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ICD -10 STAFF AWARENESS. What is this course?. This course is designed to provide a basic awareness and understanding of ICD-10 and why it is so critical to our organization. What is icd-10?. We have all been hearing the whispers … and screams … about the transition to ICD-10.
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What is this course? This course is designed to provide a basic awareness and understanding of ICD-10 and why it is so critical to our organization.
What is icd-10? We have all been hearing the whispers … and screams … about the transition to ICD-10. For many of you, you may know all too well what it means and how it affects you in your job. For others, you may not know much about ICD-10 and what the fuss is all about.
International classification of diseases (ICD) • ICD-9 is currently the official system of assigning codes to diagnoses and procedures associated with hospital, outpatient, clinical and physician utilization in the United States • We will be transitioning to the next version of ICD codes – ICD-10
The DIAGNOSTIC CODE is like the rebar in the cement of a building • You may not know it’s there, but it provides the structure and it is everywhere! • Defines Patient Illness (diagnosis, signs, symptoms, diseases, disorders, treatment, and medication) • Provides for Billing and Reimbursement • Measure Quality of Care • Facilitates Clinical Research • Determines Medical Necessity • Captures Data for Reporting https://www.whitecap.com/images/articles/rebar/estimating-the-cost-for-rebar-materials-and-labor.jpg
Farewell ICD-9 • World Health Organization (WHO) took over responsibility for ICD at its creation in 1948 in its Sixth Revision (ICD-6) to provide a consistent way to monitor and trend diagnoses and diseases • The United States has been using ICD-9 for over 30 years • Payers cannot pay claims fairly using ICD-9, since the classification does not accurately reflect current technology • It is difficult to evaluate the outcome of new procedures and emerging healthcare conditions when codes are not precise • The healthcare industry cannot accurately measure Quality of Care, particularly causes of mortality • Clinical Research will be improved • Impacts Billing and Reimbursement ICD-9 Outdated
The U.S. is one of the few developed nations that has not transitioned to the ICD-10 system. Worldwide icd-10 adoption SOURCE: http://www.who.int/classifications/icd/en/
When does the change from Icd-9 to icd-10 happen? The deadline for organizations to convert from ICD-9 codes to ICD-10 codes is October 1, 2015
Benefits of icd-10 • We will be able to capture more detailed data to support clinical research, quality outcomes, and patient care • For an academic organization, ICD-10 will accommodate data capture of new technologies and procedures and allow us to better define the complexity of care provided • ICD-10 data will be more easily retrieved in electronic format, resulting in less manual work in reporting, quality reviews, and auditing
Benefits of ICD-10 (cont’d) • ICD-10 was designed with the idea that healthcare delivery and technology are not static, but constantly changing. It has far greater granularity, specificity, and more current healthcare information • An important benefit and result: The widespread efforts within our organization to prepare for ICD-10 will yield improved workflows, improved efficiency, and greater organizational integration and teamwork
How do we make this change happen? • There are seven UAHN - ICD-10 teams who will be leading the implementation effort: • Clinical Documentation Team – responsible for facilitating effective clinical documentation • Coding Team – responsible for transition to new ICD-10 codes • Education Team – responsible for staff training • Revenue Cycle Team – responsible for redesign of revenue cycle processes • Reimbursement/Finance Team – responsible for ensuring payer and contract readiness, reimbursement and financial reporting • Technology Team – responsible for remediation and integration of IT systems for ICD-10 implementation • The Health Plan – responsible for implementation as a payer
Integration with epic • The Physician Advisory and Executive Steering committees oversee the ICD-10 implementation • The Physician Advisory Committee also provides oversight for the Epic Project • ICD-10 teams and Epic teams are integrated • Enables both projects to be in sync with one another
Icd-10 implementation process • Education needs are based on the staff member’s position within the organization • Several different forms of training will be used: learning modules via HealthStream, posters, group forums, etc. • Coordination with Epic team • Epic includes both ICD-9 and -10 for dual coding options • ICD-10 tools are embedded in Epic to facilitate the transition
What Changes canwe expect? • The number of diagnostic codes will increase from approximately 17,000 today to 140,000 after ICD-10 is implemented • Clinical documentation will require greater specificity • All providers and staff involved in documentation and coding must have a thorough understanding of ICD-10 • UAHN systems and workflows will need to be modified to include ICD-10
Next steps • The ICD-10 Teams will coordinate with the departments impacted by the change • Additional implementation training for providers and staff directly affected by ICD-10, will be rolled out through September, 2015 • An ICD-10 information site can be accessed via the intranet • From the home page, click on Departments and ICD-10 • Regular communications will keep everyone informed of project progress
IN summary… • ICD-10 is a significant change, but we are all used to BIG and constant changes • ICD-10 impacts all of us in some way, making it vital that we understand what it is and how it will change our industry • Thorough preparation for ICD-10 will allow for a successful transition
HIP HIP HOORAY! We are on our way!