AGENDA

• The What & Why of ICD-10

• Current Promotions• Q&A• Practice Choice Demo• Free Tools

THE WHAT

• Currently, the United States uses the ICD code set, NinthEdition (ICD-9), originally published in 1977, and adoptedby this country in 1979 and subsequently mandated asthe Medicare claims standard in 1989

• In 1990, the WHO updated its international version of theICD-10 (Tenth Edition, Clinical Modification) code set formortality reporting. The majority of the world beganadopting ICD-10 in 1994, but the United States onlypartially adopted ICD-10 in 1999 & only for mortalityreporting.

ICD-10 INCREASES

• For diagnoses, there are14,025 ICD-9-CMcodes and 68,069 ICD-10-CM codes

• So in some cases one ICD-9 is representedby multiple ICD-10

ICD - 10 BROKEN DOWN

DIAGNOSIS CODING & DATA DIFFERENCES

I C D - 9 - C M

3–5 characters in length Over 14,000 diagnosis

codes Only V codes and E codes

start with a letter Limited space for adding

new codes Cannot identify laterality

I C D - 1 0 - C M

3–7 characters in length Over 69,000 diagnosis

codes ALL codes start with a

letter Flexible for adding new

codes Many codes require

laterality

WHY SO MANY DIAGNOSIS CODES?

Greater specificity and detail:34,250 (50%) of all ICD-10-CM codes are relatedto the musculoskeletal system.17,045 (25%) of all ICD-10-CM codes are relatedto fractures.10,582 (62%) of fracture codes distinguish rightfrom left.25,000 (36%) of all ICD-10-CM codes distinguishright from left.

ONE TO MANY820.02 Fracture of midcervical section of femur, closed

• S72.031A Displaced midcervical fracture of right femur, initialencounter for closed fracture

• S72.031G Displaced midcervical fracture of right femur,subsequent encounter for closed fracture with delayed healing

• S72.032A Displaced midcervical fracture of left femur, initialencounter for closed fracture

• S720.32G Displaced midcervical fracture of left femur,subsequent encounter for closed fracture with delayed healing

ICD-10 SIMPLIFICATION

In some cases one ICD-10code is represented bymultiple ICD-9 codes intosimplifying the process.

FROM MANY TO ONEE11341 Type 2 diabetes mellitus with severenonproliferative diabetic retinopathy with macularedemaCombines the following ICD-9 cluster:• 250.50 Diabetes with ophthalmic manifestations,

type II or specified type, not stated as uncontrolled• 362.06 Severe nonproliferative diabetic retinopathy• 362.07 Diabetic macular edema

NEW CODES TO CAPTURE NEW DATA• T500x6A Underdosing of mineralocorticoids and their

antagonists, initial encounter• T501x6A Underdosing of loop [high-ceiling] diuretics, initial

encounter• T502x6A Underdosing of carbonic-anhydrase inhibitors,

benzothiadiazides and other diuretics, initial encounter• T503x6A Underdosing of electrolytic, caloric and water-

balance agents, initial encounter• T504x6A Underdosing of drugs affecting uric acid

metabolism, initial encounter

AND SOME SLIGHTLY SILLY CODES

From the mundane to the exotic, everything and everyplace is covered. From farm country chicken coops toevery room in a mobile home to opera houses. Everyactivity included water skiing, crochet, dancing or ourfavorite walking into a lamp-post, repeatedly.• 240 different codes for being struck by . . . lightning,

falling objects and every type of ball know to man• 96 codes for being bitten by various animals, birds,

insects and aquatic life. This does not include beingstruck by them as that is a different code set.

SOME MAKE US LAUGH

• 10 codes regarding dangerous encounters with chickensincluding• Y9272 - Chicken coop as the place of occurrence of the

external cause• 9 different codes relating to being bitten by a turtle• 9 codes for reporting being bitten, struck or other contact with a

macaw• 27 codes to report water skiing related injuries including initial,

subsequent and secondary consequences of Burn due to waterskis on fire

• Our personal favorite here• W2202XD – Walked into lamppost, subsequent encounter

CAN EVEN DIAGNOSE HOMER SIMPSON

W85XXXD - Exposure to electric transmission linessubsequent encounter

DON’T CODES GET UPDATED ALL THE TIME???

• ICD-10 codes are completely different from ICD-9codes.

• ICD-10 codes are alphanumeric and contain 3 to7 characters.

• ICD-10 is more robust and descriptive with “one-to-many” matches to ICD-9 in some instances.

• ICD-10 codes will be updated every year just likeICD-9 are now.

• ICD-9 codes will not continue to be updated afterOctober 1, 2014.

THE WHY

The transition is occurring because ICD-9 is limited data. It’s 30years old, has outdated terms, and is inconsistent with currentmedical practice. The current structure limits the number of newcodes that can be created, and the majority of categories are full.

POLL RESULTS

• How prepared are you for ICD-10 implementation?

• All set! Can't wait for ICD-11. 7%

• Informed, and working an established plan to successfulimplementation. 12%

• I've heard of it and have some ideas of what to do. 22%

• This is all news to me! 37%

• I have my plan in place. It's called retiring on September 30th,2014. 22%

ONE PLAN . . . . .

1. Opt out of Medicare: check.

2. Opt out of Medicaid: check.

3. Drop low-paying insurance contracts: check.

4. Drop fair-to-middling insurance contracts: planned by end of 2010.

5. Drop all other insurance contracts: wait--there are other (i.e., "good")insurance contracts? No, silly. There aren't.

6. Bill “terrible reimbursement” insurance as a courtesy in 2011 & 2012.

7. Begin exit strategy to next career 2011.

8. Either transition to cash only (if still legal) and/or transition to nextcareer in 2012

9. Quit practice in 2013 or 2014 or whenever this actually rolls out.

SO WHAT DOES THIS MEAN TO ME?

• Claims with ICD-9 codes for services provided on or afterthe compliance deadline cannot be paid.

• ICD-10 diagnosis codes must be used for all health careservices provided in the U.S.,

• All electronic transactions must use Version 5010standards which accommodates ICD-10 codes.

The ICD-10 deadline is October 1, 2014

WE CHOOSE TO BE PROACTIVE

SO YOU HAVE A CHOICE . . . .

Wander & figure this out on your own

We would like to offer a compass & a map.We just cannot take the journey for you.

FACT

The transition from ICD-9 to ICD-10 isgoing to change how you do business.

The transition will go much more smoothlyfor those who plan ahead and preparenow.

RECOMMENDED PLANWe recommend following CMS guidelines for a Phased Implementation

1. Planning

2. Communication and Awareness

3. Assessment

4. Operational Implementation

5. Testing

6. Transition

VENDOR PARTNERWe are here as your Vendor Partner committed to yoursuccess. We want to assist you in keeping alive the practiceyou’ve worked so hard to create.

We are providing a Phase 1 Implementation Plan and aReadiness Assessment to take with you to begin the steps ofyour phased implementation.

Thus creating a Win-Win!

CONTINUING RESOURCES

MedTech

Continued commitment to our clients

Continuing User Group meetings

Continued Dynamic Informational Seminars

Phase 1 – Top 10 List Implementation Plan

AHIMA ICD-10 Practice Readiness Assessment

One on one training

HELPFUL WEBSITES

This first site is one used by our billers currently to look up codes &has a handy conversion to ICD-10 function: http://www.icd9data.com/2013/Volume1/240-279/249-

259/250/250.00.htm

These next one is a CMS sites for ICD-9-CM to ICD-10-CM GEMs: http://www.cms.gov/Medicare/Coding/ICD10/index.html

As always there is the Forum available through the MedTechwebsite.

HELPFUL TOOLS IN NEW SOFTWARE

Medisoft Version 19 will have the following helpful tools.1. Insurance Code Version Utility You will have the ability to set the code version for

each Insurance! You will also have the ability to set the ICD-10

Effective Date for each insurance

INSURANCE CODE VERSION UTILITY

TOOLS IN NEW SOFTWARE

2. Visual IndicatorIf the insurance is set to ICD-10 and the userplaces an ICD-9 code in transaction entry:Diagnosis will be Red indicating an error!

The error will also show in Claim

Management

VISUAL INDICATOR

NEW SOFTWARE TOOLS

3. ICD-10 Mapping UtilityThe ICD-10 mapping utility is built using the CMS GEMsfiles and your existing ICD 9 database.Create new ICD-10 codes based on your existing ICD 9

codesMap your current ICD-9 code into the ICD-10 recordAllows 1:1 MappingAllows Other Mapping (many to one and one to many)

ICD-10 MAPPING UTILITY 1:1 MAPPING

MAPPING UTILITY OTHER MAPPING

WHY DO I NEED ICD 10’S WITH THEIRCORRESPONDING ICD 9’S ?Before October 1st, 2014Assists in the learning curveHelps users get started with the analysis and complete

mapping efficiently

On October 1st, 2014Office can just use ICD 10’s If the payer requires ICD 9 on the claim. Lytec handles

this for you because the ICD 10 code has it’scorresponding ICD 9 code mapped.

SUMMARY

Medisoft will allow you to:Set Insurance companies required code versionSet effective date for ICD-10 for insurance

companiesVisually see a diagnosis code version errorMap your existing ICD-9 codes to ICD-10 codesRevenue Management will capture the correct

ICD-9 or ICD-10 code version and qualifier

PAPER CLAIMS/PRINT IMAGE

Unlike ANSI 5010, theClearinghouse cannot convertICD-9 to ICD-10 for you, as this ischanging & potentially filing,incorrect/inaccurate Clinicaldata.

SO TELL US WHAT YOU WOULD LIKE TO HEAR MORE ABOUT: