Precyse amdis presentation-ormondroyd
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  • 1. AMDIS Documentation Panel
  • 2. ICD-10 Impact Coder Productivity Physician Productivity Rework Change in Charts Coded per Hour 3-12 Mos. post transition Long Term Increase in Queries DNFB / DNFC Increase in Inquiries, Claims Adjustments & Rejections -5% to - 10%* Coder: -20% • Inpatient: ~5 charts/day • Outpatient: ~8 charts/day • ER: ~24 charts/day Coding Manager: -35% to -50% -10% to -20% +45 to +90 min/day -10% to -25% Source: Advisory Board Research & Analysis, recent Precyse customer data
  • 3. ICD-10-CM Impact ICD-10-CM is manageable as the documentation impacts fall in 8 to 10 core impact areas:  Axis of Classification  Possible 7-digit codes  Laterality  Trimester Specificity  Drug and Alcohol Code Expansion  7th Digit Expansion Codes  Complication Codes  Combination Codes  Increased Specificity
  • 4. An Example of Impact  ICD-10 often combines disease specificity, common sites/locations, and manifestations of the disease into one code  Non-specific documentation (such as Regional Enteritis) will result in significant increases in queries and increases in denials Regional enteritis of the large intestine Unspecified intestinal obstruction 560.9 555.1 K50.112 Crohn’s Disease of the large intestine with intestinal obstruction
  • 5. An Example of Impact ICD-10-CM is a much more clinically-based system Allows physicians to truly show severity of a patient’s illness ICD-9-CM ICD-10-CM 455.- 10 Hemorrhoid codes • External • Internal • Unspecified K64.- 8 Hemorrhoid codes • Degree of severity (First to Fourth)
  • 6. ICD-10-PCS Impact  All diagnostic information is excluded  Standardized and self-contained (No Latin, terms have one definition, etc)  No more Eponyms  No more unspecified procedures  Will require use by coders of far more specific anatomical and pathophysiological concepts
  • 7. The Big ‘Holes’ to Fill  Avoiding umbrella/non-specific codes  Specific documentation of underlying conditions and manifestations  ICD-10 ready templates/prompts  Telling the ‘whole’ clinical story  Drive severity of illness/medical necessity
  • 8. ICD-10 Training to Ready Documentation
  • 9. • Determine severity of illness and prove medical necessity. • Grow compensation and reimbursement. • Address technology and healthcare reform initiatives. • Ensure strong reputation. - Physician profiling/national registries - Quality reporting - Consumer health sites • Avoid the risk of audits. How to ‘Sell’ the ICD-10 Message?
  • 10. The ICD-10 Tree  ICD-10 is similar to a tree Physicians Ancillary Departments Coders Finance HIM IT/IS
  • 11. Best Practices: Get Physician Buy-In  Make it practical  Make it convenient and mobile  Use a combination approach eLearning, peer-to-peer, and internal programs  Communicate the ‘What’s In It For Me’ effectively
  • 12. Best Practices: Tiger Team  Create a Tiger Team that takes the education before everyone else  Allows you to develop ‘super users’ who will be able to help others, answer questions, and provide potential training  Comprised of individuals from all major education groups, such as coders, CDIS, physicians, and others
  • 13. Best Practices: Collaborate with CDIS  View the Clinical Documentation Improvement Specialist role as the most critical to success  Use them as your ‘champion’ to: • Do face-to-face education • Integrate documentation education into current practices • Rework queries/forms • Develop additional education collateral and printable documents
  • 14. Best Practices: Strong Communication Plan  Essential to look at ICD-10 as an Education and Communication event  Should try to use:  Posters/Collaterals for awareness  E-mail Blasts  Organization Newsletters  Mailbox Stuffers  Organization Webinars  ICD-10 Website on Intranet