1. ICD-10 Forum: Implementation Checklist
Steps 35-41: Night Before Steps (and Steps after 10/1)
Presented by: Delilah Allison, Business Systems Analyst (EDI/DEV) Carol Wigley, Corporate Trainer September 23, 2015

2. Housekeeping Items Phones are muted on entry
Please keep phone muted so the sound will be good for everyone and the recording will be clear.
Use the Q&A Panel for Questions
We will do our best to answer all questions during the session
This will be a recorded session
Slides will be included in the Recap

3. ICD-10 Agenda ICD-10 Implementation Checklist
Steps Night Before Go-Live Steps
ICD-10 Resources
Q&A
ICD-10

4. ICD-10 Implementation Checklist
NEW CHECKLISTS ARE AVAILABLE!! Two versions:
ICD-10 Implementation Checklist for Ambulatory Products
ICD-10 Implementation Checklist for Ambulatory Products – No Database Copy
The checklists can be found on the Links and Resources section of the ICD-10 Page of the Knowledge Exchange.
The checklist is periodically updated. Subscribe to this article to get notified of future updates.
How to Subscribe to a KE Article

5. Implementation Checklist

6. Implementation Checklist

7. Implementation Checklist

8. Night Before - Steps 35 – 36 File Maintenance Set-Up
Cameron/Carol

9. File Maintenance Set-Up: Payer Master
Step 35: Optional but Required
Setup Payers for ICD-9 Code(s) on Claims
Set up ICD-9 codes for non-HIPAA covered entity payers
Per CMS this is a payer who is not mandated to transition to ICD /01/2015. (e.g. Workers Compensation, Motor Vehicle Accident payers)
These payers will still require an ICD-9 coded claim
Payer Master File
Defaults- 2 tab
Select the ‘Send Diagnosis Mapping on Claim’ check box
Select the Payer, Else General Mapping from drop down (NextGen recommended setting)
Attach the Claim Edit Library with claim edit #278 enabled to PracticeLibraries: Claim Edit library tab

10. File Maintenance Set-Up: Payer Master
Step 35: Optional but Required
Setup Payers for ICD-9 Code(s) on Claims
NG recommended Setting

11. File Maintenance Set-Up: Payer Master
Payer Diagnosis Mappings Utility on the KE:
Note: the ICD-10 Implementation Checklists have been updated to reflect the availability of this utility.
Non-HIPAA covered entities, such as Workers’ Compensation and Motor Vehicle Auto insurance payers, are not mandated to implement ICD-10-CM/PCS
Automatically flags the Payer Master/Defaults 2/Send Diagnosis Mappings on Claims/Payer Mappings, else General Mappings (NextGen recommended setting) option, by Financial Class, for the non-HIPPA covered entity payers who are not transitioning to ICD-10 on October 1, 2015
Save providers time on tasks and help work efficiently on the night prior to the ICD-10 implementation date

12. File Maintenance Set-Up: Claim Edit Library
Step 36: Recommended
Enable claim edit 279 in the Claim Edits Library for HIPAA covered entity payers
Claim edit #279: This payer only accepts ICD-10 codes
Make the severity ‘Warning’: soft edit; claim will still generate
Purpose of this edit is for the end users to review the rebills to ensure the ICD-9 code generated on the claim after the ICD-10
Claim Edit 279: can be enabled after the end of the month billing cycle or 09/30/2015. It is a practice preference.

13. File Maintenance Set-Up: ICD-10 Compliance Checks
Claim Printing Library
1500 Claims: CMS 1500 (2012)
Submitter Profile Library
ANSI X12 Version: Version 5010

14. Caveats: Optional depending upon Practice
Review the Claim Edit Library for the Claim Edits with Configurable Diagnosis Code(s)
Note: You must manually add the ICD-10 codes to the claim edits
KE link:  
Review the NextGen PM reports that allow for configuration of ICD codes
KE link:
Delilah

15. Caveats: Optional depending upon Practice
Disable the Practice PreferencesEncounters Setting: ‘Copy Diagnosis from Previous Encounter’ functionality the night before go- live 09/30/2015 until at least a month after 10/01/2015
Prevent ICD-9 codes from copying into 10/01/2015 service dates in Charge Entry DIAG field
Delilah

16. Caveats: Optional depending upon Practice
Contract Library
Review all contracts: Required Diagnosis field on Fee Schedule Tab - can be updated using the Contract Utility
Sliding Fee
Should review all Sliding Fee Scheduled to determine if any are DX Code Range defined and update
Claim Modifiers
Add/Modify Claim Modifiers - "Add if ICD9 On Charge" selected in Modifier Change for Claims field and update  ICD9 Selection
Encounter Rate Library
Should review all Encounter Rate Libraries - Enc Rate SIM Maintenance Screen to see if any Required ICDs have been attached
Delilah

17. Night Before - Steps 37 to 41
Cameron/Carol

18. Step 37 Turn on ICD-10 for Template Defaults (KBM) - Required -
Cameron/Carol

19. Turn on ICD-10 for Template Defaults (KBM)
Required
Activates the ICD-10 codes for Template Defaults
Activates the ICD-10 for the template defaults
If you made changes for a default ICD-9 and added a default ICD-10 this will allow the ICD-10 to show

20. Step 38 Run Immunization Script (KBM) - Recommended -
Cameron/Carol

21. Run Immunization Script (KBM)
Changes ICD-9 to ICD-10 for Pending/Non-Administered Immunizations and Vaccine Inventory
Converts designated ICD-9 to Z23 ICD 10 code
Applies only for 1 to 1 mappings in the Immunizations section of the Orders Module
Multiple mappings will have to be done manually on the patient level, due to the specificity of ICD-10 codes
***Recommended Step****
Changes ICD9 to ICD10 for Pending/Non-Administered Immunizations
Located on the ICD-10 Transition Tool Kit system template in the ICD-10 Immunization and Dual Coding Scripts panel
For pending immunization orders and Vaccine inventory
SQL script should be run once on the morning of 10/1/2015 or your designated ICD-10 transition dated
Especially since it affects the pending Immunizations
Affects vaccine inventory built from October 1, up to 9/30/15

22. Medication Update for Immunizations
Optional - August 2015 Medication Update
Includes Immunizations with default ICD-10 codes
Clients can apply this the night before,
on 10/1/2015 or after 10/1/2015
Clients will need to manually switch default ICD-9 codes to ICD-10 codes until the update is applied
Available for download by 9/23/2015
Contains documentation on manually switching Immunization ICD code
It will be labeled August 2015
For pending immunization orders and Vaccine inventory
*****Should not run before the night of 9/30/2015******
*****Clients will need to manually switch ICD-10 codes (if they don’t run the August 2015 Med Update until after 10/1/2015)*****
SQL script should be run once on the morning of 10/1/2015 or your designated ICD-10 transition dated
Especially since it affects the pending Immunizations
August 2015 Medication Update contains default ICD-10 so don’t run it before 10/1/2015
What’s Next>Product News

23. Step 39 Run ICD-10 Diagnosis History Script (KBM) - Optional -
Cameron/Carol

24. Run ICD-10 Diagnosis History Script (KBM)
Dual Coding (Optional)
If your organization has been using “dual coding” pop-up before the transition date to select ICD-10 codes
All stored ICD-10 codes will be pulled over into the patients Assessment History in the EHR which were given prior to the stop date
Run in Production database only after
Optional: Requires NG Ambulatory EHR hotfix
***Clarify: clients not using dual coding prior to transition date don’t have to do this step at all***
DUAL CODING Popup
If your organization was using dual coding popup prior to transition date, you can add those ICD-10 codes to the past encounter with this button.
***Supports capturing equivalent ICD-10 code from encounter’s ICD-9 code and save mappings for application to utilize.
You can run the script from the ICD-10 Transaction Tool kit system template
Run the SQL Script to add ICD-10 Diagnosis Codes to Patients’ Diagnosis History
So if clients have been using dual coding they can run the SQL Script.
First time: In Prod put a stop date of 9/17/2015 for example, run the script,
and that way the dual codes on locked encounters are moved over now.
Second time
then on 9/30, in Prod put an end date of 10/1/2015 and all encounters up to 9/30/2015 that are locked, will then move the dual codes over
*** If client’s haven’t or didn’t run it the first time, then on 9/30 they can run it once.
set the stop date put end date of 10/1/2015 and all the encounters up to 9/30/15 that are locked will then move the dual codes over now.
These are the instructions on the template:
a. On the morning of 10/1/2015 (or your designated transition date), with an end date to ensure all encounters up to that date are complete and locked
b. Run as second time with an end date of 10/1/2015 after all encounters up to 9/30/2015 are complete and locked
****if Documents are regenerated after the ICD-10 codes have been added, the ICD-10 codes will display on any documents showing the encounter’s diagnosis (Chart Note, Master IM document.

25. Run ICD-10 Diagnosis History Script (KBM)
Dual Coding (Optional)
If documents are regenerated after the ICD-10 codes have been added, the ICD-10 codes will display on any documents showing the encounter diagnosis such as Chart Note, Master IM document
Run in Production database only after
Use an end date to ensure all encounters up to that date are complete and locked
ICD-9 codes will remain in the patient history along with the ICD-10 codes
Optional: Requires NG Ambulatory EHR hotfix
***Clarified: clients not using dual coding prior to transition date don’t have to do this step at all***
DUAL CODING Popup
If your organization was using dual coding popup prior to transition date, you can add those ICD-10 codes to the past encounter with this button.
***Supports capturing equivalent ICD-10 code from encounter’s ICD-9 code and save mappings for application to utilize.
You can run the script from the ICD-10 Transaction Tool kit system template
Run the SQL Script to add ICD-10 Diagnosis Codes to Patients’ Diagnosis History
So if clients have been using dual coding they can run the SQL Script.
First time: In Prod put a stop date of 9/17/2015 for example, run the script,
and that way the dual codes on locked encounters are moved over now.
Second time
then on 9/30, in Prod put an end date of 10/1/2015 and all encounters up to 9/30/2015 that are locked, will then move the dual codes over
*** If client’s haven’t or didn’t run it the first time, then on 9/30 they can run it once.
set the stop date put end date of 10/1/2015 and all the encounters up to 9/30/15 that are locked will then move the dual codes over now.
These are the instructions on the template:
a. On the morning of 10/1/2015 (or your designated transition date), with an end date to ensure all encounters up to that date are complete and locked
b. Run as second time with an end date of 10/1/2015 after all encounters up to 9/30/2015 are complete and locked
****if Documents are regenerated after the ICD-10 codes have been added, the ICD-10 codes will display on any documents showing the encounter’s diagnosis (Chart Note, Master IM document.

26. Day of and After ICD-10 Effective Date Steps 40 and 41
Cameron/Carol

27. Step 40 Favorites Add ICD-10 Favorites (KBM) - Recommended -
Cameron/Carol

28. Favorites Add ICD-10 Favorites (KBM)
For each provider, add ICD-10 equivalents for ICD-9 codes to their favorites list
Can occur immediately on the ICD-10 Go-Live day
Providers can also use the Legacy Mapping option in the Diagnosis search window to locate the equivalent ICD-10 code(s) for the ICD-9 code in their favorites
***Recommended step***
Remove all ICD-9 codes from My Favorite Diagnosis Codes
Can also use Legacy mapping to locate ICD-10 equivalent codes for the ICD-9 code
***Manual entry***

29. Step 41 Favorites Remove ICD-9 Codes (KBM) - Recommended -
Cameron/Carol

30. Favorites Remove ICD-9 Codes (KBM)
Recommended
The practice should determine how many days after the ICD-10 effective date they will remove the ICD-9 codes from provider favorites
Enough time should be given to allow providers enough time to set up their ICD-10 favorites prior to removing all ICD-9 favorites
You can run the script from the ICD-10 Transition Tool Kit system template
Remove all ICD-9 codes from My Favorite Diagnosis Codes

31. Favorites Remove ICD-9 Codes (KBM)
Recommended
Removing ICD-9 codes from Provider Favorites
Filters by User, Category and Dx Code
Removes ICD-9 Codes from the Provider Favorites
Located on ICD-10 Transition Tool Kit system template on the Remove ICD-9 codes from Provider Favorites
Ngkbm ICD9toICD10 Dbp Prov will populate with providers on 10/1/2015
Select user, click Search button
Can filter by category, dx description, dx code
It will display user, category then can also select a specific category

32. KBM 8.3.10 ICD-10 Hotfix Known Issue
An issue was found where the foundation navigation, if customized prior to installing the ICD-10 hotfix for , the navigation would appear blank after applying the hotfix
If you’re having the ICD-10 hotfix applied by NextGen
NextGen will ensure the corrected hotfix is applied
If you are installing the ICD-10 hotfix yourself
A fix for this issue is available by contacting customer support
An updated ICD-10 hotfix package will be made available on the Knowledge Exchange soon

33. FAQ – NG Share
Q: I have NG Share installed. Will applying the KBM ICD-10 hotfix cause any problems with NG Share? A: An issue was identified with the KBM Base ICD-10 hotfix (Hotfix 2). This has been corrected in Base ICD-10 hotfix 3 now posted to the KE. All clients who use NG Share and are on this version of have been notified individually. In all other versions of the KBM you should not experience any issues with NG Share if you apply the KBM 8.3.x ICD-10 hotfix. Because NG Share is not typically something that you can test in your test database, be sure to test this functionality prior to the start of the workday after installing the KBM ICD-10 hotfix in PROD. Please note: If you have not yet installed NG Share, or are planning to install NG Share after October 1, you must still complete all the installation requirements for NG Share (which includes additional KBM related components). Visit the NG Share Home Page for more details.

34. New to the Knowledge Exchange!
Just in Time Provider eLearning (eLearning License required)
30 minute education for Providers – What they will experience on 10/1
Job Aid for ICD-10 Codes in EDR v4.x
NextGen Reports with Configurable Diagnosis Table
NextGen Claim Edits with Configurable Diagnosis Code Table  

35. New to the Knowledge Exchange!
White Paper – Orders Dual Coding Best Practices
White Paper – ICD-10 Dual Coding for Encounters
Payer Diagnosis Mappings Utility
Note: the ICD-10 Implementation Checklists have been updated to reflect the availability of this utility.

36. Make Use of Available Resources!
In addition to the Checklist, have you made use of other resources available on the ICD-10 Links & Resources Page?
Checklist, Implementation & Testing Plans Section
Test Plans
Claims Testing Scenarios
Clinical Workflow Test Cases
Readiness Audit
Hotfix Resources Section
KBM 8.3.x Hotfix Links
KBM Transition Toolkit
EHR Memorized Reports Diagnosis Code Search Utility

37. ICD-10 Test Case Questionnaire
We encourage you to take a new questionnaire we have to get feedback about the ICD-10 Test Cases
Test Cass cover Practice Management, EHR and KBM Workflows
Test Cases provide you a structured way to validate ICD-10 Config
Find the Test Cases and Questionnaire on the Knowledge Exchange
Your feedback will help us improve our Test Cases for future product releases

38. NEW! Applying ICD-10 Hotfixes
Step-by-step installation instruction for applying Core (EHR/EPM) ICD- 10 HF package and the KBM ICD-10 Hot Fix package along with all the other package installs necessary to complete the Hot Fix install. This session will NOT go into the details of the configuration or setup of the ICD-10 codes. WebEx Session Information: Join by phone: Call-in toll-free number Conference Code:

39. Webinar Dates and Times
Duration
Tuesday, September 15, 2015
2:00 PM EST
2 hours
Thursday, September 17, 2015
Monday, September 21, 2015
11:00 AM EST
8:00 PM EST
Friday, September 25, 2015
4:00 PM EST
Monday, September 28, 2015
Tuesday, September 29, 2015
Wednesday, September 30, 2015

40. ICD-10 Roadmap Webinar Series
Monthly Complimentary Webinars
Thursday, September 24, 2015 – 4:00 pm Eastern
Topic: Prepare for Impact
What do you need to know and do in the final days leading up to ICD-10?  Join us on this month's webinar to get the details and learn what NextGen's doing to support your final steps to ICD-10 readiness.
To Register:

41. ICD-10 File Maintenance Set Up Forum
Bi Monthly
2nd and 4th Thursday of each month.
Purpose:
Provide Step by Step ICD-10 set-up in File Maintenance
Review PM Billing Workflow
Produce test claim file to submit to Payer(s)/Clearinghouse(s)
e=full&portalPageId= &channelID= &contentTag=QL _ICD-10RegisterUpcomingWebinars

42. Friendly Friday Date: Every Friday - Beginning in June (June 5, 2015)
Time: 3-5 pm Eastern Topic: ICD-10 EHR/KBM Setup, Configuration and Workflow
Register in the Knowledge Exchange
Submit Questions in Advance by opening a support ticket using the Subject: Friendly Friday Training – ICD-10
Sessions Continue through October 30.

43. Remaining ICD-10 Forum Calls
September 30 – Night Before Tasks
October 7 – Latest News & Updates
October 14 – Latest News & Updates
Sessions Continue through October 28
Questions

44. Thank You!