Transitioning to ICD-10-CM/PCS

Agenda Overview Implementation Team Organization Awareness Impact Analysis Financial Impact Training Plan Timeline

ICD-10 Implementation OCTOBER 1, ICD-10-CM and ICD-10-PCS code sets implementation date – In January 2009, HHS published a Final Rule requiring the adoption of ICD-10-CM and ICD-10-PCS code sets to replace the 30-year-old ICD-9-CM coding system used for billing purposes ICD-10-CM - International Classification of Disease, 10 th Revision, Clinical Modification – Diagnosis Code Set ICD-10-PCS – International Classification of Disease, 10 th Revision, Procedural Coding System – Procedure Code Set Billing Format (X12 version 5010)update also required to accommodate new code formats – Effective Date – January 1, 2012

ICD-10 Implementation SettingDiagnosis Code SetProcedure Code Set Hospital InpatientICD-10-CMICD-10-PCS Hospital OutpatientICD-10-CMCPT/HCPCS Physician FacilityICD-10-CMCPT/HCPCS Physician OfficeICD-10-CMCPT/HCPCS Skilled NursingICD-10-CMCPT/HCPCS Home HealthICD-10-CMCPT/HCPCS Note: Only inpatient hospital setting impacted by change in procedural coding system

Implementation Team Charge: Implementation Plan Development and Oversight Internal Staff – Health Information Management – Finance – Information Technology – Medical Staff Leadership – Other Use of Consultants

Organization Awareness Communication Plan – Who, what, when Need for Participation in Impact Analysis Need for Multi-Year Resource Planning

Impact Analysis Assess all software applications that currently store, transmit or received ICD-9-CM codes for potential impact Required Changes to Workflow – Analysis of coding and billing functions throughout the revenue cycle – Billing Forms/Spreadsheets – Clinical Documentation Issues – Impact on internal and external reporting Evaluation of contracts for which payment is based on ICD-9-CM codes

Financial Impact Potential impact to hospital – $15 million to $20 million Need to plan for decrease in productivity to prevent billing backlogs during training and initial implementation

Training Plan Varies based on employee role (audience) Content Timing Delivery Methods Contracted Out or Provided by Internal Staff

Recommended Implementation Schedule / Implementation Plan Impact Assessment Implementation Preparation Go Live Preparation Post – Implementation Follow-Up Phase I Phase II Phase III Phase IV Year