In this 45-minute webinar, You will hear from top members of our ICD-10 team, Thomas Grove, Principal and D’Arcy Guerin Gue, Executive Vice President, as they discuss how to ensure the smoothest possible conversion, by restructuring your strategy in eleven critical areas. Find the recording here - http://landing.phoenixhealth.com/icd-10-2015-webinar

1. © 2014 Phoenix Health Systems. All rights reserved.
RE-STRATEGIZING FOR A
SUCCESSFUL ICD-10 / 2015
TRANSITION
1

2. © 2014 Phoenix Health Systems. All rights reserved. 2
Our Presenters
D’Arcy
Guerin
Gue
EVP
Corporate
Services
Phoenix
Health
Systems
Thomas
Grove
Principal,
ICD-­‐10
Leadership
Team
Phoenix
Health
Systems
Phoenix Health Systems’ consulting services and knowledge leadership
resources include a strong emphasis on ICD-10 project management and other
regulatory initiatives, such as Meaningful Use.
http://www.phoenixhealth.com

3. © 2014 Phoenix Health Systems. All rights reserved. 3
SEND US YOUR QUESTIONS:
Expand
the
“QuesDons/Chat”
area
Choose
“Send
quesDon
to
Staff”
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the
drop
down
Enter
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quesDon
into
the
chat
pane
Ask them through the chat pane on the GoToWebinar dashboard.

4. © 2014 Phoenix Health Systems. All rights reserved. 4
OBJECTIVES OF THIS WEBINAR
Understand
the
ICD-­‐10
Delay
• What
we
know
(and
don’t
yet
know).
• Why
the
delay.
Developing
a
strategy
to
go
forward
that
• Meets
organizaDonal
needs.
• EffecDvely
uses
personnel.
• Makes
the
most
of
the
effort
already
expended.
• Minimizes
redundant
spending.

5. © 2014 Phoenix Health Systems. All rights reserved. 5
THE ICD-10 DELAY
ICD-­‐10
ImplementaDon
dates:
• Originally
October
1,
2013
• CMS
delayed
to
October
1,
2014
“We
have
delayed
it
several
/mes,
most
recently
last
year.
There
will
be
no
change
in
the
deadline
for
ICD-­‐10”
-­‐-­‐
Marilyn
Tavenner,
CMS
Administrator
HIMSS
2014

6. © 2014 Phoenix Health Systems. All rights reserved. 6
April
1
-­‐
Congress
delays
implementaDon
of
ICD-­‐10
to
“not
prior
to
October
1,
2015.”
May
1
–
CMS
confirms
the
new
ICD-­‐10
transiDon
date
as
October
1,
2015.
CMS
also
announced:
§ End-­‐to-­‐end
tesDng
with
providers,
originally
scheduled
for
July
21
–
25,
will
be
cancelled.
“AddiDonal
opportuniDes
for
end-­‐to-­‐end
tesDng
will
be
available
in
2015.”
§ ICD-­‐9
will
sDll
be
used
unDl
September
30,
2015,
which
appears
to
rule
out
a
soa
phase
in.

7. © 2014 Phoenix Health Systems. All rights reserved. 7
According to an April, 2014 survey performed by HFMA:
90% 58%
Most respondents were not able to predict financial impact:
71% 22%
Of
hospitals
>
600
beds
were
confident
in
their
readiness.
Of
hospitals
100
beds
or
less
were
confident
in
their
readiness.
Of
hospitals
had
analyzed
less
than
half
of
their
contracts
for
financial
impacts.
Of
hospitals
had
completed
conDngency
plans
to
miDgate
transiDon
risk.
MGMA
noted
in
February,
2014
that
only
10
percent
of
physician
pracDces
had
“made
significant
progress”
on
ICD-­‐10
readiness.
Why a Delay?

8. © 2014 Phoenix Health Systems. All rights reserved. 8
Edmund
Billings,
MD,
Chief
Medical
Officer
for
Medsphere
Systems
CorporaDon,
described
healthcare
providers
as
belonging
to
one
of
two
groups:
Group
One
–
“Have-­‐a-­‐lot”
FaciliDes
FaciliDes
who
are
equipped
with
the
resources
to
meet
ICD-­‐10
deadlines
and
feel
confident
of
a
posiDve
outcome.
• For
these
faciliDes,
the
delay
is
an
opportunity
to
slow
their
efforts,
and
perhaps
focus
on
Meaningful
Use.
Group
Two–
“Have-­‐not”
FaciliDes
FaciliDes
(usually
smaller
providers)
who
were
behind
on
ICD-­‐10
efforts,
and
are
breathing
a
collecDve
sigh
of
relief
as
a
result
of
the
delay.
• For
these
faciliDes,
the
delay
is
an
opportunity
to
finish
ICD-­‐10
preparaDons
in
a
more
raDonal
way.

9. © 2014 Phoenix Health Systems. All rights reserved. 9
q Will
there
be
addiDonal
tesDng
opportuniDes
with
CMS
and
other
payers?
q How
much
will
the
delay
cost
providers?
q When
will
CMS
educaDon
resources
be
updated?
q How
will
the
current
“parDal
code
freeze”
be
handled?
What We Still Don’t Know

10. © 2014 Phoenix Health Systems. All rights reserved. 10
April 2014 October 2014 October 2015
Before
the
delay
–
with
six
months
to
go
–
providers
should
have
been:
q Performing
or
finalizing
coder
and
provider
training.
q Preparing
to
train
their
work
force.
q ExecuDng
internal
and
payer
tesDng.
q Coding
charts
in
ICD-­‐10
for
pracDce
and
analysis.
A@er
the
delay
–
with
18
months
to
go
–
providers
should
be:
q Redefining
the
organizaDonal
strategy
for
ICD-­‐10,
including
developing
a
new
project
plan
with
a
modified
Dmeline.
This
new
strategy
must:
q Meet
organizaDonal
regulatory
needs,
e.g.
Meaningful
Use.
q EffecDvely
uDlize
personnel.
q Make
the
most
of
the
effort
and
dollars
already
expended.

11. © 2014 Phoenix Health Systems. All rights reserved.
Ensure the Smoothest Possible
ICD-10 Conversion in 2015…
Restructure your implementation strategy in at least 11 critical areas:
1. IT
2. Testing
3. Revenue Analysis
4. Cash Management
5. Contracts
6. Clinical Documentation Improvement (CDI)
7. Physician Engagement
8. Education
9. Human Resources
10. Practice Coding
11. ICD-10 Coding and Back-Mapping
11

12. © 2014 Phoenix Health Systems. All rights reserved. 12
IT Strategy
Assess the status of major IT projects in the organization.
Some
project
prioriDes
(those
driven
by
mandatory
upgrades
to
support
ICD-­‐10)
will
change.
Some
project
end
dates
may
shia
to
provide
resources
to
projects
with
fast
approaching
deadlines,
like
Meaningful
Use
Stage
2.
§ It
probably
doesn’t
make
sense
to
put
off
upgrades
for
a
year.
• Other
improvements
and
fixes
can
be
made
in
the
soaware.
• ICD-­‐10
compliant
soaware
supports
both
ICD-­‐9
and
ICD-­‐10.
Vendors
stretched
for
implementaDon
resources
will
have
more
Dme,
providing
some
relief.
Consider
new
implementaDons
-­‐
Computer
Assisted
Coding
may
now
be
possible.

13. © 2014 Phoenix Health Systems. All rights reserved. 13
Testing Strategy
The additional year offers more time for industry-wide testing.
§ Unit
tesDng
§ Integrated
tesDng
§ TesDng
with
clearinghouses
§ TesDng
with
payers
Most
tesDng
will
be
claim
acceptance
tesDng.
Few
payers
have
offered
end-­‐to-­‐end
tesDng.
§ The
lack
of
end-­‐to-­‐end
tesDng
means
providers
will
have
likle
insight
on
how
their
coded
claims
actually
interact
with
the
clinical
rules
in
the
payer’s
claims
processing
system.
§ Based
on
historical
experience
with
the
HIPAA
v4010
to
v5010
conversion,
there
will
be
providers
who
“Pass”
in
tesDng
and
“Fail”
in
producDon.

14. © 2014 Phoenix Health Systems. All rights reserved. 14
Revenue
Analysis
Strategy
Providers
now
have
Dme
to
perform
more
analysis
on
the
revenue
impacts
of
ICD-­‐10.
Four
Key
Steps
to
Revenue
Impact
Analysis
1. Assess
current
documentaDon.
2. Assess
ICD-­‐10
coding.
3. Assess
the
impact
of
your
ICD-­‐10
coding
on
DRG
assignments.
4. Assess
the
impact
of
proposed
ICD-­‐10
payer
reimbursement
rates
on
cash
flow.
Doing
this
analysis
now
provides
data
for
revenue
forecasDng,
and
also
idenDfying
areas
for
process
improvement
that
will
benefit
your
current
cash
flow.

15. © 2014 Phoenix Health Systems. All rights reserved. 15
Cash Management Strategy
Remedy
the
negaDve
impacts
on
hospital
cash
reserves
as
a
result
of
the
rush
to
implement
upgrades
for
MU
and
ICD-­‐10.
Impacts
of
rushed
implementaHon
§ Limited
resources
used
in
implemenDng
new
systems
were
unavailable
for
regular
producDon
work,
resulDng
in
slow
billing
and
receivables.
§ Revenue
impacts
from
rushed
implementaDon.
§ Costs
to
perform
projects
have
depleted
ready
cash.
Hospitals
can
use
the
extra
12
months
to:
§ Reduce
unbilled
inventory
and
unresolved
claims.
§ OpDmize
upgraded
systems
and
enhance
workflow
processes
(systems
and
manual).
§ Retain
cash
prior
to
October
2015
to
prepare
for
ICD-­‐10
impacts.

16. © 2014 Phoenix Health Systems. All rights reserved. 16
Contract
Strategy
Quickly
address
contracts
for
ICD-­‐10
services.
Most
computer-­‐based
training
vendors
license
content
using
a
yearly
model.
Extending
ICD-­‐10
means:
§ Changing
dates
of
use.
§ Extending
the
length
of
use
→
more
$.
§ Contract
negoDaDon
will
be
required.
for
contracts
without
delay
clauses.
Resource
websites
and
other
subscripDon
services
will
be
similarly
affected.
Vendors
for
contract
coding
services
will
be
most
severely
impacted.
§ These
vendors
will
likely
be
willing
to
negoDate
to
retain
the
use
of
their
services
over
the
next
year
so
that
they
can
retain
the
staff.

17. © 2014 Phoenix Health Systems. All rights reserved. 17
CDI Strategy
Don’t
let
Clinical
DocumentaDon
Improvement
efforts
be
affected
by
the
ICD-­‐10
implementaDon.
Training
in
enhanced
documentaHon
should
not
be
delayed
§ Quality
physician
documentaDon
is
independent
of
which
coding
scheme
is
used.
§ Enhanced
documentaDon
will
improve
current
case
mix
and
revenue.
§ Revenue
analysis
results
can
be
used
to
guide
training.
§ Complete
documentaDon
provides
a
more
realisDc
foundaDon
for
coders
pracDcing
ICD-­‐10
coding,
revenue
analyses,
and
tesDng.
Consider
documenHng
using
SNOMED
terminology
§ The
terminology
is
more
logical
for
physicians.
§ Streamlines
the
transiDon
from
ICD-­‐9
to
ICD-­‐10.
§ SNOMED
codes
are
required
for
Meaningful
Use.

18. © 2014 Phoenix Health Systems. All rights reserved. 18
Physician
Engagement
Strategy
§ UnderuDlized
coders
can
provide
office
coding
and
documentaDon
services.
§ Skilled
trainers,if
already
employed,
can
provide
training
to
physician
offices.
§ AddiDonal
physician
training
in
documentaDon
can
be
provided.
§ OrganizaDons
with
poor
physician
involvement
in
EMR
and
CDI
projects
can
use
this
Dme
to
beker
engage
key
physicians
in
both
efforts.
Use
the
extra
year
to
provide
benefits
to
physician
offices
as
part
of
their
physician
engagement
strategies.

19. © 2014 Phoenix Health Systems. All rights reserved. 19
Education Strategy
Assess
the
current
state
of
ICD-­‐10
training.
Most
faciliHes
have
already
started
the
80
–
120
hours
of
training
required
for
coders.
Hospitals
have
three
choices
on
how
to
proceed:
1. Complete
coder
training
now
and
provide
coders
the
opportunity
to
code
in
ICD-­‐10.
2. Complete
coder
training,
but
plan
refresher
training
next
year.
3. Stop
training
now
and
plan
to
fully
train
staff
in
2015.
Broader
workforce
training
that
hasn’t
begun
should
probably
be
delayed
unDl
next
year.

20. © 2014 Phoenix Health Systems. All rights reserved. 20
Human
Resources
Strategy
ProacDve
hiring
may
have
resulted
in
overstaffing
due
to
the
delay.
§ Staffing
may
be
reduced
through
akriDon.
§ Planned
hiring
can
be
slowed.
If
providers
choose
NOT
to
reduce
staff,
coders
can:
§ PracDce
coding
exercises
to
improve
ICD-­‐10
accuracy
and
producDvity.
§ Perform
documentaDon
assessments
as
part
of
Clinical
DocumentaDon
Improvement
efforts.
§ Provide
quality
oversight
of
exisDng
coding
acDviDes.
Also
consider
novel
approaches…
§ Using
coders
in
physician
pracDces
to
assess
and
improve
coding.
§ Paying
coders
a
bonus
to
delay
their
start
date.
§ Offer
part
Dme
employment.

21. © 2014 Phoenix Health Systems. All rights reserved. 21
Practice Coding Strategy
Two
forms:
1. Dual
coding
allows
coders
to
pracDce
ICD-­‐10
coding
by
using
both
ICD-­‐9
and
ICD-­‐10
codes
on
a
single
chart.
2. PracDce
coding
allows
coders
to
code
a
specific
set
of
charts
in
ICD-­‐10.
Benefits
§ AcDonable
data
for
coder
readiness
assessments.
§ Focused
remedial
training
can
be
provided
for
trouble
areas.
§ ProducDvity
assessments
will
provide
management
with
useful
advance
data
on
the
quanDty
of
resources
and
overDme
required
in
October
2015.
§ AcDonable
data
for
assessing
revenue
impacts
and
provider
documentaDon
training
efforts.
Allow
coders
to
pracDce
their
ICD-­‐10
coding
skills.

22. © 2014 Phoenix Health Systems. All rights reserved. 22
ICD-10 Coding and Back Mapping
§ Most
providers
who
planned
to
go
live
with
ICD-­‐10
before
October
1,
2014
were
planning
to
use
this
method.
§ Mapping
from
ICD-­‐10
back
to
ICD-­‐9
is
considerably
easier,
since
there
is
more
specificity
in
ICD-­‐10.
§ Providers
would
have
access
to
a
full
set
of
ICD-­‐10
data
for
tesDng
and
financial
projecDons.
§ This
soluDon
works
aaer
a
formal
transiDon
to
ICD-­‐10,
because
coders
do
not
have
to
worry
about
which
payers
are
not
accepDng
ICD-­‐10
data.
Some
organizaDons
are
planning
to
switch
to
ICD-­‐10
coding
and
use
a
mapping
table
to
map
back
to
ICD-­‐9
for
billing.

23. © 2014 Phoenix Health Systems. All rights reserved. 23
2014
2015
May-­‐
Jun
Jul-­‐
Sep
Oct-­‐
Dec
Jan-­‐
Mar
Apr-­‐
Jun
Jul-­‐
Sept
Oct-­‐
Dec
Replanning
RenegoHate
Vendor
Contracts
ImplementaHon
Clinical
DocumentaHon
Improvement
Finish
ICD-­‐10
ImplementaHons
Revenue
and
Cashflow
Analysis
Coder
PracHce
Process
&
System
OpHmizaHon
OrganizaHonal
Training
Post-­‐Live
Monitoring
Putting It All Together: Phases for
ICD-10 / 2015

24. © 2014 Phoenix Health Systems. All rights reserved. 24
Takeaways
q Use
the
addiDonal
year
to
refine
your
overall
strategy,
especially
where
the
earlier
deadline
was
requiring
rushed
acDvity,
short
cuts,
or
risky
gaps.
q Leverage
Dme,
money
and
effort
already
spent
by
idenDfying
the
acDviDes
you
can
sDll
move
forward
on,
but
at
a
slower
pace.
Losing
the
momentum
and
buy-­‐in
you’ve
achieved
will
cause
unnecessary
expense
and
duplicaDon
of
past
work.
q Reassess
and
refine
your
educaDon
and
training
efforts
in
line
with
your
new
Dmeline.

25. © 2014 Phoenix Health Systems. All rights reserved.
Takeaways
q Focus on your revenue cycle with a
vengeance -- and identify as many process
improvements you can make in this extra year,
to benefit your cash flow and minimize post
go-live disruption.
q Continue IT and workflow redesign projects at
a slower pace.
q Continue general awareness education and
communication updates across your
organization.
25

26. © 2014 Phoenix Health Systems. All rights reserved.
Summary:
ICD-10 Transition on October 1, 2015
Restructure your implementation strategy in at least 11 critical areas:
1. IT
2. Testing
3. Revenue Analysis
4. Cash Management
5. Contracts
6. Clinical Documentation Improvement (CDI)
7. Physician Engagement
8. Education
9. Human Resources
10. Practice Coding
11. ICD-10 Coding and Back-Mapping
26
If you were not making sufficient progress on ICD-10, you are in luck.
Use the extra time wisely!

27. © 2014 Phoenix Health Systems. All rights reserved. 27
Burning Questions?
Expand
the
“QuesDons/Chat”
area
Choose
“Send
quesDon
to
Staff”
from
the
drop
down
Enter
your
quesDon
into
the
chat
pane
Ask them now through the chat pane on the goToWebinar dashboard.

28. © 2014 Phoenix Health Systems. All rights reserved. 28
ü
Solid
ICD-­‐10
experDse
to
help
you
plan,
implement,
train
and
test
with
your
own
resources,
as
much
as
possible.
ü
Overall
project
leadership
and
support.
ü
Strong
emphasis
on
revenue
cycle
impact
management.
ü
Capacity
to
fill
internal
staff
and
experDse
gaps
on
short
term
or
long
term
project
phases.
ü
A
la
carte
services,
depending
on
your
needs
and
staffing.
ü
Diligent
akenDon
to
minimizing
costs.
Phoenix Health Systems ICD-10 Solutions

29. © 2014 Phoenix Health Systems. All rights reserved. 29
About Phoenix Health Systems
• Phoenix
Health
Systems
was
founded
over
20
years
ago
to
provide
IT
consulDng
and
outsourcing
services
to
healthcare
organizaDons.
• Phoenix
has
always
aligned
its
capabiliDes
to
key
healthcare
IT
iniDaDves,
especially
regulatory
mandates,
such
as
HIPAA,
HITECH,
Meaningful
Use
and
ICD-­‐10.
Over
the
years,
we
have
been
heralded
as
knowledge
leaders
in
these
areas.
• ConsulDng
Services:
Phoenix
focuses
on
project
leadership,
strategic
planning,
systems
implementaDon,
and
revenue
cycle
opDmizaDon.
We
also
provide
consulDng
and
outsourcing
in
areas
such
as
process
changes
and
infrastructure
issues.
• Outsourcing
Services:
Phoenix
provides
on-­‐shore
Service
Desk,
PC
support
and
network
management
outsourcing
to
numerous
hospitals.
• A
central
driver
of
our
client
relaDonships
is
working
together
to
tailor
highly
cost-­‐effecDve
soluDons,
without
sacrificing
quality,
or
creaDng
disrupDon
in
hospital
operaDons.

30. © 2014 Phoenix Health Systems. All rights reserved. 30
Contact
Us!
Email
dgue@phoenixhealth.com
or
thomas.grove@phoenixhealth.com
Looking
for
more
details
about
us
or
want
to
download
one
of
our
ICD-­‐10
resources?
Visit
hkp://www.phoenixhealth.com
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