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Introductions Review of this afternoon's sessions:Overview of 5010 and ICD-105010 Working SessionICD-10 Working Session. Welcome!. Agenda for Overview Session5010ICD-10Implementation ResourcesQuestions. 5010 Questions. What is 5010 and why do we have to do this?. Who uses 5010? . EDI 5010 Overview.
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1. Facilitators:
Kit Cairns, WIITTS
Karen Navarro, University of WI Hospital & Clinics
Claudia Yoakum-Watson, WEA Trust and CCRS
3. Agenda for Overview Session
5010
ICD-10
Implementation
Resources
Questions
4. 5010 Questions
5. What is 5010?
Started with requirement that the Secretary of the Department of Health and Human Services (HHS) adopt standards for covered entities to use when they electronically conduct certain health care administrative transactions.
The Transactions and Code Sets final rule published on Aug. 17, 2000, adopted standards for the statutorily identified transactions, some of which were modified in a subsequent final rule published on Feb. 20, 2003.
On January 16, 2009, HHS announced a final rule that replaces the current Version 4010/4010A and NCPDP Version 5.1 with Version 5010 and Version D.0, respectively.
6. What is 5010?
Improvements in structural, front matter, technical, and data content.
More specific in requiring the data that is needed, collected, and transmitted in a transaction.
Significant improvements for the reporting of clinical data, enabling the reporting of ICD–10–CM diagnosis codes and ICD–10–PCS procedure codes, and distinguishes between principal diagnosis, admitting diagnosis, external cause of injury and patient reason for visit codes.
7. Because of the Final Rule published
by the US Department of Health and
Human Services on 1/16/2009:
http://edocket.access.gpo.gov/2009/pdf/E9-740.pdf
8. December, 2010
Complete internal testing – able to send & receive compliant transactions
January, 2011
Begin external testing with trading partners
January 1, 2012
All covered entities must be in production
9. Covered Entities:
11. ICD-10 Questions
12. ICD-10 Code Structure
13. Diagnosis Code Structure
14. Procedure Code Structure
15.
16. Implementation Tasks
17. Implementation Tasks
18. Implementation Tasks
19. Implementation Tasks
20. Implementation Tasks
21. HIPAA COW: www.hipaacow.com
WEDI: www.wedi.com
CMS: www.cms.gov
22. CMS Transactions & Codesets:
http://www.cms.hhs.gov/TransactionCodeSetsStands/02_TransactionsandCodeSetsRegulations.asp
ICD 10 Final Rule: http://edocket.access.gpo.gov/2009/pdf/E9-743.pdf
5010 Final Rule:
http://edocket.access.gpo.gov/2009/pdf/E9-740.pdf
23. CMS HIPAA Standards Page (gap information links):
http://www.cms.hhs.gov/ElectronicBillingEDITrans/18_5010D0.asp
CMS ICD 10 Fact Sheet: http://cms.hhs.gov/MLNProducts/downloads/ICD-10factsheet2009.pdf
X12 Presentation to NCVHS on 5010 changes:
http://www.ncvhs.hhs.gov/070730p4.pdf
24. Questions?
25. THANK YOU!
26. Contact Information:
Kit Cairns
catherine.cairns@deancare.com
608.294.6492
Karen Navarro
KNavarro@uwhealth.org
608.662.0817
Claudia Yoakum-Watson
CYoakumw@weatrust.com
608-661-6726
Or
ccrsconsulting@tds.net
608-289-4974