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Transitioning to ICD-10-CM/PCS

Transitioning to ICD-10-CM/PCS. Agenda. Overview Implementation Team Organization Awareness Impact Analysis Financial Impact Training Plan Timeline. ICD-10 Implementation. OCTOBER 1, 2013 - ICD-10-CM and ICD-10-PCS code sets implementation date

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Transitioning to ICD-10-CM/PCS

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  1. Transitioning to ICD-10-CM/PCS

  2. Agenda • Overview • Implementation Team • Organization Awareness • Impact Analysis • Financial Impact • Training Plan • Timeline

  3. ICD-10 Implementation • OCTOBER 1, 2013 - ICD-10-CM and ICD-10-PCS code sets implementation date • In January 2009, HHS published a Final Rule requiring the adoption of ICD-10-CM and ICD-10-PCS code sets to replace the 30-year-old ICD-9-CM coding system used for billing purposes • ICD-10-CM - International Classification of Disease, 10th Revision, Clinical Modification • Diagnosis Code Set • ICD-10-PCS – International Classification of Disease, 10th Revision, Procedural Coding System • Procedure Code Set • Billing Format (X12 version 5010)update also required to accommodate new code formats • Effective Date – January 1, 2012

  4. ICD-10 Implementation Note: Only inpatient hospital setting impacted by change in procedural coding system

  5. Implementation Team Charge:Implementation Plan Development and Oversight • Internal Staff • Health Information Management • Finance • Information Technology • Medical Staff Leadership • Other • Use of Consultants

  6. Organization Awareness • Communication Plan • Who, what, when • Need for Participation in Impact Analysis • Need for Multi-Year Resource Planning

  7. Impact Analysis • Assess all software applications that currently store, transmit or received ICD-9-CM codes for potential impact • Required Changes to Workflow • Analysis of coding and billing functions throughout the revenue cycle • Billing Forms/Spreadsheets • Clinical Documentation Issues • Impact on internal and external reporting • Evaluation of contracts for which payment is based on ICD-9-CM codes

  8. Financial Impact • Potential impact to hospital • $15 million to $20 million • Need to plan for decrease in productivity to prevent billing backlogs during training and initial implementation

  9. Training Plan • Varies based on employee role (audience) • Content • Timing • Delivery Methods • Contracted Out or Provided by Internal Staff

  10. Recommended Implementation Schedule Year 2009/ 2010 2011 2012 2013 Phase I Implementation Plan Impact Assessment Phase II Implementation Preparation Phase III Go Live Preparation Phase IV Post – Implementation Follow-Up

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