ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10...

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ICD-10 CHANGE AHEAD Change is HARD 1) ICD-9 CM implemented in 1979 2) Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000, Australia 1998 3) Canada has used ICD-10 since 2001

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Transcript of ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10...

Page 1: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

ICD-10CHANGE AHEAD

Change is HARD1) ICD-9 CM implemented in 1979

2) Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000, Australia 1998

3) Canada has used ICD-10 since 2001

Page 2: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

More Codes More Detail

• Greater specificity• Ability to measure healthcare services• Refinement of grouping and reimbursement

methodologies• Enhancement of public health surveillance• Decreased need to include supporting

documentation with claims

Page 3: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Other Features

• Includes updated medical terminology and classification of diseases

• Provides codes to allow comparison of mortality and morbidity data

• Provides for better data for: Measuring care furnished to patients Designing payment systems Processing claims0

Page 4: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Further Enhancements

• Making clinical decisions• Tracking public health Worldwide: WHOIdentifying Fraud and AbuseConducting research

Page 5: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Implementation

• Date extended to October 1, 2014

More time to prepare physiciansStaffVendorsSystems

Page 6: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Education

• Allow at least 12 -15 months for education

of coding staff• Recommend review of ICD-

10 chapters by body system• Review of rules changes in

sequencing of diagnoses

Page 7: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

ICD-10 Chapters

• 21 chapters • From Infectious Disease

through factors Influencing Health Status and Contact with Health Services.

• Sense Organs, Eye and Ear are separate chapters

(7 & 8)Chapter 16 is Conditions originating in the Perinatal Period—Newborn only

Page 8: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Other Chapters

• Chapter 17 • Congenital malformations,

deformations andChromosomal abnormalities

Page 9: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Other Chapters

• Chapter 20External Causes of morbidityIncludes transport accidents, Slipping, tripping and fallsExposure(contact with animals causing injury)Drowning, near drowningSmoke, fire, flames

Page 10: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Chapter 20 continued

• Assault• Legal intervention• Operations of war and

Military operations• Terrorism

Coders should review all coding guidelines listed for ICD-10, as coding clinics will no longer be applicable.

Page 11: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

POA Present on Admission

• POA Guidelines will be reported.

• Inpatient admissions principal and secondary dx as well as external cause of injury.

Page 12: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Clinical Documentation Improvement

• Concurrent coding• Queries• Involve and Educate other

staff: Nursing Case Managers Allied Health Cardiopulmonary Laboratory Pharmacy Rehab staff

Page 13: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Concurrent will expedite

• Concurrent moves the process more quickly

• Education of Medical Staff• New Physicians/New Grads have already used ICD-10--How do we help the senior members of our Medical Staff?

Page 14: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Use Existing Opportunities

• Medical Staff Meetings Develop an ICD-10 minute or section for each Medical Staff meeting (just like Safety Moments)

The accuracy and specificity will assist the physician/practitioner, as much if not more than the Facility.

Page 15: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

What Vendors/Programs use Codes

• Check systems• Test Systems State Reporting Registries Billing and Collection Systems

Testing should be scheduled by the vendor. ASK2013 or early 2014 to work out bugs!

Page 16: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Prepare

• Coders should begin to use ICD-10 in actual accounts 1) Use ICD-9 and ICD-10 2) Determine what documentation may be needed in addition to what your physicians are usuallydocumenting 3) Educate as needed

Page 17: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Computerized Coding Systems

• CAC: Computer assisted coding

Electronic record/scanned record

Will still need coders to edit

Page 18: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Reimbursement

• Prediction of some variation in payment

Mapping will need further review

Page 19: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

Websites

• AHIMA.org• CMS• WVHIMA.org

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Page 22: ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000,

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