’s ICD-10 initiative is proceeding on plan. We are in the process of completing our internal Compliance Level 1 testing and are fully engaged in Compliance Level 2 testing with physicians, providers and external entities. • Open Line Friday ICD-10 Edition teleconferences will continue every 3rd Friday of each month. Audio podcast recordings are available through the Podcast link located at www.floridablue.com/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 May timeframe; details of our provider testing, including a self-service option, are 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. • Attention Small to Medium sized providers: “Build your action plan and start your transition to ICD-10 now with the CMS “Road to 10” tool. It’s simple. Visit the www.roadto10.org” Open Line Friday: ICD-10 9
  • 10. 10 Rhonda Buckholtz CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC Vice President ICD-10 Education & Training American Association of Professional Coders Open Line Friday: ICD-10 AAPC’s ICD-10 Delay Approach Please refer to our guest speaker’s program material if available which can be accessed at www.floridablue.com/ICD-10 under Open-Line Friday located in right margin.
  • 11. . Send ICD-10 questions, comments or feedback to floridablueopenlinefriday@floridablue.com. 11 Open Line Friday: ICD-10 AAPC’s ICD-10 Delay Approach
  • 12. 12 ICD-10 The most effective way to do it, is to do it! – Amelia Earhart
  • 13. Next Steps Next Steps Build your ICD-10 action plan now with the CMS “Road to 10” tool. Visit www.roadto10.org 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 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 13
  • 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: 14 Open Line Friday: ICD-10
  • 15. 15 Addendum Open Line Friday: ICD-10 Rhonda Buckholtz, CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC Vice President of ICD-10 Education and Training, AAPC Rhonda Buckholtz has more than 20 years of experience in healthcare, working in the reimbursement, billing, and coding sectors, in addition to being an instructor. She is responsible for all ICD-10 training and curriculum at AAPC. She has authored many articles for health care publications and has spoken at conferences across the country. She is co-chair for the WEDI ICD-10 Implementation Workgroup and has provided testimony ongoing for ICD-10 and standardization of data for NCVHS. She also sits on the Provider Outreach and Education committee for Novitas Solutions (formerly Highmark Medicare Services).