ICD-10: What Physicians Need To Know
 

ICD-10: What Physicians Need To Know

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Do you understand how ICD-10 will impact your practice and the way you document patient encounters? Learn about the four steps you need to take to ensure that you and your practice are ready to make ...

Do you understand how ICD-10 will impact your practice and the way you document patient encounters? Learn about the four steps you need to take to ensure that you and your practice are ready to make the transition to ICD-10 on October 1, 2015. This CME-accredited webinar provides the tools you need to get prepared.

You’ll learn:
• What ICD-10 is and why the change is happening
• What the four steps are you need to take now to transition to ICD-10
• How to improve your documentation to ensure ICD-10 success

The event is presented by Tom Giannulli, MD, MS, and CMIO at Kareo and Abhinav Gautam, MD, CMO, and Cofounder of Nexus Clinical.

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ICD-10: What Physicians Need To Know ICD-10: What Physicians Need To Know Presentation Transcript

  • PAGE 1PAGE 1 What Physicians Need to Know
  • PAGE 2 Your Hosts Today… Tom Giannulli, MD Chief Medical Information Officer, Kareo Abhinav Gautam, MD Chief Medical Officer, Nexus Clinical
  • PAGE 3 Our Schedule for Today… 1 Introduction & Welcome 2 ICD-10: What Physicians Need to Know 3 Discover ICD-10 Resources 4 Answer Questions
  • PAGE 4 Participate via Social Facebook.com/GoKareo Twitter.com/GoKareo Linkedin.com/company/Kareo We’ll be live tweeting during today’s webinar! How to participate: 1. Follow @GoKareo on Twitter 2. Follow @DrTom_Kareo on Twitter 3. Join the conversation using #KareoTip 4. Join Building Best Practices group on LinkedIn
  • PAGE 5 Tom Giannulli, MD, MS  Chief Medical Information Officer at Kareo and designer of Kareo EHR  15 years experience in mobile technology and medical software development  Previously CMIO at Epocrates, founder of Caretools, VP of Advanced Research for Data Critical, and founder and CEO of Physix  Practicing physician in internal medicine  M.S. in biomedical engineering  M.D. from University of Texas, Houston
  • PAGE 6 Abhinav Gautam, MD  Co-founded Nexus @ 27  Chief Medical Officer at Nexus Clinical  Also Assistant Professor of Clinical Anesthesiology @ University of Miami  Completed residency in Anesthesiology from the University of Miami  Published numerous peer reviewed articles in anesthesiology, surgery, and bio semiotics  Inventor with patents pending
  • PAGE 7 Our Schedule for Today… 1 Introduction & Welcome 2 ICD-10: What Physicians Need to Know 3 Discover ICD-10 Resources 4 Answer Questions
  • PAGE 8 Breaking News
  • PAGE 9 What We’ll Cover Today 1. ICD-10: What Is It & How Is It Different? 2. 4-Step Plan for Success 3. The Role of Technology 4. Questions
  • PAGE 10PAGE KAREO | CONFIDENTIAL Why Engage Patients? Why Change to ICD-10? ICD-9 is outdated and out of room. U.S. is last major country not to make the change.
  • PAGE 11 ICD-10 Overview  A number of other countries have already put ICD-10 in practice, including:  United Kingdom (1995);  France (1997);  Australia (1998);  Germany (2000);  Canada (2001)
  • PAGE 12 ICD-10: How It Differs ICD-9 ICD-10 Diagnosis Codes are 3-5 characters Codes are 3-7 characters Approximately 14,000+ codes 69,000+ codes First character is numeric or alpha (E or V) 2-5 are numeric First character is alpha, characters 2 and 3 are numeric, 4-7 are alpha or numeric Difficult to analyze data due to nonspecific codes Expanded to allow more specificity and accuracy resulting in improved data analysis
  • PAGE 13 ICD-10: How It Differs ICD-10-CM Code format Comparison ICD-10 (7 characters) to ICD- 9 CM (5 digits) ICD-9 Code format X X X X X X X X X X X X category Categoryetiology, extension anatomic site Example: S91.321A : 2cm laceration of the right foot with foreign body severity etiology, anatomic site, manifestations Example: 892.1 is the same diagnosis, without laterality
  • PAGE 14 ICD-10: New Features  Laterality: Left, Right, Bilateral ICD-9 ICD-10 374.84 Cyst of Eyelids H02.821 Cysts of right, upper eyelid H02.822 Cysts of right, lower eyelid H02.824 Cysts of left, upper eyelid H02.825 Cysts of left, lower eyelid 371.01 Minor Opacity of Cornea H17.811 Minor Opacity of Cornea, right eye H17.812 Minor Opacity of Cornea, left eye H17.813 Minor Opacity of Cornea, bilateral
  • PAGE 15 ICD-10: New Features  Combination Codes:  Certain conditions and common associated symptoms and manifestations.  Poisonings and their associated external causes. Example K57.21 Diverticulitis of large intestine with perforation and abscess with bleeding Example T42.3x2S Poisoning by barbiturates, intentional self- harm, sequela
  • PAGE 16 ICD-10: New Features  Combination Codes, con’t.:  Obstetric Codes: Identifies trimester instead of episode of care  ICD-9 ICD-10 646.11 Edema or excessive weight gain Antepartum O26.01 Excessive weight gain in pregnancy, first trimester O26.02 Excessive weight gain in pregnancy, second trimester O26.03 Excessive weight gain in pregnancy, third trimester
  • PAGE 17 ICD-10: New Features  Fill in the Character: Character “x” is used as a character placeholder to all for future expansion ICD-9 ICD-10 679.11 Fetal comp from in utero procedure, delivered first trimester O35.7xx1 Maternal care for damage to fetus by other medical procedure, fetus 1 O35.7xx2 Maternal care for damage to fetus by other medical procedure, fetus 2 O35.7xx3 Maternal care for damage to fetus by other medical procedure, fetus 3
  • PAGE 18 ICD-10: New Features  Exclusions:  Exclude Type 1: Indicates the excluded codes that should never be used with the selected diagnosis code (do not report codes together). Example: Congenital Hydrocephalus ICD-10 Type 1 Excludes Q03.0 Congenital Hydrocephalus Malformations of aqueduct of Sylvius Q07.0_ Arnold-Chiari Syndrome, Type II G91._ Acquired Hydrocephalus P37.1_ Hydrocephalus due to congenital Toxoplasmosis Q05.0_ to Q05.4 Hydrocephalus with spina bifida
  • PAGE 19 ICD-10: New Features  Exclusions, con’t.:  Exclude Type 2: Indicates that the condition excluded is not part of the condition represented by the selected diagnosis code. Patient may have the condition(s) excluded and, in this case, both codes may be reported to capture both conditions. Example: Dermatitis due to Substances Taken Internally ICD-10 Type 2 Excludes L27.2 Dermatitis due to ingested food T78.0_ to T78.1_ Adverse food reaction, except dermatitis L23._ to L25._ Contact dermatitis L56.1 Drug photoallergic response L56.0 Drug phototoxic response L50._ Urticaria
  • PAGE 20 Additional changes for ICD-10  New concepts in ICD-10  There are 21 chapters in ICD-10 each one beginning with a letter except for ‘U’ .  Tabular Index is divided in chapters and subdivided into blocks.  The term “Sepsis” is being replaced with the term “Septicemia” in Chapter 1 of ICD-10.  In some cases multiple codes are still needed. For example, a patient diagnosed with a malignant left ovarian tumor, major weight loss, and situational depression (C56.2, R63.4, F32.9).
  • PAGE 21 ICD-10: New Features  Other Changes:  Injuries are grouped by anatomical site rather than injury type.  Category restructuring and code reorganization occur in a number of ICD-10 chapters. This has resulted in a different classification of certain diseases and disorders than ICD-9.  Certain diseases are reclassified to different chapters or sections to reflect current medical knowledge.  New code definitions (i.e., definition of acute myocardial infarction is now 4 weeks instead of 8 weeks).  ICD-9 V codes and E codes are now incorporated into the main classification.
  • PAGE 22 What We’ll Cover Today 1. ICD-10: What Is It & How Is It Different? 2. 4-Step Plan for Success 3. The Role of Technology 4. Questions
  • PAGE 23 4-Step Plan: Code Mapping  Code Mapping adds five (5) key benefits to your practice.  It enables you to gain an understanding of the structure of the ICD-10 codes specific to your specialty.  It helps you understand the equivalent ICD-10 codes and determine if more specific documentation is required.  Once you start using ICD-10, it will improve the accuracy of your billing.  It guides changes to documents and forms.  It helps you plan and customize your staff training.
  • PAGE 24 4-Step Plan: Code Mapping Ranking ICD-9 Codes ICD-9 Diagnosis Description ICD-10 Codes ICD-10 Diagnosis Description 1 401.9 Unspecified essential hypertension I10 Essential (Primary) Hypertension 2 414.00 Coronary atherosclerosis of unspecified type of vessel, native or graft I25.10 Atherosclerotic heart disease of native coronary artery w/o angina pectoris 3 427.31 Atrial fibrillation 148.0 148.2 148.91 Paroxysmal atrial fibrillation Chronic atrial fibrillation Unspecified atrial fibrillation
  • PAGE 25PAGE KAREO | CONFIDENTIAL Why Engage Patients?
  • PAGE 26 4-Step Plan: Documentation  Improving documentation is your #1 priority and responsibility in the ICD-10 transition!  Start documenting in more detail now! The expectations for detail will be higher with ICD-10. An EHR will help.  Know your codes. Code mapping can provide a head’s up on what codes you will use most after October 1, 2014.  Get some help. Consider hiring a Clinical Documentation Improvement (CDI) specialist to help.
  • PAGE 27 4-Step Plan: Documentation  Initial encounter: Indicated by an ‘A’ as the 7th character Example: T22.111A: Burn of first degree of right forearm, First or Initial encounter  Subsequent encounter: Indicated by the letter ‘D’ Example: T22.111D: Burn of first degree of right forearm, Subsequent encounter  Sequela: Indicated by the letter ‘S’ as the 7th character Example; T22.111S : Burn of first degree of right forearm, Sequela
  • PAGE 28 4-Step Plan: Documentation  Examples of Specialty Changes:  Surgeons: Note combination codes for digestive conditions. Certain digestive conditions are now combination codes that require specific information for coding.  OB/GYN: Document the specific trimester. Many of the codes in Chapter 15 require coders to report the specific trimester of the patient’s pregnancy.  Orthopedics: Site specificity is a common theme in ICD-10-CM, and many of the orthopedic diagnoses will require this information.
  • PAGE 29 4-Step Plan: Documentation  Examples of Primary Care Changes:  Headaches: Lots of new codes for headaches. For migraine (code G43), physicians must specify common, hemiplegic, persistent, chronic, ophthalmologic, abdominal, or menstrual.  Ear Infections: Various codes to denote specific forms of a middle ear infection. These codes are grouped in H65-H67 and distinguish between forms of otitis media: Serous, Allergic, Mucoid, Nonsuppurative, Suppurative, Tubotympanic suppurative, Atticoantral suppurative.
  • PAGE 30PAGE KAREO | CONFIDENTIAL Why Engage Patients?
  • PAGE 31
  • PAGE 32 4-Step Plan: Training  Physician training for ICD-10 may vary depending on the complexity of changes for your specialty:  Online and in-person options. Cost will vary based on needs.  May need clinical documentation training through certified ICD-10 trainer, EHR and template training from EHR vendor, specialty training from medical society.  Should be supported by training for practice staff, especially coders/billers.
  • PAGE 33PAGE KAREO | CONFIDENTIAL Why Engage Patients?
  • PAGE 34 4-Step Plan: Financial Planning
  • PAGE 35 What We’ll Cover Today 1. ICD-10: What Is It & How Is It Different? 2. 4-Step Plan for Success 3. The Role of Technology 4. Questions
  • PAGE 36 Role of Technology  Eliminates need to update most forms  Simplifies documentation  Enables code mapping  Supports more accurate, complete coding  Improves billing with electronic superbill
  • PAGE 37 Role of Technology  Can provide more options for billing and coding like outsourcing  Can make all collection effort more streamlined and effective to strengthen revenue
  • PAGE 38 Documentation
  • PAGE 39 Superbill
  • PAGE 40 Our Schedule for Today… 1 Introduction & Welcome 2 ICD-10: What Physicians Need to Know 3 Discover ICD-10 Resources 4 Answer Questions
  • PAGE 41 Discover ICD-10 Resources
  • PAGE 42 Let’s Answer Your Questions Dr. Tom Giannulli: drtom@kareo.com Dr. Abhinav Gautam: dr.abhinav.gautam@nexusclinical.com 888-775-2736 sales@kareo.com Kareo.com/chat Facebook.com/GoKareo Twitter.com/GoKareo Linkedin.com/company/Kareo Follow us!