Provider 7.2.6 ICD 10 Compliant Release A S K E S I S W E B I N A R F E B R U A R Y 1 9, 2 0 1 4
Agenda ICD 10 overview Application development path to compliance Objectives Components CMS 1500 Documentation plan Implementation sequence Provider 7.2.6 demonstration Questions
ICD 10 Implementation Covered entities must adopt ICD 10 for services provided on or after October 1, 2014 Providers Payers Clearinghouses ICD 10 codes must be used on healthcare claims Behavioral Healthcare currently uses DSM IV TR The DSM has always been translated into ICD The codes to which DSM is translated must change
Parallel Development Base code Provider 7.2.5 MR1 P1 First quarter 2014 Provider 7.2.6 ICD 10 Compliance Provider 7.3.0 EHR 2014 Certification Merge to produce Provider 8.0 Second quarter 2014
Upgrade Requirements Provider 7.2.6 EDI x12 837 v2.0
Inventory of Application Clinical Documents Diagnosis Browser, Diagnosis Document History and Physical, Treatment Plan, Outpatient Assessment and Medication Management Application Screens Problem List, Clinical Transactions, Coverage Plan, PPS Configuration, Medication Orders, Chart Generator, Chart Viewer, Patient Administration Summary, Order Entry Diagnostic Test, Clinical Decision Support Rules and Criteria, DSM Groups, Quick Patient, Case Load Manager, Inpatient ADT Details and Clinical Transactions List Core Application Processes Batch Processor, EDI X12 837 (HIPAA Engine)
Design / Functional Requirements Mapping of DSM IV to ICD 10 Retain consistency of features with current release Support electronic claim production using ICD 10 Utilize mapping whenever possible to minimize need for entry of new Diagnosis Document Support local mapping of Axis III ICD 9 codes to ICD 10 codes Reports that will assist the customer identify the areas where mapping is not 1 to 1 or use of Axis III
Payer Specific Readiness Database value for payer ICD 10 readiness No GUI to manage the setting Defaulted to ready (CMS has said so)
System Configuration
Diagnosis Document Control of Effective Date Determines the code version to use (ICD 9 or ICD 10) Diagnoses with Valid to dates prior to Effective Date are not displayed by default Document can be used for versioning as well as new Effective date cannot be set to future date New and versions will: Prepopulate with diagnosis from prior document Map to ICD-10 when possible, highlight those not 1 to 1
Effective Date and Versions of ICD ICD Start Date set to: Jan 1, 2014 Discontinued codes can be accessed ICD 9 codes are displayed with DSM IV descriptions ICD 10 codes Displayed with DSM IV descriptions
Diagnosis Browser Functions Use of ICD 9 Codes Maintain ICD 9 codes as searchable values
Diagnosis Browser Functions Text String(s) Search and Ranking Enhance Description search Multiple strings separated by space; first string is principal Large ranked result set
Diagnosis Browser Functions Concatenate DSM IV diagnoses with specifiers Matches to unique ICD 10 code Diagnosis Specifier populated and locked
Clinical Transactions At time of completion map to ICD 10 If not mapped 1 to 1, report in Batch Error Handler Axis III not mapped, report in Batch Error Handler Enter new diagnosis document Map ICD 9 codes to ICD 10 codes locally Use of Diagnosis Browser based on Procedure Date All existing logic for pulling onto clinical transaction remains unchanged Cloning will execute the mapping as well
CMS 1500 National Uniform Claim Committee Resources for Implementing the revised CMS - 1500 Revisions to current document Applicable to Provider 6.2.1 and up to Provider 7.2.6 Continues to use ICD 9 Meets paper claim submission requirement for April 1, 2014 Release of CMS 1500 for Provider 7.2.6 Maintenance Release ICD 10 compliant CMS 15oo and UB 04
ICD 10 7.2.6 Help Documentation Different than usual DVD release One guide, Applying Version 7.2.6, on the root of the DVD Contains ICD-10 7.2.6 related changes in one document In PDF format Includes Release Notes All other Help documentation included as usual Copyright page will say 7.2.5, but that s ok! Why? We wanted a single guide that contained ICD-10 changes And was manageable to read We wanted the ability to update quickly and post revisions Client Resource Center (CRC) 7.2.6 and Adoption of ICD-10 page; will contain Revisions of Applying Version 7.2.6 Askesis Resources and Information Industry Resources and Information FAQs Feedback regarding 7.2.6 Help documentation Contact Askesis Support per the usual channels
Sequence of Implementation CMS - 1500 (ICD-9) EDI x12 837 V 2.0 Provider 7.2.6 Oct 1, 2014 CMS -1500 (ICD-9) Provider 7.2.6 EDI x12 837 V 2.0 Oct 1, 2014
Demonstrate Scenarios New Diagnosis Document Prior to ICD 10 implementation date Version Diagnosis Document Prior to ICD 10 implementation date Following ICD 10 implementation date New Diagnosis Document Following ICD 10 implementation date Previous Diagnosis Document exists for patient New Diagnosis Document Following ICD 10 implementation date No Diagnosis document exists for patient
Questions