What your EMR Vendor Should Provide in the ICD10 Transition

1. What your EMR Vendor Should Provide in the ICD10 Transition Julie Lundberg March 27, 2014

2. Pressures Applied From Multiple Directions “As an independent physician, Dr. Ragland must carefully devise strategies to keep her three-person practice afloat amid rising overhead, flat or dropping reimbursement rates, and new federal rules, many of them related to the health care law.” “If you don’t code properly, you don’t get paid.” Small practices: up to $83,290 (2008), now up to $226,105 Medium practices: up to $285,195 (2008), now up to $824,735 “Some physicians may end up paying nearly three times more for ICD-10 implementation than had been predicted just five years ago, according to a new report from the American Medical Association.”

3. Agenda

4. Technology Platform

5. Certified EMR

6. Practice Management Software ICD9 & ICD10 Selectors in Charge Entry ICD-10 code library 837 electronic claim output in updated ICD10 compliant format

7. ICD10 Claims Testing Submit test claims to your clearinghouse with ICD10 codes If your vendor tests and passes with your current version, you may not need to go through this process!

8. EMR Software DxCPT screen accepting both ICD-9 and ICD-10 [system guides the user per the setting dates]: Here is an example of how other areas in the system will accept ICD-10. [Clinical Decision Support]

9. Transition Date Global: Knows the date of service and presents proper code set to biller and provider Payer Level Override: Set transition date at plan level to allow for those payers not ready on 10/1 May add setting to not respect payer override for doctor (so as to not distract away from new focus on ICD10)

10. Clinical Documentation Tools ICD10 requires greater specificity in documentation. What charting tools can help? Templates Tags Voice Recognition Dictation Software

11. ICD10 Code Selection Help! GEM: Generic Equivalent Mapping: Maps from ICD9 to ICD10 (and possibly even Snomed) PFT: Provider Friendly Terminology: Allows the clinician to say what he/she wants to say, then maps that to the proper ICD10 code NLP: Natural Language Processing: Index free text and map provider terms to proper codes Alert provider to need for greater specificity, present attributes (Encounter type, Severity Type, Laterality, FX healing) to guide selection of proper ICD10 code.

12. Education

13. Practice Portal Just in time training Learn at your own pace Choose the learning style that works for you!

14. Webinars Web-based seminars presenting industry and product knowledge in an interactive format Pose questions to vendor experts

15. Documentation Step-by-step instructions demonstrating key workflows

16. Services

17. ICD10 Consulting

18. Impact Analysis

19. Chart Audit Is your charting specific enough for ICD10?

20. Services: Historical Claims Analysis Determine most commonly used codes Convert to ICD10

21. Case Study

22. Case Study: Turf Toe? • Hallux Rigidus, right big toe • ICD9: 735.2 • ICD10:M20.21 • Onycholysis • ICD9: 703.8 • ICD10: L60.1 • Hammer Toe • ICD9: 735.4 • ICD10: M20.41

23. Case Study: Place of Injury • ICD10:M20.21 (Squash Toe?) • E849.4 Accidents occurring in place for recreation and sport • Y92.311 Squash court as the place of occurrence of the external cause

24. Case Study: Place of Injury • ICD10:M20.21 (Cricket Toe?) • E849.4 Accidents occurring in place for recreation and sport • Y93.07 Cricket pitch as the place of occurrence of the external cause

25. Case Study: Place of Injury • ICD10:M20.21 (Curling Toe?) • E849.4 Accidents occurring in place for recreation and sport • Y93.2 Activities involving ice and snow