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ICD 10 Update: Are you Ready! Putting the ICD-10-CM/PCS GEMs into Practice

ICD 10 Update: Are you Ready! Putting the ICD-10-CM/PCS GEMs into Practice. Tasha E. Green, MS, RHIA, CHTS-TR. ICD 10 Update: Are you Ready!. ICD-10 Introduction to About ICD-10 Benefits of ICD-10 Implementation Timeline. ICD 10 Update: Are you Ready!. Roadmap to ICD 10. Implementation.

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ICD 10 Update: Are you Ready! Putting the ICD-10-CM/PCS GEMs into Practice

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  1. ICD 10 Update: Are you Ready! Putting the ICD-10-CM/PCS GEMs into Practice Tasha E. Green, MS, RHIA, CHTS-TR

  2. ICD 10 Update: Are you Ready! • ICD-10 • Introduction to • About ICD-10 • Benefits of ICD-10 • Implementation Timeline

  3. ICD 10 Update: Are you Ready!

  4. Roadmap to ICD 10

  5. Implementation • Planning & Analysis • Establish Project Structure • Assess business & policy impacts • Establish risk management • Design • Identify & Define System Requirements • Establish Risk Management

  6. Implementation (Continued) • Development • Finalize system changes • Verify Vendor changes • Team Approach • Are you here?

  7. Implementation (Continued) • Testing: • Conduct Internal Testing • Conduct External Testing • Implementation • Prepare and establish the production and go-live environments • Deliver on-going support

  8. Transition and Testing @ Large Practices • March 2013 to September 2014 • March 1, 2013 to December 31, 2013: Conduct high-level training on ICD-10 for clinicians and coders to prepare for testing (e.g., clinical documentation, software updates) (ongoing) • April 1, 2013: Start testing ICD-10 codes and systems with your practice’s coding, billing, and clinical staff (9 months) Use ICD-10 codes for diagnoses your practice sees most often • Test data and reports for accuracy • Monitor vendor and payer preparedness, identify and address gaps (ongoing) • October 1, 2013: Begin testing claims and other transactions using ICD-10 codes with business trading partners such as payers, clearinghouses, and billing services (10 months minimum) • January 1, 2014-April 1, 2014: Review coder and clinician preparation; begin detailed ICD-10 coding training (6-9 months) • Work with vendors to complete transition to production-ready ICD-10 systems

  9. Are You Ready? Inpatient Coder Outpatient Coder Data Manager

  10. Are You Ready? Educators Current Students Prospective Students

  11. Lessons Learned from ICD-10 Implementation • ICD-10 initially cuts coder productivity by 50 percent. • Ultimately, more coders will be needed once ICD-10 is required. • All hospitals are looking for coding talent. • Coders trained on ICD-10 and given the opportunity to code real, live cases every day become energized, and employer loyalty is strengthened. • Undertake coder assessments to determine exactly what training is required. • Specialty coding is recommended during the initial six months of ICD-10 go-live to ensure coding and revenue accuracy.

  12. Test Now: No Time to Wait • Take steps towards • Awareness • Assessments • Training • Documentation modifications • Be well-prepared and way-ahead in 2014

  13. What are GEMs • General Equivalence Mappings • Mappings between ICD-9-CM and ICD-10-CM/PCS • Act as a translation dictionary to bridge the language gap between ICD-9-CM and ICD-10-CM/PCS • Help users understand, analyze, and manage the translation of one code set to the other

  14. Understanding the GEMs • GEMs : More complex than a simple one-to-one crosswalk. • GEMs • Convert large databases and create data sets to test systems and applications • Link data in long-term clinical studies • Develop application-specific mappings • Analyze data collected before and after the transition to ICD-10-CM/PCS

  15. DO NOT USEGEMs As simple crosswalks: They are reference mappings to assist users in navigating the complexity of translating meaning from the contents of one code set to the other code set. As a substitute for learning how to use the ICD-10-CM/PCS code sets

  16. Mapping • Provides a linkage between a code in one set and its closest equivalent in the other code set • Stay Tuned to More about Putting the ICD-10-CM/PCS GEMs into Practice ! • MDHIMA QBM –December 6, 2013

  17. Resources ICD 10 Implementation Guides https://implementicd10.noblis.org/table-of-contents/?guide=large Path to ICD Preparedness: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_050206.hcsp?dDocName=bok1_050206 Start Implementing ICD 10: http://www.ahima.org/topics/icd10 Putting the ICD-10-CM/PCS GEMs into Practice http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_050190.hcsp?dDocName=bok1_050190

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