Preparing for ICD-10 Transition Teleconference Hosted by Community Health Association of Mountain/ Plains States (CHAMPS) January 30, 2013, 12:00 PM – 1:00 PM MT Presented by Gervean Williams, Director, Community Health Center Finance and Operations, National Association of Community Health Centers (NACHC)

The NACHC Mission To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved populations.

ICD – 10 Myths It’s not going to happen My employees are responsible for the changes It won’t require many operational changes My software vendor is responsible for the changes We have plenty of time We are ready now

ICD-9 History World Health Organization National Center for Health Statistics Adopts ICD-9 in 1979 ICD-9 is the International classification of diseases, 9 th revision

Why Change to ICD-10 ICD-9 is over 30 years old More specific and accurate capture of data Improved ability to measure health care services Alignment with WHO

Timeline DateCompliance Step January 1, 2010 Payers and providers should begin internal testing of Version 5010 standards for electronic claims Implemented December 31, 2010 Internal testing of Version 5010 must be complete to achieve Level I Version 5010 compliance Implemented January 1, 2011 Payers and providers should begin external testing of Version 5010 for electronic claims CMS begins accepting Version 5010 claims Version 4010 claims continue to be accepted Implemented December 31, 2011 External testing of Version 5010 for electronic claims must be complete to achieve Level II Version 5010 compliance Implemented January 1, 2012 All electronic claims must use Version 5010 Version 4010 claims are no longer accepted Implemented October 1, 2014 Claims for services provided on or after this date must use ICD-10 codes for medical diagnosis and inpatient procedures CPT codes will continue to be used for outpatient services Pending

Potential Impact of 5010/ICD - 10 Information Technology Finances Providers and Staff

IT Concerns Impact of transaction types IT Staff Electronic Medical Record(EMR) Practice Management Software (PMS)

Finances Budget considerations –Software and Hardware –Upgrades –Testing –Training Will you be able to send claims electronically?

Budget Considerations Software and licensing Hardware Upgrades Training Updating forms Testing

MGMA Budget Sample Cost Breakdown 3 physician practice Education2,500 Process Analysis (Consultant/Additional Staff Hrs)7,000 Changes to Super bills (Consultant/Reprinting)3,000 IT Costs (Upgrades/New Technology)7,500 Increased Documentation (Dictation/New Technology)44,000 Cash flow Disruption (Lost Production)20,000 Total84,000

Provider and Staff Training Who –Providers, Clinical staff, Billing, and Finance When –Phase training How much – Varies depending on responsibilities

Planning Needs Assess your current systems Identify your internal and external teams Contact your IT and clearinghouse vendors Develop an implementation timeline Train, Test, Train, and Test

Key Steps Organize project team & resources for project completion Conduct preliminary impact analysis (mission critical issues) Create implementation timeline (need vs. nice to have) Develop ICD-10 Implementation Budget (plan more, not less) Analyze documentation needs (EMR, dictation, hand-written) Develop communication plan (special news letter, staff meetings, special sessions, etc.) Develop training plan (targeted AND integrated training) Complete information systems design & development Conduct business process analysis (optimal not perfect) Conduct needs assessment (Missed anything?) Complete deployment of system changes (test, test, final) Note: Based on AMA’s “Implementation of ICD-10…;” Chapter 4, page 45

Community Health Center Issues Billing –UB-04 and 1500 Uniform Data System – Table 6 Grant Writing Registry

Resources ICD – 10 On Demand Webinar TID17717 AAFP uments/prac_mgt/codingresources/timeline.Par File.tmp/ICD10Timeline.pdf CMS Resources Page

Misc….Medicare Changes CR 7038 PAL Enrollment Application Fee (855 form) Revalidation

Acknowledgements CMS ICD-10 Planning Priority Management Group, Inc

Contact Information Gervean Williams Director of Finance and Operations NACHC

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