ICD-10 Update All Blue 2014 Workshops

1. ICD-10 Update All Blue 2014 Workshops 1

2. Agenda • Provider Readiness • Steps for Provider Preparedness • BCBST Readiness Summary • BCBST ICD-10 Testing Information • Questions & Next Steps All Blue Workshops 2014 > ICD-10 3

3. ICD-10 Provider Readiness • WEDI surveyshowed roughly 80% of health care providers had not completed business changes or begun testing before 2014. Twenty percent of vendor respondents said they were halfway or less than halfway complete with product development in support of ICD-10 • Thirty-seven percent of today’s documentation is ready for the transition, according to the American Association of Professional Coders • Roadmaps are available at CMS.gov that include the following: • Small and Rural clinical practices • Small Hospitals • Large Practices • Communications Plan guidance • Checklists All Blue Workshops 2014 > ICD-10 4

4. Activities for Provider Preparedness • Assess Workflow and Systems • Complete a gap analysis on the expected workflow and process changes • Include IT systems • Assess System Vendor Readiness • Upgrade or replace the practice’s IT systems • Include forms and reports • Documentation Considerations • Assess whether current clinical documentation will support the level of specificity necessary • Priority list of diagnoses requiring more detailed documentation • Revenue and Cash Flow Considerations • Know which payers have fully transitioned to ICD-10-CM • Professional services are paid based on the procedure code, but the diagnosis code supports medical necessity • Train on New Processes and Systems • Ensure staff can be trained prior to the compliance date on all changes All Blue Workshops 2014 > ICD-10 6

5. BlueCross Preparedness • BCBST Systems Testing • Quality Assurance Testing is complete for Core Systems • System Integration Testing and End-to-End testing is in process • UAT Testing is in process • Provider Testing • Pilot Testing began October 2013 • Provider Testing Tools are being implemented • Provider Testing is open for professional and institutional providers • Provider Communications • Provider Administration Manual updates throughout the year • BlueAlertSMarticles for the remainder of the year will focus on ICD-10 updates • Compliance statement on BCBST.com and FAQs • Training of BCBST Employees • Training began in 2013 and will continue in 2014 and 2015 • ICD-10 Delay Planning has concluded All Blue Workshops 2014 > ICD-10 7

6. ICD-10 Provider Testing Tool • Professional Testing Tool – Web-Based Self Help • Browser Requirements (Chrome, Safari, Internet Explorer, or FireFox) • Give health care providers (physicians, etc.) pre-defined, clinically based medical scenarios to review and determine the ICD-10 codes • Enter the data in an easy, efficient manner • Provide peer reports and/or notification of the correlation between input and output codes • Provider Steps for tool registration and testing • Provider Registers on the website • Provider users access application • Provider completes scenarios • Provider reviews results • To express interest in testing, send email to ICD10_GM@BCBST.com All Blue Workshops 2014 > ICD-10 9

7. ICD-10 Provider Testing Tools - Narratives • Each Specialty has a maximum of ten narratives available. • Each Narrative defines a specific healthcare encounter (Narratives include Chief Complaint, Past Medical History and Office Visit Notes pertaining to a Patient) • Providers register via a website, and will receive an email inviting them to participate with an embedded link to the testing tool All Blue Workshops 2014 > ICD-10 9

8. ICD-10 Provider Testing Tools – Provider Report Sample SAMPLE All Blue Workshops 2014 > ICD-10 9

9. ICD-10 Provider Testing Tool – Provider Specialties MedTenn Conference 2014 > ICD-10 9

10. ICD-10 Provider Testing Tool - Institutional • Facility Testing Tool – Web Based Self Service • Browser Requirements (Chrome, Safari, Internet Explorer or FireFox) • Providers can test scenarios with DRG code being returned (Grouper 30) • Scenarios can be selected by the testing provider • Largely based upon DRGs of interest • Evaluation of results • To express interest in testing send e-mail to ICD10_GM@BCBST.com • Provider Steps for tool registration and testing • Provider contacts BCBST, BCBST loads claim scenarios • Provider Registers on the website • Provider users access application • Provider completes scenarios • Provider reviews results • Provider can express interest in testing by sending an email to ICD10_GM@BCBST.com ICD-10 Program

11. Questions & Next Steps All Blue Workshops 2014 > ICD-10 10

12. Appendix Useful Links • Tennessee Hospital Association (THA) www.THA.com • Tennessee Medical Association (TMA) • www.tnmed.org • BCBST ICD-10 Page (BCBST.COM) • www.bcbst.com/providers/icd-10.page • American Association of Professional Coders (AAPC) • www.aapc.com/icd-10/index.aspx • American Health Information Management Association (AHIMA) • www.ahima.org/icd10 • Implementation Planning (CMS) www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/ICD10/02b_Latest_News.asp • CMS “Road to ICD-10” Toolkit http://www.roadto10.org/ All Blue Workshops 2014 > ICD-10 11