ICD10 Hotfix Review EHR Transition Tools and Dual Coding Presented by: Carol Helminen –Support Specialist II and Gina Ehni- Training Consultant

Agenda Hotfix review Dual Coding Transition Toolkit Intercept Tool

Confused? Don’t know which direction to take? And running out of time?

ICD-10 Hotfix versions 8.3.0 HF1 8.3.1 HF1 8.3.2 HF1 8.3.3 HF2 8.3.8 OPH HF11 8.3.10 HF1 8.3.8 Base if never installed any 8.3.8 hotfix 8.3.8 Cumulative if installed previously released 8.3.8 hotfix Mmic will be running CDL after upgrade

KBM ICD10 Hotfix Updated templates with hard coded ICD-9 codes Fix defects associated with ICD-10 workflows Update Dx Groups for My Plan order sets with ICD-10 KBM sub document to print dual coded information on documents Clients can add this where needed Sub report for crystal reports to print dual coded information Available on - but can be added where needed LabCorp Radiology Quest Generic Lab

ICD 10 Hotfix Contents Corrected Defects in PM, EHR and KBM Compatibility for ICD-10 checking -Medical Necessity ICD Intercept Tool – To catch ICD-9 codes after mandate date to convert to ICD-10 prior to sending to PM Transition Toolkit – Tool to identify templates, Dx Groups, Order Sets, Quick Notes, Quick Saves and Template default. As well as tools for favorites and for testing Dual Coding Option – Prior to mandate date, map ICD-9 codes to ICD-10 per patient Orders – Use Dual coding to map ICD-9’s to ICD-10’s for future and recurring orders from orders module

ICD 10 Hotfix - Other Tools Optik – Leverage Charge Intercept for on-hold orders to prevent ICD-9 when save over transition NextGen Shared ICD Reports – To identify memorized reports in which an ICD-9 code are utilized Dashboard – Includes ICD-10 in addition to ICD-9’s Nextgen Mobile – Disable invalid codes from being selected Utilize ICD-9 Intercept Tool Utilize ICD Legacy lookup View nextgen shared icd reports Sub_document show and best practice recommendation is to add to Lab Requisition, Referral documents, Master IM

Dual Coding Available for all 5.8 versions Access to Dual Coding Tools -> Enc Dual Coding Top Toolbar Order Module – new order Best practice- use dual coding in Prod prior to 10/1/15 Encounters have both codes on them and can be updated after to 10/1/2015 to ICD10 code Future or recurring orders- use dual coding to substitute ICD9 to ICD10 Code Sub document and crystal report updates to display ICD9 to ICD10 mapping Sub_ICD_dual_coding.ndx White paper crystal report Master IM document- Ariana Test for encounter date 07/23/2015

Transition Toolkit System Template Tool to assist in identifying ICD-9 codes in your database Templates, including triggers, variables and labels Delete Provider Favorite codes ICD-9 Quick Saves, Quick Notes and Template Defaults Diagnosis Groups Functionality Access Transition Toolkit Run specific search Optional export to spreadsheet Analyze the results Make corrections This template needs to be downloaded from KE site.

Transition Toolkit Downloading and installing package Importing templates System / Practice templates checkbox Copying of images to Nextgenroot\EMR\Templates\Images folder Run stored procedure script against database ICD20_Toolkit_Complied_SP.sql MMIC will download and import this template for any client who wants us to do it. Demo or view of Transition Toolkit in test db Find download on KE

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Transition Toolkit Panel Review Hardcoded ICD Code Search Tool Brings in anything with a *99.9 format, need to make sure is indeed an ICD code Dx Groups and Template Defaults, Quick Saves, Quick Notes Remove ICD-9 codes from Provider Favorites ICD-10 Immunization and Dual Coding Scripts ICD Intercept Tool This tool can potentially identify character sequences that may not be diagnostic codes or could be ICD-10 codes making it very important to you to carefully review the results before taking any action. Hardcoded DX Code Search To Locate hardcoded dx codes on NG KBM or custom templates, regardless of whether or not you are using the NG KBM. Tool identifies all places in the KBM that may contain hardcoded ICD-9 codes that must be mapped to ICD10 code. You can run as many times as needed to locate all hardcoded codes. Diagnosis groups, quick saves, quick notes and template default searches Locate potential ICD-9 codes or locations that do not have required ICD-10 codes defined- DX groups search finds instances in dx group that have ICD-9 codes defined but not a corresponding ICD-10 code. Fix using DxGroups/Reference System practice template (NGKBM Common DX Framework). Template defaults, quick saves/quick notes- identifies all that contain ICD-9 instead of ICD-10. Use NGKBM Template Defaults template to correct. (System template NGKBM Template Defaults) Remove ICD-9 codes from provider favorites Locates invalid or expired dx codes within provider favorites. You can export and you may want to do this to distribute to the provider so they can address their own favorites. ICD-10 Immunization and Dual coding Scripts Can be used to run two scripts that perform critical updates to the database ICD-10 Immunization Script- updates any ICD9 codes in pending immunizations orders to ICD-10 codes. Not only replaces those codes in associated dx for vaccine favorites and the dx contained in vaccine inventory. Dual Coding Script- adds the ICD-10 codes mapped using the dual coding template to the patients dx history. Activate the ICD Intercept Tool Tool must be activated prior to the ICD-10 transition date to intercept residual ICD-9 codes submitted to superbill after the ICD-10 transition date- When active this detects ICD-9 codes and present the user with options for replacing the code or continue with ICD9 code

Transition Toolkit Making Corrections Adding a Dx Group on the Practice Template Common Dx Framework Assign an ICD-10 to a Diagnosis Group Updating Triggers and Conditions within Template Editor Field length for ICD-10 should be 10 characters for the code and 255 for the description Show examples of fixing items within system/practice templates or the Field length for ICD-10 should be 10 characters for the code and 255 for the description This does check MR pop ups as well Brings in anything with a *99.9 format, need to make sure is indeed an ICD code

Transition Toolkit Remove ICD-9 Codes from Provider Favorites Click on Search button Able to filter per User, Category and Dx Code Remove ICD-9 codes from provider favorites Locates invalid or expired dx codes within provider favorites. You can export and you may want to do this to distribute to the provider so they can address their own favorites.

Transition Toolkit ICD-10 Immunization and Dual Coding Scripts ICD-10 Immunization Script Updates the vaccine inventory from an ICD-9 code to an ICD-10 code Dual Coding If using Dual Coding prior to transition these will be added to the patient diagnosis list Run Twice On morning of Transition date (10-1-15) with an end date ensuring all encounters up to that date are complete and locked Second time run after all encounters up to 9-30-15 are complete and locked with an end time of 10-1-15 ICD-10 Immunization and Dual coding Scripts Can be used to run two scripts that perform critical updates to the database ICD-10 Immunization Script- updates any ICD9 codes in pending immunizations orders to ICD-10 codes. Not only replaces those codes in associated dx for vaccine favorites and the dx contained in vaccine inventory. Dual Coding Script- adds the ICD-10 codes mapped using the dual coding template to the patients dx history.

Transition Toolkit Activate the ICD Intercept Tool Used to intercept ICD-9 codes submitted to Superbill after the ICD-10 transition date Activate the ICD Intercept Tool Tool must be activated prior to the ICD-10 transition date to intercept residual ICD-9 codes submitted to superbill after the ICD-10 transition date- When active this detects ICD-9 codes and present the user with options for replacing the code or continue with ICD9 code

ICD-9 Code Intercept Tool Purpose: Catches the ICD-9 codes on submission. Displays the Procedure Charge Mapping dialog box to select an ICD-10 code on or after the compliance date. 3 Possible Scenarios 1 – 1 Match 1 – Many Match You may need two or more ICD 10’s to be equal to 1 ICD-9 code This happens when and ICD9 code is being used after 10/1/2015- system catches it and this tool pops up Test Patient- Bobbi Test for encounter 8/6/2015