A lady walks into the doctor’s office…

1. Blue Cross Blue Shield of NebraskaICD-10 WorkplanLisa Fisher, RN MHADirector Health Network ServicesBlue Cross Blue Shield of Nebraskalisa.fisher@nebraskablue.com402-982-6254

2. A lady walks into the doctor’s office… W6101xA Bitten by parrot, initial encounter W6101xD Bitten by parrot, subsequent encounter W6101xS Bitten by parrot, sequela W6102xA Struck by parrot, initial encounter W6102xD Struck by parrot, subsequent encounter W6102xS Struck by parrot, sequela W6109xA Other contact with parrot, initial encounter W6109xD Other contact with parrot, subsequent encounter W6109xS Other contact with parrot, sequela W6111xA Bitten by macaw, initial encounter W6111xD Bitten by macaw, subsequent encounter W6111xS Bitten by macaw, sequela W6112xA Struck by macaw, initial encounter W6112xD Struck by macaw, subsequent encounter W6112xS Struck by macaw, sequela W6119xA Other contact with macaw, initial encounter W6119xD Other contact with macaw, subsequent encounter W6119xS Other contact with macaw, sequela W6121xA Bitten by other psittacines, initial encounter W6121xD Bitten by other psittacines, subsequent encounter W6121xS Bitten by other psittacines, sequela W6122xA Struck by other psittacines, initial encounter W6122xD Struck by other psittacines, subsequent encounter W6122xS Struck by other psittacines, sequela W6129xA Other contact with other psittacines, initial encounter W6129xD Other contact with other psittacines, subsequent encounter

3. Health System Impacts • Estimate a permanent 3-4% increase in physician time spent on documentation • Changes will impact coverage policies, authorization and payment decisions • Increased documentation to support coding

4. BCBSNE’s Work Plan • Mapping Benefits, Products, and Medical Policy to ICD-10 • Target completion end of 2012  • New ICD-9 codes required retro of earlier mappings • Other projects will be initiated 4th quarter 2012 • Staff Training • Staffing Plan • Vendor Management • Business process changes • Information Changes – Reports, Databases, Applications

5. Provider Communication • Anticipate participation in Nebraska work group to identify areas of need • ICD-10 website on nebraskablue.com • ICD-10 articles in monthly newsletter • Workshops for ICD-10

6. Testing • Internal Testing in 2013 • Provider Testing in 2014 • Ensure services are being paid according to plan (e.g., same as ICD-9 or intentional refinement) • Will use same process as 5010 testing Vendor Management • Community Manager • claims in and send back 835’s • Automated process 

7. Questions? W56.01XA Bitten by dolphin, initial encounter