Transition to ICD 10 CM Diagnostic Code Set

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Presentation transcript:

Transition to ICD 10 CM Diagnostic Code Set June 2014

Workshop Agenda - June 23rd 2014 Highlights of the Previously Shared ICD10 CM Presentation http://www.shafafiya.org/Dictionary/Workshops/20140320_ICD_10_Presentation.pptx Stakeholder Preparation for Transition Phases: Transition to ICD 10 CM http://www.shafafiya.org/Dictionary/Workshops.html Establishing ICD 10 Transition Working Group.

Workshop Agenda - June 23rd 2014 Providers and payers were invited to a 2 hour workshop – about 100 members came HAAD presented the “Transition to ICD 10 Diagnostic Code Set presentation” and answered related questions HAAD invited volunteers to represent payers and providers to create a working group to facilitate the transition Supporting material for each of the transition phases is published on Shafafiya http://www.shafafiya.org/Dictionary/Workshops.htm

Arial Stakeholders’ Transition Working Group Representatives (pending contact emails*) HAAD Lina Jichi (Chair) Michelea Peech Marwan Al Naboulsi Mohammad Al Haj Luis Perfetti Providers Public Providers: Seha Mubadala Health Care Private Providers Al Noor Ahlia NMC Burjeel Oasis Advanced Cure Diag. Ctr. Western Region?? Payers Public Payers: Daman Private Payers ADNIC TPA NAS Vendors and others 3M Accumed Abu Dhabi Police

Highlights ICD-10-CM/PCS: Incorporates much greater specificity and clinical information, which results in: Improved ability to measure health care services; Increased sensitivity when refining grouping and reimbursement methodologies; Enhanced ability to conduct public health surveillance; and Decreased need to include supporting documentation with claims; Includes updated medical terminology and classification of diseases; In the US as of 2014 ICD-10-CM (Diagnosis) Will affect inpatient and outpatient ICD-10-PCS ( Procedures) Will only affect inpatient in the U.S. NOT UAE -We have CPT for outpatient & inpatient reimbursement

Highlights ICD-10-CM In the US as of 2014 Provides codes to allow comparison of mortality and morbidity data; and Provides better data for: Measuring care furnished to patients; Designing payment systems; Processing claims; Providers making clinical decisions; Tracking public health; Identifying fraud and abuse; and Conducting research. In the US as of 2014 All software will be ICD 10 based All certified coders will be ICD 10 based All RVU’s will be ICD 10 based ICD 9 CM will no longer be updated after 2012

DSP voted to retain 1st October, 2015 Deadline Upgrade to ICD 10 CM June 2014 DSP voted to retain 1st October, 2015 Deadline EncouterStart date 1/10/2015 00:01

Is it a big change? Comparison ICD-10-CM ICD-9-CM Mechanical complication of other vascular grafts 156 codes, including T82.310 – Breakdown (mechanical) of aortic (bifurcation) graft (replacement) T82.311 – Breakdown (mechanical) of carotid arterial graft (bypass) T82.312 – Breakdown (mechanical) of femoral arterial T82.318 – Breakdown (mechanical) of other vascular grafts T82.319 – Breakdown (mechanical) of unspecified vascular grafts T82.320 – Displacement of aortic (bifurcation) graft (replacement) T82.321 – Displacement of carotid arterial graft (bypass) T82.322 – Displacement of femoral arterial graft (bypass) T82.328 – Displacement of other vascular grafts ICD-9-CM Mechanical complication of other vascular device, implant and graft 1 code (996.1)

Comparisons ICD-9 Code Format ICD-10 Code Format ICD-10-CM 68,069 14,025 Diagnosis Codes ICD-9 Code Format ICD-10 Code Format X X X X X X X X X X X X extension category etiology, anatomic site, manifestation category etiology, anatomic site, severity

Comparisons

Tentative Timeline

Make Your Plan to ICD 10 CM Phase 1: Implementation plan development and potential impact assessments Establish interdisciplinary steering committee to develop ICD‐10 implementation strategy Development of potential impact assessments Implementation budget Systems inventory Identifying the impact from vendors and payer contracts Vendors and Contracts

Make Your Plan to ICD 10 CM Phase 2: Implementation preparation Training/awareness on Codes and Code uses (data etc) AND documentation Education on the available GEM and how to use Phase 3: “Go live” preparation Confirm with systems vendor(s) Finalize all systems - testing of systems changes, and provide intensive ICD‐10 education to coding staff. Complete all in‐house systems changes and testing. Claims on or after Deadline must use ICD‐10‐CM

Any Questions Please Contact Make Your Plan to ICD 10 CM ICD-9-CM to data coded under ICD-10-CM due to the differences in the code sets. This will impact reports that compile statistical data for trend analysis Download GEM from CMS website http://www.cms.gov/Medicare/Coding/ICD10/2014-ICD-10-CM-and-GEMs.html Any Questions Please Contact ccsc@haad.ae