ICD-10 Updates Screen & Inquiry Changes

Areas of Change Encounter Menu Encounter Entry Encounter History Inquiry/Screens CPOD Screens CMS 1500 Screens

Encounter Entry Menu ICD-9 vs. ICD-10

Encounter Entry Menu - Current

Encounter Entry Menu – ICD-10

ICD-10 – 2 New Menu Options

#1 Encounter Entry By PEF (ICD10)

Encounter Entry By PEF (ICD10) When this option is selected, you will receive the new encounter entry screen for the PEF# entered. This screen is designed for the new ICD-10 codes. This option is the same as ‘Encounter Entry By PEF Number’ option, except it will return the new encounter entry screen.

#2 Patient Encounter Entry (ICD10)

Patient Encounter Entry (ICD10) When this option is selected, you will receive a new encounter entry screen for the Patient ID entered. This screen is designed for the new ICD-10 codes. This option is the same as the ‘Patient Encounter Entry’ option, except it will return the new encounter entry screen.

Function to request Encounter Entry for ICD-10 XEBAPEFN XEBAPEFN then Transmit

Encounter Entry Screens ICD-9 vs. ICD-10

ICD-9 Encounter Entry Screen

ICD-9 Entry area

ICD-9 Entry examples Up to 4 could be entered per CPT code Each ICD-9 had to be 5 characters If the ICD-9 code was less than 5 digits, dashes were use in place of the spaces.

ICD-10 Encounter Entry Screen

NEW Encounter Entry Screen Can enter up to 30 CPT codes over two pages Can enter up to 12 ICD-10 codes Units can be up to 4 digits The override section has increased to 25 characters

New fields on the ICD-10 Encounter Entry Screen

Primary ICD-10

Indicates which ICD-10 code is the primary ICD-10. Required Acceptable values – A through L

ICD-10 Codes

User can enter up to 12 different ICD-10 codes Format example A18.31 Must be entered in the order of the field label. A first, B second, C third and so on. You cant enter one in A and then the next in G.

ICD-10 Code example

ICD-10 Billing Order

The purpose of this field is for when the ICD-10 codes need to be ordered differently for billing purposes. The field is not required. If entered, it must be numeric. Zero will keep the ICD-10 code from being sent with the billing.

ICD-10 Billing Order example

ICD-10 Diagnosis Indicator

The purpose of this field is to designate which ICD-10 code needs to be associated with a specific CPT code. The field is not required. If entered, it must be A through L Multiple indicators can be entered for one CPT code.

ICD-10 Diag Indicator example

Page 2 Indicator

The purpose of this field is to request a second page for entering more CPT codes. This field is not required and should only be entered when the second page is needed. If entered, it must be Y or X. If the indicator is entered, when you transmit you will receive the second page.

Page 2

The purpose of this page is to allow users to enter more CPT codes if needed. This page will work the same as the first page. Some fields can’t be changed on the second page, such as the PEF number. Primary ICD-10 indicator and the ICD-10 codes will carry over from the first page.

Fields in red squares cant be changed on the second page

Primary ICD-10 and ICD-10 codes will carry to second page

Encounter History Inquiry/Screens ICD-9 vs. ICD-10

Inquiries The PERI function will still return a list of a patient’s PEFs. If you put an X next to a PEF, it will return the screen back in the format it was entered, either ICD-9 or ICD-10. The EHIE will return the Encounter History screen in the format the encounter was entered, ICD-9 or ICD-10.

CPOD Screens ICD-9 vs. ICD-10

Current CPOD - Medicaid

Current CPOD - Medicare

Current CPOD - Insurance

NEW CPOD - Medicaid

NEW CPOD - Medicare

NEW CPOD - Insurance

NEW CPOD – ICD-10 codes

NEW CPOD – ICD-10 pointers

NOTE: On the CPOD screens, if the encounter has more than 12 services that need to be re-billed, you will need to use the CMS-1500 screens

CMS-1500 Screens ICD-9 vs. ICD-10

The next 4 slides show the current CMS-1500 screens

CMS-1500 screen #1 ICD-9

CMS-1500 screen #2 ICD-9

CMS-1500 screen #3 ICD-9

CMS-1500 screen #4 ICD-9

The next 4 slides show the NEW CMS-1500 screens for ICD-10

CMS-1500 screen #1 ICD-10 – No change

CMS-1500 screen #2 ICD-10 – No change

CMS-1500 screen #3 ICD-10

CMS-1500 screen #3 ICD-10 codes

CMS-1500 screen #3 ICD-10 pointers

CMS-1500 screen #4 ICD-10

Remember When performing a PERI inquiry or EHIE inquiry, your screen will be returned in the format (ICD9 or ICD10) the encounter was originally entered.

Any Questions?