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Billing with ICD 10 Understanding what Centricity Practice Solutions can do for you.
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Disclaimer The content of this presentation represents the views of the author and presenters. GE, the GE Monogram, Centricity and Imagination at Work are trademarks of General Electric Company.
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HealthCo - Our Story Value Added Reseller Over 400 clinics 2013 and 2014 GE Channel Partner of the Year Presenter: Donna Dietz, Senior Implementation Consultant Co-Presenter: Andrea Cunningham, Director - Professional Services
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Agenda Timelines Planning/Preparation Tools Set-Up
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http://cms.gov/Medicare/Coding/ICD10/index.html
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R46.1 is “bizarre personal appearance” “Are you going to share the story that talks about improvement in patient care or the one that makes you laugh?” … John Lynn/ HealthcareScene.com blog network Z63.1 “Problems in relationship with in-laws” V97.33XA “Sucked into jet engine, initial encounter” V97.33XD “Sucked into jet engine, subsequent encounter” V97.33XS “Sucked into jet engine, sequela”
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ICD-9 14000+ Codes Last major industrialized nation to switch 35+ years old Limits growth ICD-10 68000 Codes Flexible for expansion More specific diagnoses
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“Based on the survey results, it appears the delay has had a negative impact on some readiness activities – especially external testing. Uncertainty over further delays was listed as a top obstacle across all industry segments,” Jim Daley, WEDI past-chair and ICD-10 Workgroup co-chair, said in a public statement…..”Jim Daley Author Vera Gruessner | Date April 7, 2015Vera Gruessner https://ehrintelligence.com/2015/04/07/is-the-industry-ready-for-the-icd-10-implementation-deadline/
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Deadlines Prior to October 1, 2015 – ICD-10 Test purposes only – ICD-9 to bill dates of service <10/01/2015 After October 1, 2015 – ICD-10 for all dates of service on or after 10/01/15 – ICD-9 for all dates of service before 10/01/2015 http://cms.gov/Medicare/Coding/ICD10/index.html
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Is Your Practice– ICD-10 Ready
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CMS – ICD-10 Compliant
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Clearinghouse – ICD-10 Compliant
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Clearinghouse – Testing Status Check clearinghouse website State of readiness – Testing of ICD-10 transactions HealthCo has tested with our supported clearinghouses – Availity, Centricity EDI, HCRNet, Health-e-Web, Relay Health
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Payors – ICD-10 Compliant
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Billing Service – ICD-10 Compliant
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CPS 12– ICD-10 Compliant
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ICD-9 Codes ICD-10 Codes – All available for Load – Many with ICD-9 Mapping * Enterprise Date Carrier Date Mixed Carrier Dates
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Work to Do Practice Management
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Centricity Enterprise ICD-10 Implementation Date Carrier ICD-10 Implementation Date ICD-10 Diagnosis Codes – Cross Mapping ICD-9 Codes when applicable
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Enterprise ICD-10 Implementation Date
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Carrier ICD-10 Implementation Date
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Carrier Preparation Tasks Identify Carriers that are exempt from ICD-10 requirements (Work Comp, Liability) Identify Carriers that will not be ready to accept ICD-10 codes on 10/01/2015 – Websites, calls Update Carrier Implementation Date far future date (Example: 12/31/9999)
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Prepare for Mapping Determine Top Diagnoses Identify NOS Laterality 7 th Character “X” Character
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ICD9>ICD10 Source: Centers for Medicare & Medicaid Services (CMS) General Equivalence Mapping (GEMs). Based on 2011 GEMS mapping.
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S S Location Displaced Transverse Fracture Category Extension Shaft of Humerus Initial Encounter of closed fracture 4 4 2 2 3 3 2 2 1 1 A A Etiology Laterality Right Arm Humerus Fracture
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All Femur Fracture Codes ICD-9: 16 codes ICD-10: 1530 codes
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ICD-10 CM Format Alphabetic Index – 21 Chapters Tabular List Instructional Notes
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GEMS General Equivalence Mapping Created by CMS and CDC Crosswalk Tool Backward and Forward Mapping Posted annually with updated Will be maintained for 3 years post implementation
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ICD-10 Diagnosis Codes Load ICD-10 codes Map to ICD-9 as applicable Review “pre-mapped” – User is responsible for accuracy
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Load ICD-10 Codes
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Mapping
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Visit Record – ICD 10 Enterprise Date ICD 10 Insurance Carrier ICD 10 Implementation Date Date of Service – Prior to October 2015 – ICD-9 – October 2015 or later – ICD-10
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Claim Insurance Carrier Implementation Date Medicare – Implemented ICD-10 Consolidated Healthcare – Not implemented
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Visit – ICD 10 Codes Display
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Date of Service Prior to 10/01/2015
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DX Search Based Enterprise Implementation Date & Date of Service
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Do you have a plan?
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Plan for Chart Requirements
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Questions
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Resources CMS http://cms.gov/Medicare/Coding/ICD10/index.html WHO http://apps.who.int/classifications/icd10/browse/2015/en AMA WEB
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