1. Rayellen.Kishbach@WoltersKluwer.com Know.Right.Now Presented by: Rayellen Kishbach 2015 ICD-10 Tools on MediRegs

2. During this session, we will explore: Utilizing electronic ICD-10-CM and ICD-10-PCS codebooks to speed research/increase efficiency Feedback on new functionality in the ICD-10 CodeBook Native coding in ICD-9 and ICD-10 and utilizing the GEMs maps using our ICD Explorer tool American Hospital Association (AHA) and Medicare issuances (Manuals, PQRS, IOCE/MCE) related to ICD-10 Local & National Coverage under ICD-10 How to stay on top of ICD-10 changes with custom email alerts Session #1, Sept 9th - Coding Resources

3. During this session, we will explore: MS-DRG Grouping and Payment under ICD-10 with concrete shift examples American Hospital Association (AHA) and Medicare issuances (Manuals, NCD Coding Guidelines, IOCE, MCE) related to ICD-10 Local & National Coverage under ICD-10 How to stay on top of ICD-10 changes with custom email alerts Session #2, Sept 15th - Reimbursement Resources

4. Clarifications and Questions CMS Edits and Audits

5. In place by 10/1/2015 1. Ombudsman NO 2. Delay? If VALID ICD-10 code from the right family is submitted, Medicare will process and not audit valid ICD-10 codes unless such codes fall into the circumstances described in Questions 6 & 7. 3. What’s a “valid” ICD-10 Code? Yes. Not Valid vs. Lack of Specificity required by NCD/LCD or other edit 4. Will claim rejection provider reason? “Family of codes” is the same as the ICD-10 three- character category. Don’t report the category 5. What’s a FAMILY of codes? In certain circumstances, a claim may be denied because the ICD-10 code is not consistent with an NCD/LCD edit (because current automated claims processing edits are not being modified as a result of the guidance. Also, code has to be valid 6. So, no claims denials based on specificity? NO. No denial as long as code is in the right family, and is valid. 7. Are the NCDs and LCDs being changed to include the whole family? Clarification on Edits & Audits

6. Knowing what you don’t know is half the battle. Customized alerts keep you informed about changes to ICD-10 coding, payment rates, coverage policy and more. Understand Federal and State rules changes in light of constant regulatory change. Support complete decision making with complete knowledge. Product integrates compliance, coding, payment, state and federal information. ICD-10 and MediRegs

7. Coding Comprehensive electronic codebooks for ICD-9-CM and ICD-10- PCS with archives ICD Explorer for dual coding and translation AHA ICD-10 Coding Handbook AHA Coding Clinic for ICD-10 Payment Integrated ICD-9 and ICD-10 MS- DRG Grouper with Provider Specific Payment Calculator Upgrade to the MS-DRG Analyzer with Batch Grouping capabilities Medical Necessity MAC LCDs and Coverage Articles National Coverage Determinations Regulatory CMS Transmittals and educational material Medicare Manuals IPPS Updates Educational Webinars Industry expertise in free webinars with archives of past recordings Coding & Compliance Suite ICD-10 Resources Special Products – Upgrade to the ICD-10 Batch Grouper and Payment Analyzer or get help with your ICD-10/MS-DRG Shift Analysis!

8. ICD-10 CodeBooks & Coding Tools Personalize: Tailor your page for more specific LCDs Store searches Bookmark useful pages Use the left-hand navigation pane to get to all these great ICD-10 resources

9. ICD-10-CM Guidelines appear right on page – No Flipping through the book! Codes “exploded out” to the 7 th character specificity – No guessing! Reportable codes shown in BOLD font ICD-10-PCS Familiar Table layout plus Full code and description shown on screen Extensive Definitions and Keys Updated automatically with E- mail alerts! Save pages and searches to get to your specialty quickly Handy indexes from CMS integrated with the book help you understand quality reporting, HAC, HCC and more. Delivered with CMS and MAC documents, manuals, coverage determinations and more Advantages of eBooks

10. ICD-10-CM CodeBook Chapter & Section instructions expand at the top of the page. All instructions and guidelines included 7 th character specificity clearly spelled out Bolded code is a valid code

11. ICD-10 Explorer

12. ICD Explorer – GEMs Mapping

13. Here is a great tip: Go to Advanced Search. Search for ICD-10 TITLES ONLY. Store the search! Coding Guidance Library

14. AHA Coding Clinic for ICD-10 Upgrade to Compliance & Regulation Suite – PLUS or Audit & Revenue Resource Center for AHA resources integrated in your subscription.

15. Are you TIRED of seeing this?

16. All Local Coverage Determinations and Articles are being re-written in ICD-10. Keeping up with the volume of data has become a challenge for CMS and for claims edit systems. Our state-specific Local and National coverage search is fast, automatically updated, and contains the information you need to fully understand indications and limitations of medical necessity and coding rules. Medical Necessity

17. Conversion/Coding Infrastructure Revsions to NCDs Maintenance Updates R1199OTN R1388OTN R1478OTN R1537OTN Also: https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html NCD Coding Guidelines

18. Coverage Research Simplified Integrated procedure and diagnosis coding LCDs, articles, NCDs, Medicaid Manuals Research hundreds of references in one location

19. MS-DRG Grouper & Calculator

20. Rayellen Kishbach Customer Success, Healthcare Compliance & Reimbursement Legal & Regulatory Solutions U.S. Wolters Kluwer Phone: 888.307.3540 rayellen.kishbach@wolterskluwer.com rayellen.kishbach@wolterskluwer.com Questions?