SIMPLIFYING ICD-10 For MRI Services.

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Presentation transcript:

SIMPLIFYING ICD-10 For MRI Services

Snapshot: ICD-9 vs. 1CD-10 ICD-9 ICD-10 CODES 14,000 68,000 CHARACTERS Up to 5 numeric characters Up to 7 alpha or numeric characters INCLUSION OF CO-MORBIDITIES Limited inclusion of co-morbidities, complications, severity, and risk Includes co-morbidities within codes LATERALITY Does not distinguish based on body part laterality (left v. right) Includes laterality when appropriate TIME OF EVENT Combines initial and ensuing encounters Separates codes for initial and subsequent visits

The key to ICD-10 success is not just the code, but the code AND the story.

Let’s talk ICD-10. Q. A.

Q. A. “More information is needed.” The goal of ICD-10 is provide more specific information and greater detail that will provide better data to ultimately improve the quality of patient care. Because ICD-10 is more specific, to accurately code a diagnosis, more specific documentation will be required. In addition to the code, we need the STORY: Location/laterality (ie: left, right) Severity of pain (severe, moderate, mild) Mechanism of injury History/context And the clinical notes! “What is the BIGGEST change I can expect?” A.

Here’s how it looks on paper

“Does this impact CPT codes?” “No.” Q. The ICD-10 change doesn’t affect CPT coding for outpatient procedures. Like ICD-9, ICD-10 are diagnosis codes. “Does this impact CPT codes?” A.

Q. A. “What if I don’t KNOW the ICD-10 code?” “Go to shields.com/ICD10” Q. Shields.com/ICD10 is an online resource with featuring an ICD-9 to ICD-10 converter. If you are having trouble with that resource, just give us the ICD-9 code and “the story”; our scheduling team can help translate it for you. Remember to the STORY – it’s even MORE important than the code on its own. Location/laterality (ie: left, right) Severity of pain (severe, moderate, mild) Mechanism of injury History/context “What if I don’t KNOW the ICD-10 code?” A.

Shields.com/ICD10 Tools and resources for support on the ICD-10 transition Download our “cheat sheets” of top ICD-9 and ICD-10 conversions based on specialty Download this presentation for reference or office tutorials Use our ICD-9 to ICD-10 (and vice versa) converter 836.0

Q. A. “Describe the pain and injury.” If you complete the STORY, our scheduling team can help make that correction. For example, if you order an MRI of the RIGHT shoulder, but provide the ICD-10 code for “shoulder pain, left shoulder, first incident”, your story will still look like this: Location/laterality: RIGHT SHOULDER Severity of pain: SEVERE Mechanism of injury: FELL OFF BIKE AND INJURED RIGHT SHOULDER History/context: FIRST INCIDENT We’ll see the error, call you to confirm, and fix it “What if I put the INCORRECT ICD-10 code?” A.

“Can you TRANSLATE the ICD-9 code to ICD-10 “Hmm…Sort of.” Q. We have two great resources to help you: Shields.com/ICD10 features an ICD-9 to ICD-10 converter (and vice versa). Plug in your ICD-9 and your ICD-10 options will appear. Simple! Shields has invested in scheduling software for our team that will help translate ICD-9 codes to ICD-10 codes BUT… There is not always an exact translation. ICD-10 is a LOT more specific. Bottom line? We won’t leave you hanging. We’re here to help you and will do whatever we can to get the correct code into your order and your patient scheduled quickly. “Can you TRANSLATE the ICD-9 code to ICD-10 for me?” A.

Q. A. “No way.” “Will this slow down the MRI SCHEDULING process? Our schedulers, our coders, our reimbursement team and our radiologists are ready and prepared for ICD-10 and committed to getting your patients in quickly. If you are having any challenges with ICD-10 ordering or feel like it might impact your patient’s appointment, contact me immediately. You and your patients are our TOP priority. “Will this slow down the MRI SCHEDULING process? A.

Q. A. “We’re preparing to help YOU.” When it comes to helping YOU with ICD-10, here’s what you can expect from us: Shields.com/ICD10 New written order forms with a section on ICD-10 (the STORY) ICD-10 cheat sheets with frequently used ICD-9 codes by specialty New ONLINE order form coming soon Like you, Shields is learning ICD-10 and introducing new processes internally to ensure we are set up for success. This includes: New technologist interview forms Radiologist training Scheduler training Practice tests “What is SHIELDS MRI doing to prepare for ICD-10? A.

New online order form – October 2015 New user experience Access from shields.com homepage AND Shields Express Link Drop-down list of doctors Smart ICD-10 tool – it will translate it for you! Option to “add attachment” for clinical notes

MSK Example: MRI of the knee for meniscus tear ICD-9 ICD-10 836.0 Tear of medial cartilage or meniscus of knee, current S83.221A Peripheral tear of medial meniscus, current injury, right knee, initial encounter CO-MORBIDITIES LATERALITY TIME OF EVENT

MSK Example: MRI of the shoulder for rotator cuff sprain ICD-9 ICD-10 840.4 Rotator Cuff (capsule) sprain S43.422A Sprain of left rotator cuff capsule, initial encounter CO-MORBIDITIES LATERALITY TIME OF EVENT

Neuro Example: MRI of the orbits ICD-9 ICD-10 368.11 Sudden vision loss H53.131 Sudden vision loss, right eye CO-MORBIDITIES LATERALITY TIME OF EVENT

Neuro Example: MRI of the neck ICD-9 ICD-10 784.2 Localized swelling, mass and lump head and neck R22.1 Localized swelling, mass and lump neck CO-MORBIDITIES LATERALITY TIME OF EVENT

Thank you! We’re here to help.