10-CM/PCS Barriers and Opportunities
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1 HIPAA Summit West VI ICD CM/PCS Barriers and Opportunities Dan Rode, MBA, CHPS, FHFMA Vice President, Advocacy and Policy AHIMA
2 ICD CM/PCS
3 What we ll cover: AHIMA What is now known about ICD-10 conversion What is unknown or uncertain Goals of the implementation process Internal implementation and testing Post ICD-10 implementation and compliance Resources Questions
4 AHIMA: 84-year old non-profit, professional association health information management (HIM) 9 Professional credentials (newest in analytics and CDI) 64,000 + members at 40 employer types and close to 120 different functions related to HIM and informatics Close to 300 schools with HIM related (practical informatics) programs from Associate to Masters degrees. Best practice standards for: data collection, use and exchange, classifications and terminologies, privacy and security, and education of the profession. HIM Principles: individual integrity - confidentiality
5 Known: ICD-10-CM/PCS compliance date is October 1, year, 11 months, and 19 days, or 719 days CM (clinical modification) all HIPAA entities PCS (procedure coding systems) inpatient only Coding freeze has been extended October 2015 ARRA-HITECH Meaningful Use Stage 2 is effective October 1, 2013 or January 1, SNOMED-CT recommended in MU-2 MU-3 NPRM targeted for January 2014 ICD-11 (ICD/SNOMED-CT) 2016+
6 Known: It s just not claims any more! Use of ICD-10 in: Quality e-measures Reimbursement Provider comparisons Public health reporting Oversight analysis Internal administrative quality, utilization, and other analytics programs Provider and health plan case management Internal, enterprise, and external registries Best practice (?)
7 Unknown: Impact of ICD-10 on quality-based reimbursement systems before and after compliance date Impact of ICD-10 on quality comparisons collections for practices and facilities Merger of data in accountable care organizations and similar arrangement such as bundling pilots SOMED-CT recommended in MU-2 MU-3 NPRM targeted for January 1, 2014 ICD-11 (based on 10) adopted when?
8 Data, information, and systems demands Data integrity Collection Aggregation (internal) Storage Security Use (Release /Access) Clinicians Enterprise Patients Claims Public Health Oversight Groups Research Exchange
9 ICD CM/PCS Implementation Goals Integrate into practice/process and systems: it s not just a software change. Follow official coding standards and correct coding guidelines Ensure correct claims and adjudication results (within classification standards and guidelines) Maintain data integrity: what goes in = what comes out
10 Internal Implementation and Testing System Usage of ICD Administrative Clinical Claims Data basses or registries Data collection > 9 diagnoses and 6 procedures Data changes: 7 characters alpha numeric Data warehouse (registries) Automated systems Encoders Computer Assisted Coding Coding by Coding Professionals
11 Internal Implementation and Testing External Systems Laboratory Pharmacy Other ancillary systems Enterprise systems ACO partners Trading partners (Health Plans and Others)* Clearinghouse /Billing System* New Systems RFP: Require ICD-10 readiness and testing New modules are they compatible with existing or newly revised systems
12 Internal Implementation and Testing Transaction v Coding Coding Scenarios fit the organization or practice Coding integrity in a clearinghouse situation Health plan testing reimbursement results Documentation Correct Codes Correct Codes Accurate Reimbursement
13 Post ICD-10 Implementation and Compliance On-going auditing and data improvement Organized analytics and quality improvement Documentation improvement! Lifting of the coding freeze (October 1, 2015) Coordination and Maintenance Meetings fall 2014 and spring 2015 (IP-PPS NPRM) Integration with EHR systems and SNOMED-CT Computer Assisted Coding (CAC) Other environmental changes health reform
14 Resources AHIMA ICD-10 Web Site Centers for Medicare and Medicaid Services (CMS) Center for Disease Control and Prevention (CDC) National Center for Health Statistics (HCHS) HIPAA ICD-10 Federal Register notices: Initial regulations: January 16, 2009 Delay regulation: September 5,
15 Questions / Contact Dan Rode, MBA, CHPS, FHFMA Vice President, Advocacy and Policy American Health Information Management Association 1730 M Street, NW, Suite 502 Washington, DC (202) , ext 11 dan.rode@ahima.org
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