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Impact Assessment for ICD10 Implementation
This document provides guidance and tools for medical practices to assess the impact of transitioning from ICD-9 to ICD-10 coding. It instructs users to identify current workflows, staff, software, and top codes that use ICD-9. It also has users assess necessary changes to workflows, look up code matches, and evaluate vendor and payer readiness. Finally, it has users plan training, including allocating tasks, training, testing costs, and technology purchases needed to implement ICD-10 by the October 2014 deadline.
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Impact Assessment for ICD10 Implementation
- 1. 1 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. MY ICD10 POSSE WEBSITE Please go to our website http://myicd10.advancedmd.com/ and download our Impact Assessment Tool if you didn’t receive it via email.
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- 3. 1. Understand thebasics of completing an Impact Assessment 2. Understand how to use the tools to complete an Impact Assessment 3. Answer questions and get your feedback Complete Survey – Price of today’s admission 3 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information.
- 4. 4 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. ICD-9 Technology Processes People ICD-10 Technology Processes People Current State of your Office Identify Assess Plan Budget Future State of your Office Who When $$$$
- 5. 5 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY AND LIST ALL OF YOUR OFFICE WORKFLOW PROCESSES THAT USE ICD-9 CODES TODAY Office Workflows Patient Financial Flow Patient Demo Appointment Scheduling Appt Confirmation Pt Check-in (Pre-Auth/Referral) Patient Clinical Flow Problem List History and physical Medications Patient Assessment-Documentation Orders (Lab/x-ray) Results Processing - Inbound/outbound Patient Education Health Maintenance-(Health Watcher) Charge Capture Charge slip/encounter form/super bill Coding the Charge Slip Claims generation Clearinghouse claims rejections Carrier claims rejections Track and Analyze success and failures Client perform reimbursement analysis A/R Follow-up/Decision Support Workflows can be found on the tab labeled - 1) Project Master tab
- 6. 6 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY AND LIST ALL OFFICE STAFF AND PROVIDERS WHO CURRENTLY WORK WITH ICD-9 CODES PHYSICIAN/OWNER NURSE MA MANAGER – ICD PROJECT TEAM BILLER – ICD PROJECT TEAM CODER – ICD PROJECT TEAM FRONT DESK Office staff members can be found on the tab labeled – 1) Project Master tab – Row 1 Physician/Owner Nurses OtherClinicalStaff Manager BillingStaff Coding FrontDesk
- 7. 7 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY AND LIST CURRENT ELECTRONIC SYSTEMS (E.G., PRACTICE MANAGEMENT SYSTEM, IN-HOUSE LAB, EHR, ETC.) THAT USE ICD-9 PartnerType Vendors/Partners ContactName ContactEmail ContactPhone PM/EHR ADP AdvancedMD ICD10 Posse icd10posse@advancedmd.com 801-984-9500 Ancillary Lab Corp Ancillary Radiology Technology Systems on the tab labeled – 2) Vendors Partners tab
- 8. Family Practice Office •984 Unique ICD-9 Codes 2012 • Top 10 ICD-9 Codes make up 33% • Top 20 ICD-9 make up 50% 8 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY YOUR MOST FREQUENTLY USED ICD-9 CODES Diagnosis Code Diagnosis Description Total Cumulative % % of Total V70.0 ROUTINE GEN MED EX@HLTH CARE FACL 2356 7% 7% 780.79 OTHER MALAISE AND FATIGUE 1747 12% 5% 257.2 OTHER TESTICULAR HYPOFUNCTION 1420 17% 4% V04.81 NEED PROPH VACCINATION&INOCULAT FLU 1015 20% 3% 314 ADD CHLD WITHOUT MENTION HYPERACTV 870 22% 3% 272.2 MIXED HYPERLIPIDEMIA 830 25% 3% 268.9 UNSPECIFIED VITAMIN D DEFICIENCY 734 27% 2% 244.9 UNSPECIFIED HYPOTHYROIDISM 663 29% 2% 401.9 UNSPECIFIED ESSENTIAL HYPERTENSION 654 31% 2% 784.1 THROAT PAIN 638 33% 2% Can be found on the tab labeled – 3) Most Frequently Used DX 2012
- 9. 9 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. IDENTIFY AND LIST ALL OF YOUR OFFICE WORKFLOW PROCESSES THAT USE ICD-9 CODES TODAY IDENTIFY AND LIST ALL OFFICE STAFF AND PROVIDERS WHO CURRENTLY WORK WITH ICD-9 CODES IDENTIFY AND LIST CURRENT ELECTRONIC SYSTEMS (E.G., PRACTICE MANAGEMENT SYSTEM, IN-HOUSE LAB, EHR, ETC.) THAT USE ICD-9 IDENTIFY YOUR MOST FREQUENTLY USED ICD-9 CODES
- 10. 10 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. ASSESS POSSIBLE WORK FLOW CHANGES YOU WILL NEED TO MAKE TO IMPLEMENT ICD-10 (E.G., DATA COLLECTION FORMS, ENCOUNTER FORMS, SUPERBILLS, ETC.) Office Workflows Process Step Questions LevelofImpact ACTION PLAN Charge slip/encounter form/super bill Look at the current Superbill and identify how many codes this will translate into using ICD10 codes. How large with this make the ICD10 charge slip? Will that size charge slip be feasible using a printed/hard copy? Evaluate the current charge slip for currently used codes vs. outdated codes. Map remaining codes from ICD9 to ICD10. H After evaluating the current printed superbill, the project team determined that the new ICD10 superbill would be over 8 pages long. The ICD10 project team suggest that we start using an electroning format of a Charge slip. Workflows can be found on the tab labeled - 1) Project Master tab
- 11. HOW WILL THELEVEL OF SPECIFICITY AFFECT • HOW THE PHYSICIAN DOCUMENTS • SITE • SPECIFICITY • LATERALITY • TIMING • MANIFESTATIONS • STAGE • STATUS • DRUG/ALCOHOL/TOBACCO DEPENDENCE 11 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information. USING ICD-10 CODE BOOK OR SOFTWARE TOOL TO LOOK UP YOUR MOST FREQUENTLY USED CODES AND IDENTIFY WHAT THE BEST POTENTIAL ICD-10 MATCH WOULD BE
- 12. 12 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. ASSESS YOUR VENDORS READINESS PartnerType Vendors/Partners ContactName ContactEmail ContactPhone W illyou be changingor upgradingforICD10 com pliance? Are you on trackto m eetthe OCT 2014 com pliance date? W illyou be testing in preparation for ICD10? W hen? How ? How m uch w illthis costourpractice to upgrade? PM/EHR ADP AdvancedMD ICD10 Posse icd10posse@advancedmd.com 801-984-9500 Using ADP ADVANCEDMD’s cloud based system, our clients have already benefitted from a year ofdevelopment, which we have completed behind the scenes, to build the foundation that will give upgraded functionality. ADP ADVANCEDMD Users will continue to see these enhancements throughout the next two years. We are on track to a fully functional and tested ICD- 10 product by the October 2014 deadline. Yes Last Quarter 2013 As with most enhancements, ICD-10 functionality is included in with your monthly subscription fee. Changes to functionality will be included in our general releases and all ofour clients will be able to process their claims using the ICD-10 codes. Ancillary Lab Corp No 2nd Quarter 2014 Ancillary Radiology Yes 2nd Quarter 2014 Technology Systems on the tab labeled – 2) Vendors Partners tab
- 13. 13 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. ASSESS YOUR PAYERS READINESS Payers 2012RevenueDollars 2012%ofRevenue ContactName ContactEmail ContactPhone W illyou be prepared to m eettheICD-10 Deadline? W hen w illyou be ready to test? W hatare yourplansfortestingclaim scontaining ICD-10 codes? How w illyou involve individualofficesin that process? Ifso,w hen? Do w e need to re-negotiate ourcontractsw ith thispayer? Ifw e need to re SELECTION HEALTH CARE 180,730$ 27% BLUE CROSS BLUE SHIELD 122,712$ 18% UHC STATE 47,397$ 7% DESERT BENEFIT 47,249$ 7% EDUCATORS INSURANCE ASSOC 44,234$ 7% CIGNA 41,403$ 6% AETNA 35,066$ 5% ALTIUS 30,654$ 5% PUBLIC EMPLOYEES HEALTH 26,378$ 4% UHC 22,920$ 3% HUMANA 15,026$ 2% BLUE CROSS BLUE SHEILD OF SOMEWHERE 11,682$ 2% AARP 9,679$ 1% Mountain Adminstrators 9,102$ 1% MEDICARE - PART A 8,347$ 1% STATE MEDICAID 4,677$ 1% MANAGED CARE ADMIN 4,373$ 1% CIGNA of Earth 1,058$ 0% MEDICARE ADVANTAGE 967$ 0% MEDICAID 353$ 0% MAIL HANDLERS BENEFIT PLAN 169$ 0% CONNECTICUT GENERAL 145$ 0% Technology Systems on the tab labeled – 4) Payers tab
- 14. 14 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. ASSESS POSSIBLE WORK FLOW CHANGES YOU WILL NEED TO MAKE TO IMPLEMENT ICD-10 (E.G., DATA COLLECTION FORMS, ENCOUNTER FORMS, SUPERBILLS, ETC.) USING ICD-10 CODE BOOK OR SOFTWARE TOOL TO LOOK UP YOUR MOST FREQUENTLY USED CODES AND IDENTIFY WHAT THE BEST POTENTIAL ICD-10 MATCH WOULD BE ASSESS YOUR VENDORS READINESS ASSESS YOUR PAYERS READINESS ASSESS THE NEED TO HAVE A CONSULTANT TO ASSIST YOU WITH TRANSITIONING TO THE ICD-10 CODE SET (E.G., IDENTIFY SYSTEM CHANGES, IDENTIFY WORK FLOW CHANGES, AND CONDUCT TRAINING)
- 15. 15 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. PLAN AND OUTLINE HOW YOU INTEND TO TRAIN YOUR OFFICE STAFF ON THE NEW ICD-10 PROCESSES PLAN WHEN TO CONDUCT THE TRAINING PLAN WHO YOU INTEND ON NEEDING TRAINING AND WHO WILL BE INVOLVED IN TESTING Office Workflows Process Step Questions LevelofImpact ACTION PLAN Charge slip/encounter form/super bill Look at the current Superbill and identify how many codes this will translate into using ICD10 codes. How large with this make the ICD10 charge slip? Will that size charge slip be feasible using a printed/hard copy? Evaluate the current charge slip for currently used codes vs. outdated codes. Map remaining codes from ICD9 to ICD10. H After evaluating the current printed superbill, the project team determined that the new ICD10 superbill would be over 8 pages long. The ICD10 project team suggest that we start using an electroning format of a Charge slip.
- 16. 16 © Copyright2011 ADP, Inc. Proprietary and Confidential Information. IMPLEMENTING A NEW SUPER BILL PROCESS – WHO, WHEN, AND HOW MUCH Who •Entire Staff When •Project Team Map out process in their April and May meetings •Office will meet to discuss and give input May 10th •Bi-Monthly training for staff starting Jan 2014 •Bi-Monthly training testing for staff starting Feb 2014 How Much will it cost •Tasks-$7,040 •Training-$6,710 •Testing-$3,530 •Technology-$987 Purchase Feb 2014
- 17. 1. Don’t letthis project overwhelm you 2. Start now 3. Answer questions and get your feedback Complete Survey – Price of today’s admission 17 © Copyright 2011 ADP, Inc. Proprietary and Confidential Information.