Resources for ICD 10 Implementation Toolkit

Transcription

1 Resources for ICD 10 Toolkit "New Health Care Electronic Transactions Standards: Versions 5010, D.0, and 3.0." This four page fact sheet describes the whys, whats, and whos of basic information on the new 5010, D.0, and 3.0 transaction standards required to submit electronic claims. "Version Technical Comments and Responses Supplement, January 2009." This is a 239 page collection of comments and responses on the technical design of 5010 addressed by a workgroup of subject matter experts under the leadership of representatives from Blue Cross and Blue Shield and Electronic Data Services. pdf chnicalcommentsonversion5010.pdf "5010: Taking Electronic Billing and Electronic Data Interchange to the Next Level." This is a two page reference card. Page one provides links to several pertinent Web sites for 5010 and D.0. Page two shows a timeline for implementation and steps to prepare for the transition. fcard_icn pdf CMS Version 5010 & D.0 & 3.0 Overview Web site. This CMS Web page contains additional links on resources for 5010 and 3.0. It also includes links to an overview, background, federal regulations, and policies. "5010 and ICD 10: What They Are and How to Prepare for Them?" This archived AMA audio webinar provides an overview on implementing ICD 10, including a detailed nine step implementation plan, key points, and AMA resources. Background of ICD Background of ICD "International Statistical Classification of Diseases and Related Health Problems (ICD 10): Americanized Version Source Information." This Unified Medical Language System site provides Web site information for National Library of ICD 10 (not ) and update frequency. Medicine WHO International Classification of Diseases (ICD) Web site. This site provides general information on WHO classification of diseases and ICD World Health 10. Organization current/icd10ae/ CMS ICD 10 Web site. This site provides resources and timelines to help Background of ICD providers, payers, and vendors prepare for the U.S. health care industry's 10 CM/PCS upgrade to Version 5010 and transition to ICD CMS ICD 10 Provider Resources Web site. This Web site provides background and timeline for the change, resources for training and budgets, and impact on current systems. It includes multiple downloads on myths and facts and an overview designed for the provider/md user of ICD 10. opofpage Budget "Budgeting for ICD 10." This article explores breaking down costs by category to help tackle a complex task. Different expenses will peak in different years, and not all costs will be obvious. hima/bok1_ hcsp Budget 5010/ICD 10 "ICD 10 Cost Prediction Modeling Tool." This tool assists users in predicting the financial impact of transitioning to ICD 10. Developed in Excel, the tool explores the costs incurred in transitioning to ICD 10, the effect ICD 10 will have on future revenue, and steps that can be taken to mitigate the costs and risks of moving to ICD 10. The tool helps users understand the impact of ICD 10 in four key areas: coding, revenue cycle, project management, and information technology. CMS ICD 10 Industry Updates Web site. CMS ICD 10 updates immediately notify subscribers via e mail of important information and reminders about the Version 5010 and ICD 10 transitions. Healthcare Information and Management Systems 10CostPredictionModeltool.xlsx 10_Industry_ _Updates.asp#TopOfPage AHIMA ICD 10 Toolkit Review Draft Do not cite or quote 1

2 Resources for ICD 10 Toolkit AHIMA Approved /PCS Trainers Web site. AHIMA approved ICD 10 trainers can be found at this web link. The list is divided by state and whether the professional is approved for /PCS or ICD 10 CM. Also included is a list of ambassadors that may be contacted to discuss training needs. AHIMA /PCS Development AHIMA Code Set Maintenance Web site. This page provides an overview of the maintenance process for code sets, industry and standards activities, and links that pertain to code set maintenance. AHIMA Development "Partial Freeze to ICD 9 and ICD 10 for Smoother Transition." This AMA fact sheet provides education about important dates on code set freezes. icd9 icd10 factsheet.pdf 5010/ICD 10 CMS Medicare Fee for Service Provider Resources Web site. This site provides information and educational resources to providers on the implementation and transition of ICD 10 and 5010 environment. derresources.asp#topofpage /PCS Development "Partial Code Freeze Prior to ICD 10." This three page MedLearn article announces the ICD 9 and ICD 10 code freezes in effect for 2012 and pdf "ICD 10 Information." This nine page MedLearn article covers the background, benefits, and structure of /PCS and GEMS. It also includes a section titled What to Do Now in Preparation for ICD 10? 19.pdf Clinical "Ready Your CDI Staff for ICD 10 implementation." This article provides guidance for implementation of ICD 10 for CDI staff. of Clinical Specialists 4 Clinical MSDRGs "Column: What Impact Will ICD 10 Have on MS DRG Payments?" This article provides insight into the financial impact of ICD 10. of Clinical Specialists 8 Clinical Clinical of Clinical "News: Use OIG Compliance Tips for ICD 10." This article provides insight into the compliance aspect of ICD 10 implementation. Specialists "Top Issues for ICD 10." This article discusses the top 10 documentation issues for ICD 10. They are diabetes mellitus, injuries, drug underdosing, cerebral infarctions, AMI, neoplasms, musculoskeletal conditions, pregnancy, respiratory/vents, and. International Classification of Diseases, Tenth Revision, Clinical Modification () Web site. The site provides a synopsis of the background for. National Center for Health Statistics 9 hima/bok1_ hcsp " Official Guidelines for Coding and Reporting, 2012." This National Center for document outlines guidelines for coding and reporting using. Health Statistics pdf AHIMA ICD 10 Toolkit Review Draft Do not cite or quote 2

3 Resources for ICD 10 Toolkit CMS 2012 and GEMs Web site. The 2012 files contain information on the new diagnosis coding system, which is a replacement for ICD 9 CM, Volumes 1 and 2. Files include coding guidelines, list code descriptions, tables and index, reimbursement mappings, and General Equivalence Mappings for. " Root Operation Groups: Root Operations that Take Out Some or All of a Body Part." This article is the first article in a series of four articles that reviews the coding guidelines regarding root operations. It explains excision, resection, detachment, destruction, and extraction. Ms.asp#TopOfPage hima/bok1_ hcsp " Root Operation Groups, Part 2: Root Operations that Take Out Solids, Fluids, Gases from a Body Part, Involve Cutting or Separation Only, and Put In OR put Back or Move Some OR All of a Body Part." This article discusses the root operations of drainage, extirpation, fragmentation, division, release, transplantation, reattach, transfer, and reposition. hima/bok1_ hcsp " Root Operation Groups, Part 3: Root Operations That Alter the Diameter/Route of a Tubular Body Part and That Define Other Repairs." This article reviews the root operations of restriction, occlusion, dilation, and bypass, as well as control and repair. hima/bok1_ hcsp " Root Operation Groups, Part 4: Root Operations That Always Involve a Device, Involve Examination Only, or Define Other Objectives." This article reviews the root operations of insertion, replacement, supplement, change, removal, and revision. It also includes a discussion on root operations that involve an examination, which are inspection and mapping. The last portion of the article reviews the root operations that define other objectives. Those terms are fusion, alteration, and creation. hima/bok1_ hcsp CMS 2012 and GEMs Web site. The site provides the files that contain information on the new procedure coding system, ICD 10 PCS, which is a replacement for ICD 9 CM, Volume 3. Files include coding guidelines, list code descriptions, and tables and index for. pofpage "2011AA Source Information." This Unified Medical Language System site provides information on the purpose, description, National Library of metathesaurus scope, and update frequency of. Medicine current/icd10pcs/ 5010/ICD 10 CMS Planning Web site. The site contains downloads, including "ICD 10/Version 5010 Industry Listening Session Summary," "CMS ICD 10 Planning Initial Summary of AHIMA Executive Report," "The & Medicaid Services (CMS) ICD 10 Planning AHIMA Report," and "CMS Impact Analysis." ng.asp#topofpage AHIMA ICD TEN e newsletter. This link provides an archived list of ICD TEN e newsletters, which began in August 2010 and are typically published once a month. These newsletters prepare readers for the transition to /PCS. Each monthly issue contains top emerging news, educational opportunities, practical information on coding with the new /PCS, preparatory steps for implementation, and more. AHIMA "Top 10 List: Phase 1, /PCS Plan Development and Impact Assessment." This document provides a list of the 10 critical steps in the first phase of implementation during the first quarter 2009 second quarter hima/bok1_ pdf AHIMA ICD 10 Toolkit Review Draft Do not cite or quote 3

4 Resources for ICD 10 Toolkit "Appendix A: Planning for the Transition for LTC Facilities." This article explains the needs of a facility and their ICD 10 implementation process. The four areas that should be considered are financial resources, education/training needs, software/hardware requirements, and compatibility with existing systems. hima/bok1_ hcsp 5010/ICD /ICD 10 "The & Medicaid Services (CMS) ICD 10 Planning AHIMA Report." This 306 page report outlines the December 2009 CMS meeting with healthcare industry representatives and the group's discussions on the transition to 5010 and ICD 10. "ICD 10/Version 5010 Industry Listening Session Summary." This threepage document provides a summary of the December 8, 2009, CMS meeting with healthcare industry leaders on the transition to 5010 and ICD ngs_report.pdf 10IndustryListeningSessionSummary.pdf Medicaid CMS Medicaid Resources Web site. The site provides links to a 12 part series of topics on ICD 10 for state Medicaid agencies. Medicaid Medicaid Medicaid "State Medicaid ICD 10 Assistance Handbook." This 180 page handbook covers the nuts and bolts of ICD 10 implementation for state Medicaid agencies. It gives advice on organizing the actions associated with the transition to ICD 10, outlines strategies and activities to consider in each phase of the transition, and provides a timeline and recommended next steps for CMS regional offices. CMS ICD 10 Segments Web site. This site provides 12 PowerPoint training segments developed by CMS on ICD 10 for state Medicaid agencies. These segments provide a high level review of the federal requirements and other aspects of ICD 10 implementation, designed for state Medicaid mangers that focus on assessment and planning. dicaid_icd 10 Assistance_Handbook.pdf 10Segments.asp Minnesota Health Information Management ICD 10 Web site. The site provides tips on implementing ICD 10. MNHIMA Medicaid ICD 10 Assistance Launch Page. CMCS developed the ICD 10 Assistance Navigation Tool to help the state Medicaid agencies implement and understand ICD 10. There are three types of assistance on this site: the Medicaid ICD 10 Assistance Handbook; training modules presented at the Regional Office ICD 10 Workshops; and the ICD 10 Collaboration Site. Noblis and CMCS "Role based Model for ICD 10." An AHIMA Web site developed to identify key tasks and milestones that must be completed within specific timeframes by specific organizations or specific roles within an organizations. It includes links to additional resources. AHIMA "Developing an /PCS Coder Strategy." This article outlines how coding managers can ensure their coding staff have sufficient foundational knowledge of the biomedical sciences; learn the structure, organization, and unique features of /PCS; and understand how to apply maps and crosswalks between ICD 9 CM and /PCS. It is based on AHIMA's "Role based Model for ICD 10." hima/bok1_ hcsp AHIMA ICD 10 Toolkit Review Draft Do not cite or quote 4

5 Resources for ICD 10 Toolkit /PCS "The Top 10 List: Phase 2, /PCS Preparation." This document outlines tasks to help facilitate the process. The list is intended to highlight key areas and should be used in tandem with the more complete /PCS Transition: Planning and Preparation Checklist at This brief resource identifies key tasks that must be done in phase 2 of the implementation project, but the steps are not necessarily listed in the order of completion. The tasks are all interrelated and may need to be done simultaneously rather than sequentially. HIM professionals should take an active leadership role in this project by offering expertise and sharing resources with those involved in /PCS implementation. hima/bok1_ pdf /PCS "/PCS Transition: Planning and Preparation Checklist." This tool assists with ICD 10 implementation planning. hima/bok1_ pdf /PCS /PCS "From Point A to ICD: Successfully Implementing /PCS." This is free audio seminar from AHIMA. Product number AUDA "/PCS Action Plan, 2011." This resource can help with the ICD 10 implementation AHIMA Store California Health Information 5010/ICD 10 CMS ICD 10 and Version 5010 Timelines Web site spx?productid= px?site=chia&shopsearch=&shopsearchcat=merchandise&pr oductcat=publications&prd_key=06efc4c9 0ec f andVersion5010Timelines.asp#TopOfPag e " Widget and Timelines." This tool assists the user in identifying and taking action on the timeline benchmarks. legacy data legacy data "HIMSS ICD 10 PlayBook." The playbook provides critical information to assist hospitals, ambulatory centers, practitioners, and their staff in transitioning to ICD 10. "Crosswalk Options for Legacy Systems." Payers that are not ready to migrate from legacy systems are looking at tactical solutions for making their existing systems ICD 10 compliant in the near term. Most solutions involve a crosswalk between old and new code sets, created from four basic options. Healthcare Information and Management Systems "Reading the Fine Print on ICD 10 Conversions." Automation is a major help in converting to the ICD 10 code set, but it is not a magical solution. In fact, skipping a human review of converted systems exposes an organization to legal and financial risk. hima/bok1_ hcsp hima/bok1_ hcsp legacy data legacy data MSDRGs "Crosswalking between ICD 9 and ICD 10." This fact sheet provides detailed information on the uses of crosswalking and understanding of GEMs. CMS ICD 10 MS DRG Conversion Project Web site. This site provides information on the project for using the General Equivalence Mappings (GEMs) to convert the draft MS DRGs v28.0 to and ICD 10 PCS. In addition the draft /PCS MS DRG V28 Definitions Manual is provided. betweenicd 9 and icd 10.pdf n_project.asp#topofpage WHO WHO ICD Revision Topic Advisory Groups Web site. The link pertains to World Health WHO and its topic advisory groups. Organization "Adaption of AHRQ Patient Safety Indicators for use in ICD 10 Administrative Data by an International Consortium." This 2008 study discusses the conversions of patient safety indicators in the Australian and German version of ICD 10. It provides some code examples based on Agency for Healthcare the methodology they used. Research and Quality ances Quan_52.pdf AHIMA ICD 10 Toolkit Review Draft Do not cite or quote 5

6 Resources for ICD 10 Toolkit /PCS "ICD 9 CM to /PCS Conversion of AHRQ Quality Indicators: Summary of Challenges and Recommendations for AHRQ." This paper provides a review of /PCS and current quality indicators and the challenges when current ICD 9 CM codes will not be a one to one match. Agency for Healthcare Research and Quality "Re engineering the Coding Workflow: Assessing Today with an Eye toward Tomorrow." Coding is in the midst of profound change, which makes this the best time to re engineer coding workflow. Five steps help HIM professionals assess and evolve coding workflows with an eye toward tomorrow. hima/bok1_ hcsp "Growing ICD 10." There are two basic approaches to the ICD 10 transition: (1) a late, mad scramble to get systems converted before the deadline; or (2) an intentional cultivation that uses the transition to improve business processes, documentation, and clinical care. Three organizations offer a picture of the latter approach. hima/bok1_ hcsp "All Together Now: Planning for ICD 10, ARRA, and the Affordable Care Act." This article discusses the relationship of ICD 10 to other healthcare initiatives such as ARRA and Affordable Care Act. ahima/bok1_ hcsp Retooling Quality Measures for ICD 10. ahima/bok1_ hcsp "CMS ICD 10 Planning" Initial Summary of AHIMA Executive Report." This 15 page report summarizes a more extensive AHIMA report chronicling CMS business process that would be impacted by an ICD 10 transition. df Billing "Medicare Fee For Service (FFS) Claims Processing Guidance for Implementing International Classification of Diseases, 10th Edition (ICD 10)." "Physician Quality Reporting System and ICD 10 Conversion Milestones." This report provides conversion timeframes for the physician quality reporting system (PQRS) ICD 10 Comment Period: March 15 April 16, 2012 Web site. On March 15, 2012 NCQA will post the measures below for review and comment. NCQA will post only tables of ICD 10 codes for review; organizations must refer to HEDIS 2012 Volume 2: Technical Specifications for the complete measure specifications pdf 10_Conversion_Milestones pdf National Committee for Quality Assurance "/PCS Coding Maintenance Operational Guide." This site provides guidance to NQF, measure developers, and stewards on how to prepare for the conversion of quality measures to /PCS. NQF membership is required to access the full report. Abridged version is 10 available at no charge. National Quality Forum CM/PCS_Coding_Maintenance_Operational_Guidance.aspx Regulatory Impact "The Impact of ICD 10 on Non Covered Entities." The /PCS final rule requires HIPAA covered entities adopt the and ICD 10 PCS code sets by October 1, Adoption is not required for noncovered entities such as property and casualty insurance health plans, workers' compensation programs, and disability insurance programs that submit noncovered transactions like paper claims, quality reporting, and patient assessment data sets. hima/bok1_ hcsp AHIMA ICD 10 Toolkit Review Draft Do not cite or quote 6

7 Resources for ICD 10 Toolkit Regulatory Impact "Changes Ahead in Data Standards." HIM professionals are most familiar with the data standards mandated through HIPAA. However, the data standard adoption process is also now part of the requirements for EHR technology in the meaningful use program. Understanding the data standards adoption process under HIPAA and the meaningful use program can help HIM professionals prepare for and implement the data standards changes necessary to implement /PCS for each initiative. ahima/bok1_ hcsp Regulatory Impact Regulatory impact 5010/ICD 10 "Aligning ICD 10: Federal Initiatives Recognize the Value of Integration." This article discusses the impact of ICD 10 on regulatory initiatives, including HIPAA transactions, meaningful use and value based purchasing, and terminologies and classifications. "HHS Modifies HIPAA Code Sets (ICD 10) and Electronic Transaction Standards Overview." This is the CMS fact sheet of the final 1CD 10 implementation rule released on January 15, ahima/bok1_ hcsp nter=3407&intnumperpage=10&checkdate=&checkkey=2& srchtype=2&numdays=0&srchopt=0&srchdata=icd%252d1 0&keywordType=All&chkNewsType=6&intPage=&showAll=1 Regulatory Impact 5010/ICD 10 CMS Statute and Regulations Web site. This site contains links to the final rule and transitions and code sets regulations. TopOfPage Regulatory Impact 5010/ICD 10 Final rule, 5010 Final Rule, ICD 10 CMS Transactions and Code Set Regulations Web site. This site provides the final rules for the standards for electronic transactions and the ICD 10 final rule. It also provides additional downloads. ICD 10 Handbooks. CMS has developed four implementation handbooks as additional resources to assist the healthcare industry with the transition from ICD 9 to ICD 10 codes. Each guide provides detailed information for planning and executing the ICD actionsandcodesetsregulations.asp ge "Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA); Final Rules." This is the link to the Federal Register on the final rule for version 5010 published January 16, 2009, 34 pages. Federal Register pdf "HIPAA Administrative Simplification: Modifications to Medical Data Code Set Standards to Adopt and." This link is to the 35 page Federal Register containing the final rule for ICD 10 published January 16, Federal Register pdf AHIMA Recertification Web site. This link outlines the standards for recertification as documented by CCHIIM. Each AHIMA credential is listed along with the /PCS requirements for continuing education. AHIMA "Coding Injuries in." provides greater specificity in coding injuries than ICD 9 CM. While many of the coding guidelines for injuries remain the same as ICD 9 CM, does include some new features, such as seventh character extensions. CMS Sponsored ICD 10 Teleconferences Web site. CMS has hosted a variety of national provider education teleconferences regarding the change from ICD 9 to ICD 10. The site provides the PDF files for all calls and even podcasts for some of the calls that have been held on ICD 10 CM or PCS. hima/bok1_ hcsp CMS Latest News Web site. Site provides updates on activities and educational opportunities, including national provider teleconferences. age "Get Body Smart." This is an online textbook about human anatomy and physiology. Get Body Smart AHIMA ICD 10 Toolkit Review Draft Do not cite or quote 7

8 Resources for ICD 10 Toolkit Background of ICD 10 CM/PCS "ICD 10 Checklist." checklist.pdf "ICD 10 Project Plan Template" under AMA Educational Resources. assn.org/ama/pub/physicianresources/solutions managing your practice/coding billinginsurance/hipaahealth insurance portability accountabilityact/transaction code set standards/icd10 code set.page Background of ICD "ICD : What It Is and Why It s Being Implemented." This a fact 10 CM/PCS sheet defines and PCS why it is being implemented. overview fact sheet.pdf Background of ICD 10 CM/PCS "The Differences between ICD 9 and ICD 10." This fact sheet explains the key differences between the two code sets and provides examples. "Implementing ICD 10 in Your Practice Part One." This fact sheet provides information, guidance, and checklists to implement ICD 10 with important lists of questions to consider. icd9 differences fact sheet.pdf practice implementation part 1.pdf "Implementing ICD 10 in Your Practice Part 2." This fact sheet continues to provide information on system changes and training staff. practice implementation part 2.pdf "Testing Your Readiness for ICD 10." This fact sheet explains the testing (internal and external) needed for implementation of the ICD 10 code set. "ICD 10 Timeline: Meeting the Compliance Date." This fact sheet provides steps for implementation of ICD 10 by October 1, 2013, and advice post implementation. assn.org/resources/doc/washington/icd 10 readiness testing.pdf timeline fact sheet.pdf "Preparing for the Conversion from ICD 9 to ICD 10: What You Need to Be Doing Today." This nine page article provides advice on implementation including changes to clinical and administrative systems, reasons to convert now, advice on preparation including communication with vendors, billing services, payers, work flow, business processes, staff training, and testing. for theconversion from ICD9 ICD10.pdf American of Orthopaedic Surgeons American Clinical Laboratory ICD 10 search on the American of Orthopaedic Surgeons Web site. The site provides links to other sites and articles on ICD 10. ICD 10 search on American Clinical Laboratory Web site. This site provides documents relating to ICD 10. American of Orthopaedic Surgeons on&site=my_collection&output=xml&ie=&lr=&q=icd 10&btnG=Search American Clinical Laboratory 10 American Optometric ICD 10 search on the American Optometric Web site. This site provides several links for additional ICD 10 information, including links to CMS and podcast information. American Optometric American Physical Therapy ICD 10 search on American Physical Therapy Web site. ICD 10 information includes links to CMS; online education through WHO, and comments on the proposed rule. American Physical Therapy 10/ AHIMA ICD 10 Toolkit Review Draft Do not cite or quote 8

9 Resources for ICD 10 Toolkit American of Anesthesiogists ICD 10 search on American of Anesthesiologists. Site includes links to multiple ICD 10 related articles and publications. American of Anesthesiogists "ICD 10 Strategies for Physicians National Provider Call." Members/Member Login.aspx?redirUrl= =none&filterbydid= 99&sortByDID=1&sortOrder=descending&itemID=CMS &intNumPerPage=10 Budget Vendor "New ICD 10 Study Confirms CMS Underestimates Costs and Time Medical Group Required to Implement Complex New Code Set" fact sheet. This MGMA Management press release includes several links to medical societies. "Getting the Best from Your ICD 10 Vendor." This article reviews implementation steps on a high level on getting the vendor involved in the ICD 10 strategy. hima/bok1_ hcsp Vendor AHIMA Form Letter for Vendors Regarding ICD 10. This form letter can help organizations audit their vendors plans regarding ICD 10 compliance. It also includes a vendor questionnaire. hima/bok1_ pdf Vendor CMS Vendor Resources Web site. This site is directed at vendor readiness for the ICD 10 transition. opofpage Vendor "Talking to Your Customers about ICD 10 and Version 5010: Tips for Software Vendors." This is a two page tip sheet on talking to software vendors about ICD 10 and 5010 compliance. "ICD 10 The New Teacher's Pet." This article talks about teaching ICD 10 in academia beginning fall "Coding UTI to Sepsis in ICD 9 CM and." This article reviews the causes of UTI and sepsis as well as the differences in coding between ICD 9 CM and. tomersforvendors pdf hima/bok1_ hcsp ahima/bok1_ hcsp American Academy of Dermatology ICD 10 Search on American Academy of Dermatology Web site. This Web American Academy of site is mainly restricted to members but offers some ICD 10 resources. Dermatology /PCS State Specific ICD10Data.com Web site. This is a free ICD 10 medical coding Web site. ICD10Data.com takes the ICD 10 coding book and adds more than 4.2 million cross references between codes to make finding what you need faster and easier than ever before. It provides the ICD 10 coding books with more than 10.6 million hyperlinks between codes to make it faster and easier to find what you need. ICD10Data.com Strategic Goals for the Ohio Department of Job and Family Services, page 16 or 19. This PDF identifies the short and long term strategy for Ohio Department of ICD 10 implementation. Job and Family Services State Specific Ohio Department of Job and Family Services MITS News, February At the time of the publication the new Medicaid Information Technology System implementation will have been completed. This system will allow Ohio Department of for 5010 compliance and the ability for providers to submit ICD 10 codes Job and Family in the future. Services AHIMA ICD 10 Toolkit Review Draft Do not cite or quote 9