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Published byAnne Austin Modified over 9 years ago
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ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in 1979 2)Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000, Australia 1998 3)Canada has used ICD-10 since 2001
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More Codes More Detail Greater specificity Ability to measure healthcare services Refinement of grouping and reimbursement methodologies Enhancement of public health surveillance Decreased need to include supporting documentation with claims
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Other Features Includes updated medical terminology and classification of diseases Provides codes to allow comparison of mortality and morbidity data Provides for better data for: Measuring care furnished to patients Designing payment systems Processing claims0
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Further Enhancements Making clinical decisions Tracking public health Worldwide: WHO Identifying Fraud and Abuse Conducting research
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Implementation Date extended to October 1, 2014 More time to prepare physicians Staff Vendors Systems
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Education Allow at least 12 -15 months for education of coding staff Recommend review of ICD- 10 chapters by body system Review of rules changes in sequencing of diagnoses
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ICD-10 Chapters 21 chapters From Infectious Disease through factors Influencing Health Status and Contact with Health Services. Sense Organs, Eye and Ear are separate chapters (7 & 8) Chapter 16 is Conditions originating in the Perinatal Period—Newborn only
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Other Chapters Chapter 17 Congenital malformations, deformations and Chromosomal abnormalities
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Other Chapters Chapter 20 External Causes of morbidity Includes transport accidents, Slipping, tripping and falls Exposure (contact with animals causing injury) Drowning, near drowning Smoke, fire, flames
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Chapter 20 continued Assault Legal intervention Operations of war and Military operations Terrorism Coders should review all coding guidelines listed for ICD-10, as coding clinics will no longer be applicable.
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POA Present on Admission POA Guidelines will be reported. Inpatient admissions principal and secondary dx as well as external cause of injury.
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Clinical Documentation Improvement Concurrent coding Queries Involve and Educate other staff: Nursing Case Managers Allied Health Cardiopulmonary Laboratory Pharmacy Rehab staff
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Concurrent will expedite Concurrent moves the process more quickly Education of Medical Staff New Physicians/New Grads have already used ICD-10 --How do we help the senior members of our Medical Staff?
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Use Existing Opportunities Medical Staff Meetings Develop an ICD-10 minute or section for each Medical Staff meeting (just like Safety Moments) The accuracy and specificity will assist the physician/practitioner, as much if not more than the Facility.
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What Vendors/Programs use Codes Check systems Test Systems State Reporting Registries Billing and Collection Systems Testing should be scheduled by the vendor. ASK 2013 or early 2014 to work out bugs!
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Prepare Coders should begin to use ICD-10 in actual accounts 1) Use ICD-9 and ICD-10 2) Determine what documentation may be needed in addition to what your physicians are usually documenting 3) Educate as needed
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Computerized Coding Systems CAC: Computer assisted coding Electronic record/scanned record Will still need coders to edit
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Reimbursement Prediction of some variation in payment Mapping will need further review
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Websites AHIMA.org CMS WVHIMA.org
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