The transition to ICD-10 will affect several areas within your hospital, which means changes for most of your staff.
Areas include:
IT Systems Changes
Staff Education and Training
Business Process and Documentation Changes
Changes in Super-Bills Charges
Increased Documentation Costs
Cash Flow Disruptions
Reporting Changes
The ICD-10 Impacts presentation describes these changes and what they mean for your organization.
Use this presentation to educate and prepare your staff for the impacts of the new coding system so they are ready for the transition and the changes they will experience when the October 1, 2014 deadline hits.
Download the presentation here: http://bit.ly/13JjgG9
ICD-10 Presentation Takes Coding to New HeightsPYA, P.C.
PYA Staff Consultant Kim-Marie Walker updated physicians at Robins Air Force Base on the latest in ICD-10 as part of “Soaring Together: A Collaboration in Continuing Medical Education."
ICD-10 is an unknown terrain that the country is going toward. No one knows what to expect. Some expect productivity to decrease by as much as 50% due to its implementation. Some predict this new system will result in a shortage of coders. Is any of this true? This presentation will investigate the impacts – both foreseen and unforeseen – that ICD-10 implementation will have on radiology billing companies and radiology groups.
The transition to ICD-10 will affect several areas within your hospital, which means changes for most of your staff.
Areas include:
IT Systems Changes
Staff Education and Training
Business Process and Documentation Changes
Changes in Super-Bills Charges
Increased Documentation Costs
Cash Flow Disruptions
Reporting Changes
The ICD-10 Impacts presentation describes these changes and what they mean for your organization.
Use this presentation to educate and prepare your staff for the impacts of the new coding system so they are ready for the transition and the changes they will experience when the October 1, 2014 deadline hits.
Download the presentation here: http://bit.ly/13JjgG9
ICD-10 Presentation Takes Coding to New HeightsPYA, P.C.
PYA Staff Consultant Kim-Marie Walker updated physicians at Robins Air Force Base on the latest in ICD-10 as part of “Soaring Together: A Collaboration in Continuing Medical Education."
ICD-10 is an unknown terrain that the country is going toward. No one knows what to expect. Some expect productivity to decrease by as much as 50% due to its implementation. Some predict this new system will result in a shortage of coders. Is any of this true? This presentation will investigate the impacts – both foreseen and unforeseen – that ICD-10 implementation will have on radiology billing companies and radiology groups.
Coding for Subcutaneous Cardiac Rhythm MonitorsJessica Parker
On Nov. 2, 2020, the American Medical Association (AMA) CPT® Editorial Panel announced the approval of a new Category III CPT® code to describe remote programming of subcutaneous cardiac rhythm monitors.
PYA Consulting Manager Linda ClenDening primed attendees of the Tennessee Orthopaedic Society 2014 Annual Meeting with a presentation, “Preparing Now for ICD-10-CM,” which:
Covered the transition, impact, and operational aspects of ICD-10.
Provided a high-level review of what’s new in ICD-10 coding conventions and guidelines.
Reviewed common diagnoses/documentation requirements in ICD-10.
ICD-10-CM is the United States’ clinical modification of the World Health Organization’s (WHO) International Classification of Diseases (ICD) Tenth Revision. It is used to classify diseases and causes of illness recorded on health records, claims, and other vital information.
The U.S. Department of Health and Human Services (HHS) will require covered entities (i.e., health plans, health care providers, and health care clearinghouses) that conduct electronic HIPAA standard transactions to move from ICD-9 to the next generation ICD-10 code sets by October 1, 2015.
I was coordinator of the software development of a project in the European Commission’ Telematic Applications Programme, DG XIII entitled “The Black Sea Tele Diab System (BSTD)”. The project was the result of a collaboration between members of the BSTD consortium, made up of the following partners: University of Sheffield (project coordinator) and University of Hull, UK; Research Institute and Diabetes Center, Greece; Institute of Diabetes, Nutrition and Metabolic Diseases, “N. Paulescu” and the Romanian Society Clinical Engineering and Medical Computing, Bucharest, Romania; Gorky State Medical University, Ukraine; Centre for Pathology, Chisinau, Moldova.
This system was carefully constructed and developed to meet the requirements to encourage clinicians to abandon paper records in favor of a fully-computerized healthcare record system and to promote the electronic exchange of healthcare information between clinicians and scientists in countries of the Black Sea area. The system was developed using a modular design and object oriented method approach. It was developped based on the Good European Health Record (GEHR) Architecture that faithfully preserving the data as originally intended, as well as permitting analysis of the data, which can come from many sources using an XML exchange method.
The GEHR structure is very comprehensive, data items being stored in a number of related tables that are held in a MS Access database. The software for the system has been developed in Microsoft Visual C++ and when combined with the database, it provides an application that is fast and well integrated with the Windows environment. Development of the system has followed a stepwise approach with validation of the architecture and the incorporation of feedback from users at each key stage.
There are five major work areas: patient records, reports, graphs, Diabetes Aggregated Data (DAD) and administration. Each of these contains a number of individual application/functions which are serviced by the relational tables that store the patient details, clinical measurements, doctors and user information. The Patient Records Function offers options for the management of the EHCRs (creation/correction/visualisation), such as: registration of a new patient and entry of the first record or sheet; the recording of a new sheet; the correction/visualisation of the sheet; the recording of data about the patient’s death, etc. The System Administration Function allows: Definition of the health care facility; definition of persons as users or system managers; management of passwords and access rights for the users; definition of measurement units; limited customisation of the user interface.
In accordance with the overall Elliot Project spirit, the Bulgarian Internet of Things eHealth case will also apply the Living Lab methodology, will use some elements of Cloud Computing, and will rely on a Web Intelligence system, which will consist of 7 parts: medical algorithms; expert systems; BI (Business Intelligent) system; databases; notification system; doctors’ Operational Advisory Portal and Patients’ Prevention Advisory Portal.
Step by Step Anesthesiology Billing, Coding, Revenue Cycle Management and Pra...Michael Smith
Sun Knowledge is a leading global provider of Business and Knowledge Process Outsourcing services in the health care domain. We deliver proprietary technologies, workflow and business processes to meet our client’s expectations and enhance their workflow and business processes to meet operational capabilities.
Join - https://www.linkedin.com/company/sun-knowledge
Google - https://plus.google.com/+SunknowledgeInc
Follow - https://twitter.com/sunknowledge
Like - https://www.facebook.com/SunKnowledge
Website - www.sunknowledge.com
Service - http://sunknowledge.com/services/
Provider Solutions - http://sunknowledge.com/services/provider-solutions/
Payor Solutions - http://sunknowledge.com/services/payor-solutions/
Technology Solutions - http://sunknowledge.com/services/technology-solutions/
Contact - 41 Madison Avenue, 25th Floor, Suite 2511, NY - 10010
Phone - 646 - 661 - 7853
Email - ronnie.hastings@gotelecare.com
Telemedicine
Offered through our sister organization GoTelecare, the Telemedicine application ushers in a new era of ease and convenience in remote health care delivery. We invite you to explore its amazing capabilities and understand how it can help you as a patient or a healthcare provider.
Medication Therapy Management Patient-Oriented Software
Our proprietary Medication Therapy Management (MTM) web application is the definitive answer to resolving all your medication-related issues in the most comprehensive and cost-effective manner. Get ready to experience a whole new way to automate tasks, reduce errors, cut costs and boost productivity.
Software Development
We offer valuable guidance to our service-users on how to systematize, maintain and manage their software assets, consistently and faultlessly, throughout their life-cycle. Our competent IT professionals provide clients with an exhaustive range of solutions, allowing maximum cost-containment and addressing their business challenges effectively.
Our broad spectrum of software services includes:
~ Business Analysis and System Design
~ Technology Architecture Consulting
~ Application Software Development
~ Maintenance and Technical Support
~ Production Support
~ Troubleshooting and Issue Resolving
~ Managing Updates and Patches, and more!
This is where we can make a big difference. Our proactive and streamlined revenue cycle management process gives you complete visibility and assurance of your payments – starting from charge entry to claims submission through payment follow-up.
We have been successfully serving healthcare providers in every domain – physicians, hospitals, urgent cares and durable medical equipment. Our billers and coders are proficient in working in several industry-standard practice management and billing systems, and have an excellent track record in delighting each customer through their expertise, dedication and steady focus on making you realize your payments on time.
Ben Quirk spoke to the South Florida medical group community about the impact of ICD-10 on the healthcare industry. It was a very informative talk that covered a lot of need-to-know details, including how ICD-10 relates to Meaningful Use and SNOMED.
This webinar covers Health Information Technology (HIT) topics that are very much on everyone's mind today. From ICD-10 and SNOMED coding to MU and PQRS regs, this webinar will fill you in on the background and details you need to know. And if you're currently using an older version of NextGen/KBM, you'll find the upgrade info on those systems especially useful. Take advantage of this free information from Quirk Healthcare Solutions.
Coding for Subcutaneous Cardiac Rhythm MonitorsJessica Parker
On Nov. 2, 2020, the American Medical Association (AMA) CPT® Editorial Panel announced the approval of a new Category III CPT® code to describe remote programming of subcutaneous cardiac rhythm monitors.
PYA Consulting Manager Linda ClenDening primed attendees of the Tennessee Orthopaedic Society 2014 Annual Meeting with a presentation, “Preparing Now for ICD-10-CM,” which:
Covered the transition, impact, and operational aspects of ICD-10.
Provided a high-level review of what’s new in ICD-10 coding conventions and guidelines.
Reviewed common diagnoses/documentation requirements in ICD-10.
ICD-10-CM is the United States’ clinical modification of the World Health Organization’s (WHO) International Classification of Diseases (ICD) Tenth Revision. It is used to classify diseases and causes of illness recorded on health records, claims, and other vital information.
The U.S. Department of Health and Human Services (HHS) will require covered entities (i.e., health plans, health care providers, and health care clearinghouses) that conduct electronic HIPAA standard transactions to move from ICD-9 to the next generation ICD-10 code sets by October 1, 2015.
I was coordinator of the software development of a project in the European Commission’ Telematic Applications Programme, DG XIII entitled “The Black Sea Tele Diab System (BSTD)”. The project was the result of a collaboration between members of the BSTD consortium, made up of the following partners: University of Sheffield (project coordinator) and University of Hull, UK; Research Institute and Diabetes Center, Greece; Institute of Diabetes, Nutrition and Metabolic Diseases, “N. Paulescu” and the Romanian Society Clinical Engineering and Medical Computing, Bucharest, Romania; Gorky State Medical University, Ukraine; Centre for Pathology, Chisinau, Moldova.
This system was carefully constructed and developed to meet the requirements to encourage clinicians to abandon paper records in favor of a fully-computerized healthcare record system and to promote the electronic exchange of healthcare information between clinicians and scientists in countries of the Black Sea area. The system was developed using a modular design and object oriented method approach. It was developped based on the Good European Health Record (GEHR) Architecture that faithfully preserving the data as originally intended, as well as permitting analysis of the data, which can come from many sources using an XML exchange method.
The GEHR structure is very comprehensive, data items being stored in a number of related tables that are held in a MS Access database. The software for the system has been developed in Microsoft Visual C++ and when combined with the database, it provides an application that is fast and well integrated with the Windows environment. Development of the system has followed a stepwise approach with validation of the architecture and the incorporation of feedback from users at each key stage.
There are five major work areas: patient records, reports, graphs, Diabetes Aggregated Data (DAD) and administration. Each of these contains a number of individual application/functions which are serviced by the relational tables that store the patient details, clinical measurements, doctors and user information. The Patient Records Function offers options for the management of the EHCRs (creation/correction/visualisation), such as: registration of a new patient and entry of the first record or sheet; the recording of a new sheet; the correction/visualisation of the sheet; the recording of data about the patient’s death, etc. The System Administration Function allows: Definition of the health care facility; definition of persons as users or system managers; management of passwords and access rights for the users; definition of measurement units; limited customisation of the user interface.
In accordance with the overall Elliot Project spirit, the Bulgarian Internet of Things eHealth case will also apply the Living Lab methodology, will use some elements of Cloud Computing, and will rely on a Web Intelligence system, which will consist of 7 parts: medical algorithms; expert systems; BI (Business Intelligent) system; databases; notification system; doctors’ Operational Advisory Portal and Patients’ Prevention Advisory Portal.
Step by Step Anesthesiology Billing, Coding, Revenue Cycle Management and Pra...Michael Smith
Sun Knowledge is a leading global provider of Business and Knowledge Process Outsourcing services in the health care domain. We deliver proprietary technologies, workflow and business processes to meet our client’s expectations and enhance their workflow and business processes to meet operational capabilities.
Join - https://www.linkedin.com/company/sun-knowledge
Google - https://plus.google.com/+SunknowledgeInc
Follow - https://twitter.com/sunknowledge
Like - https://www.facebook.com/SunKnowledge
Website - www.sunknowledge.com
Service - http://sunknowledge.com/services/
Provider Solutions - http://sunknowledge.com/services/provider-solutions/
Payor Solutions - http://sunknowledge.com/services/payor-solutions/
Technology Solutions - http://sunknowledge.com/services/technology-solutions/
Contact - 41 Madison Avenue, 25th Floor, Suite 2511, NY - 10010
Phone - 646 - 661 - 7853
Email - ronnie.hastings@gotelecare.com
Telemedicine
Offered through our sister organization GoTelecare, the Telemedicine application ushers in a new era of ease and convenience in remote health care delivery. We invite you to explore its amazing capabilities and understand how it can help you as a patient or a healthcare provider.
Medication Therapy Management Patient-Oriented Software
Our proprietary Medication Therapy Management (MTM) web application is the definitive answer to resolving all your medication-related issues in the most comprehensive and cost-effective manner. Get ready to experience a whole new way to automate tasks, reduce errors, cut costs and boost productivity.
Software Development
We offer valuable guidance to our service-users on how to systematize, maintain and manage their software assets, consistently and faultlessly, throughout their life-cycle. Our competent IT professionals provide clients with an exhaustive range of solutions, allowing maximum cost-containment and addressing their business challenges effectively.
Our broad spectrum of software services includes:
~ Business Analysis and System Design
~ Technology Architecture Consulting
~ Application Software Development
~ Maintenance and Technical Support
~ Production Support
~ Troubleshooting and Issue Resolving
~ Managing Updates and Patches, and more!
This is where we can make a big difference. Our proactive and streamlined revenue cycle management process gives you complete visibility and assurance of your payments – starting from charge entry to claims submission through payment follow-up.
We have been successfully serving healthcare providers in every domain – physicians, hospitals, urgent cares and durable medical equipment. Our billers and coders are proficient in working in several industry-standard practice management and billing systems, and have an excellent track record in delighting each customer through their expertise, dedication and steady focus on making you realize your payments on time.
Ben Quirk spoke to the South Florida medical group community about the impact of ICD-10 on the healthcare industry. It was a very informative talk that covered a lot of need-to-know details, including how ICD-10 relates to Meaningful Use and SNOMED.
This webinar covers Health Information Technology (HIT) topics that are very much on everyone's mind today. From ICD-10 and SNOMED coding to MU and PQRS regs, this webinar will fill you in on the background and details you need to know. And if you're currently using an older version of NextGen/KBM, you'll find the upgrade info on those systems especially useful. Take advantage of this free information from Quirk Healthcare Solutions.
EMR ICD Coding and training for staff of medical recordsSrishti Bhardwaj
Computerization of medical Record;
Electronic medical record (EMR),
advantages of EMR,
ICD coding system :
application of ICD,
Minimum recording standards – training for staff and caregivers
ICD-10 Transition Presentation: What Health Lawyers Need to KnowPYA, P.C.
PYA Consulting Principal Denise Hall, along with co-presenter Julie Chicoine, recently updated health lawyers about ICD-10 transition readiness at the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues, held March 26-27, 2014.
The recent extension of the ICD-10 deadline was greeted with mixed reactions throughout the healthcare industry. Some favored an extension, while others preferred to move ahead with the change. In this webinar, we look at the pros and cons of the delay and how it will affect providers and patients. Reactions from other vendors are also presented.
ICD-10 Transition: What Health Lawyers Need to KnowPYA, P.C.
PYA Principal Denise Hall, along with Senior Corporate Counsel Julie Chicoine of Ohio State University Wexner Medical Center, presented “ICD-10 Transition: What Health Lawyers Need to Know” at the AHLA 2015 Institute on Medicare and Medicaid Payment Issues.
Mediscribes, Inc. is one of the fastest growing transcription & document management systems providers in United States, We Provide rendering cost-effective consolidated
ICD-10 Implementation for Physicians WhitepaperMarie Bunch
Many providers are operating with blinders on, completely unaware of the magnitude of the conversion and potential train wreck ahead for their reimbursement. Support your physicians through the difficult change ahead by helping them take the right steps forward to make their transition as efficient and painless as possible.
Regardless of the size of the practice, training for any implementation – especially for one as complex and far reaching as ICD-10 – can be costly and difficult to deliver. With only a year remaining to complete the transition, providers and their staff must step up to planning, training, software/system upgrades/replacements, as well as other necessary investments. ICD-10 will require a significant education investment in order to ensure accurate coding and minimize productivity loss. While large organizations may have the resources to purchase training materials or send staff to training sessions, smaller organizations may have to depend on special societies or share resources to provide the needed training.
Start the conversation with your physicians now. Help them through the transition with resources designed to get them on board with the transition now. Practice Management Institute® (PMI) is already helping practices adapt to the change with classes especially focused on the transition steps for medical offices, hosted by leading hospitals across the country. PMI’s Professional Services Department and Faculty Team is committed to providing the most up-to-date information on implementation guidelines, coding conversion steps and staff training fulfillment.
About PMI
PMI is the nation’s leading provider of continuing education for medical office professionals, with a broad curriculum of educational workshops that address the office training needs for private practice physicians. Classes are presented in leading hospitals, health care systems, and medical societies. For more than 30 years, physicians have relied on PMI to provide the latest information on managing an efficient and compliant practice.
CPT E/M codes are changing January 1, 2021. This webinar unpacks those changes for you, outlining everything you need to know including:
How to navigate all the changes
What these mean for reimbursement
What you need to know to make sure your providers and coders are ready.
Telemedicine has moved to the forefront of healthcare, opening up opportunities for both practices and their patients. To help unpack some of the enormous amounts of new information, This presentation focuses on:
- Relaxing of Regulatory Issues
- How Telemedicine Can Help Your Practice
- Challenges
- The Future of Telemedicine
This episode continues our COVID-19 COVID-19 Insights Webinar discussing CMS changes, available grants and loans, existing opportunities in telehealth, and more state openings for elective surgeries.
The COVID-19 pandemic continues to present challenges to healthcare practices. This presentation covers the reinstatement of elective surgeries in a few states, the greater adoption of remote tracking, and new developments with the FCC’s Telehealth Program.
It also goes over the technology CareOptimize has developed to help streamline COVID-19 monitoring and reporting, its genesis, and how this utility can help your practice post-pandemic.
This webinar continues the COVID-19 Insights webinar series. Topics include the loans and grants being offered by the government, how they differ, and how they may benefit your practice, including SBA Loans and Grants, HHS Grants, Medicare Advance/Accelerated Payments, and Telehealth Funding. The webinar also goes over the CareOptimize technology developed to assist with streamlining COVID-19 monitoring and reporting.
Does it feel like you’re falling behind on the latest CMS regulatory updates? You’re not alone. The CareOptimize COVID-19 Insights webinar is designed to keep you informed of everything going on with CMS as healthcare practices continue to adjust. Along with CMS updates, this webinar goes over SBA loans and Fee-for-service Advance/Accelerated Medicare payments.
CareOptimize COVID-19 Webinar series episode 2 continues with the most up-to-date news from CMS along with other regulatory changes affecting the healthcare industry. The primary focus is on a trio of distinct provider models and how each of them is managing their practices while adapting to the challenges of the pandemic. We also go over the technology CareOptimize has developed aimed at streamlining COVID-19 monitoring and reporting.
MIPS continues to be a major risk, with practices who do not participate subject to a 5% penalty. This webinar covers:
Rule clarification and changes that have occured since January 1st.
Measure clarification and changes that have occured since January 1st. Your measure calculations may be changing as a result.
Where your practice should be at this point in the year.
How we can help support unique workflows and provider documentation.
In the day and age of value based medicine, it is critical to optimize your reimbursements with more accurate coding.This webinar uses specific examples to demonstrate the intricacies of accurate coding and how you can actually benefit. Questions answered include:
• How is global service reporting changing?
• What procedures require reporting?
• Who is required to report?
• When do new requirements take effect?
MACRA is quickly approaching year 2. CMS recently released their 2018 Proposed Rule, and there are some significant changes everyone should be aware of.
Rather than wading through the 1,058 pages of the Proposed Rule, join CareOptimize for a look at the most important takeaways.
In less than 30 minutes, you'll learn:
Are any of your clinicians now exempt?
What is a Virtual Group, and will it save you money?
Are your practice's priorities aligned with the newly weighted categories?
How can the Proposed Rule increase your 2018 bonus?
Accountable Care Organizations (ACOs) have been part of the healthcare landscape for a while and remain an integral part of the move toward value-based medicine. CMS recently introduced a new model in the MSSP (Medicare Shared Savings Program), ACO Track 1+.
This presentation gives a broad overview of ACOs and explains the basics of the new Track 1+ model. Topics include:
- ACOs and their role in MACRA/MIPS
- Meeting or exceeding the standards
- Why the risk might be worth it
MIPS is here. Are You Ready? CareOptimize Is.
See how the MIPS Management Solution empowers practices like yours to:
1. Know provider scores in real-time and compare those to your peers across the country
2. Provide scorecards for each MIPS category
3. Model different scenarios to determine your highest MIPS score
4. Automatically submit to CMS
5. Choose which level of assistance is best for your organization
... And More!
Let's face it, changes are coming. Healthcare is about to undergo another big shift once the new administration comes in. Between the sure things and the big questions, CareOptimize has found a bit of clarity. Join us to learn what our experts advise you to do to stay on top of it all.
Are you:
Keeping up to date with your risk scoring?
Missing out on reimbursement premiums?
Ensuring accurate health profiles for your patients?
Proper risk adjustment is important, not only to ensure your patients' quality of care, but also to improve your bottom line. This CareOptimize presentation will take you from the basic tenets of risk adjustment to specific ways you can increase your risk scores and get the highest premium payments.
Meaningful Use: Programs, Penalities, and PaymentsBen Quirk
Meaningful Use is not dead!
MIPS may be just around the corner, but MU is still very much in the picture. There is enough time, however, for your practice to optimize 2016 reporting and increase 2018 payments and avoid penalties.
This presentation takes you through the steps needed to successfully attest for 2016 and be prepared for upcoming changes.
CMS has stopped being nice about ICD10. As of October 1, 2016, the grace period for not using specific codes for certain diagnoses is gone. If you are not precise with these codes, your denial rates will go up.
This presentatio helps you learn how you can avoid high denial rates and also explains:
- Key changes and revisions
- Written guidance from CMS and OIG that may negate a new guideline
- Chapter specific changes
- How to tell when you need documentation and when you don’t
2016 MIPS Final Rule: What you need to know NOWBen Quirk
Find out why you need to pay attention to this Final Rule and what adjustments you need to make to ensure you end up on the winning side of MIPS. It's a complicated program, and results from the Final Rule don't make it any easier.
With patient responsibility becoming an increasing part of clinics AR, you need to make sure you have an effective strategy in place. Learn how to maximize your collections without negatively impacting your relationships with your patients.
1. INSIGHTS
ICD-10
Wednesday, December 18, 2013
Disclaimer: Nothing that we are sharing is intended as legally binding or prescriptive advice. This
presentation is a synthesis of publically available information and best practices.
3. Quick Overview
October 1, 2014 hard cut-off
Affects all entities covered by HIPAA
14,000 ICD-9 codes grow to 68,000 ICD-10 codes
No impact on CPT codes
Version 5010 standards
Significant changes to clinical and revenue cycle
systems
• Complex conversion to updated codes
• System upgrades to expand data fields for longer codes
• Staff retraining on new versions and codes
•
•
•
•
•
•
5. ICD-10 Regulatory Mandates
Federal Mandate Department of Health and Human
Services Final Rule CMS-0013-F Published January
2009
HIPAA 5010
Transaction formats for payors
and providers
January 1, 2012
ICD-10
Diagnosis and procedure codes
for clinical transactions
October 1, 2014
6. What are ICD-10 Codes?
• Granular code set developed by WHO for:
– Increased clinical accuracy
– Improved disease tracking
– Disease trending
• More ICD-10 codes compared to ICD-9
ICD-9
14,000 diagnosis codes
4,000 procedure codes
5 digit numeric codes
ICD-10
68,000 diagnosis codes
87,000 procedure codes
7 digit alphanumeric codes
7. Anatomy of ICD-10 Diagnosis Codes
•
•
•
•
•
•
3–7 digits
Digit 1 is alpha, including O and I but no U
Digit 2 is numeric
Digits 3–7 are alpha (not case sensitive) or numeric
Decimal is after third digit
Examples:
– A78 – Q fever
– A69.21 – Meningitis due to Lyme disease; and
– S52.131a – Displaced fracture of neck of right radius, initial
encounter for closed fracture
9. Anatomy of ICD-10 Procedure Codes
• 7 digits
• Alpha (not case sensitive) or numeric digits
– O and I not used to avoid confusion with 0 and 1
• No decimal
• Examples:
– 0FB03ZX – Excision of liver percutaneous
approach, diagnostic; and
– 0DQ10ZZ – Repair upper esophagus, open
approach
10. Anatomy of ICD-10-PCS
• “Procedure”
– Complete specification of 7 characters
PCS Section
Body System
• Medical and
surgical
• Heart and
great vessels
Root Operation
• Dilation
Body Part
• Coronary
artery, one
site
Approach
• Percutaneous
Device
• Intraluminal
device
Qualifier
• Bifurcation
11. Most Impacted Specialties
• Easy transition
– Hematology
– Oncology
• Hard
– Musculoskeletal
– Injury
– Poisoning
• Most challenging
– Obstetrics
– Psychiatry
– Emergency medicine (poisoning)
• 42% of infectious disease code mappings convoluted, which will
impact most specialties
12. What is SNOMED?
• Acronym for Systematized Nomenclature of
Medicine – Clinical Terminology
• International standard for comprehensive clinical
terminology
• Available at no cost through the National Library
of Medicine
• Enables providers and EHRs to communicate in
common language
– Increased quality of patient care across specialties
– Improved accuracy of patient data analysis
13. What is SNOMED? Continued
• Structured into 19 “hierarchies” which define
the clinical concept
• Broken down into increasing granularity
• Very specific clinical concepts to define patient
condition
• More complex than ICD-10 hierarchy
14. Why is it important?
• MU2 criteria expands upon MU1
requirements to improve and utilize HIT and
EHRs
– Provide consistent, collaborative care
– Interoperability between EHRs and need for
understanding each other
• Use of common language
• Problem list
15. The ICD-10-SNOMED Relationship
• SNOMED CT has better clinical coverage than ICD
• Number of codes:
– SNOMED CT (Clinical finding): 100,000
– ICD-9-CM: 14,000
– ICD-10-CM: 68,000
• ICD focus is statistical
– Less common diseases subsumed under general categories
– After-the-fact codes
• SNOMED CT is clinically-oriented
– Used during care
– Clinical relevance and user-friendliness
• Clinically coded data generates ICD-10 code for billing
17. Effective Implementation Strategy
Impact Analysis
Needs Assessment
Project Plan
Budget
Conversion
•Identify current systems
and work processes that
use ICD-9 codes
•Talk with payers about
effect of ICD-10
implementation on
provider contracts
•Workflow and business
process changes
•Staff training
•Practice management
vendor accommodations
•Implementation plan
with clearing houses,
billing services, and
payers
•Inventory systems and
workflows
•Contingency plan for
failed go-live
•Time and costs related
to implementation
•Training
•IT/IS upgrade
•Assistance from outside
vendor/consultant
•Potential productivity
loss
•Transaction testing
using ICD-10 codes
•Historic data conversion
•Review coded data for
claims reimbursement
consistent with ICD-9
rates
19. Training
• AHIMA recommendation: begin no more than six months
before compliance deadline
• Approximately 16 hours for ambulatory coders and 50
hours for hospital coders
– Physician practice coders need to learn ICD-10 diagnosis coding
only
– Hospital coders need to learn both ICD-10 diagnosis and ICD-10
inpatient procedure coding
• Specialty-specific ICD-10 training
• ICD-10 coding training integrated into credential
maintaining CEUs
• ICD-10 resources and training materials available through
CMS, professional associations and societies
22. What’s Next?
January 8,
2014 –
Meaningful
Use 1
January 15,
2014 –
Meaningful
Use 2
January 22,
2014 –
PatientCentered
Medical
Home
(PCMH)
January 29,
2014 –
Accountable
Care
Organizations
(ACOs)