Agenda:
Agenda ICD 10 Compliance-An Introduction ICD 10 Compliance-How it will impact the providers? How to comply with ICD 10? Superia ICD 10 Compliance Service Q&A session
ICD 10-An Introduction:
ICD 10-An Introduction ICD-10 CM & PCS is an upgrade of the US-developed clinical modification (ICD-9-CM) of Diagnosis and Procedure Codes, first adopted in 1979. Department of HHS has ruled that all coding must be done in ICD-10 starting Oct 1, 2013. ICD-10-CM volume is 69000 alphanumeric codes compared to ICD-9-CM volume of 13,600 numeric codes ICD-10-PCS volume is 72000 alphanumeric codes compared to ICD-9-PCS volume of 4000 numeric codes. ICD-9-CM Code ICD-10-CM Code Flatulence, eructation, and gas pain R14.0 Abdominal distension (gaseous) R14.1 Gas pain 787.3 R14.2 Eructation R14.3 Flatulence Abdominal pain, unspecified site 789 No Code
ICD 10 Compliance-How it will impact the providers?:
ICD 10 Compliance-How it will impact the providers? Complexity and volume (5 times) in the coding will demand changes to existing “Superbills”. Practice management Systems, Insurance Coverage Systems, Billing Systems will have to changed An inability to comply with implementation may result in massive fines and rejected claims According to Delloite, significant changes in reimbursement patterns may impact provider cash flow for a considerable period of time. Significant changes to Health Plans, documentation requirements, coverage considerations. Across-the-board training to clinical and admin staffs for learning the new codes and relearning of code relationships.
How to comply with ICD-10?:
How to comply with ICD-10? Evaluating all clinical, financial and business systems that currently use ICD-9 codes. Overall Risk and Impact Assessment. Gap Analysis between current and future state. Compliance Project Plan Identification of capital cost, one time cost and recurring cost and budget for it. Compliance Implementation Conduct internal testing Payer system integration Conduct external testing Start Parallel processing Complete Transition
How to comply with ICD-10?-Suggested timeline by CMS:
How to comply with ICD-10?-Suggested timeline by CMS Phase 1: Implementation plan development and impact assessment. Timeline: 1st qtr 2009 – 2nd qtr 2011 Phase 2: Implementation preparation Timeline:1st qtr 2011 – 2nd qtr 2013 Phase 3: “Go live” preparation Timeline: 1st qtr 2013 – 3rd qtr 2013 Phase 4: Post-implementation Follow-Up Timeline: 4th qtr 2013 – 4th qtr 2014
Superia ICD-10 Compliance Service:
Superia ICD-10 Compliance Service Assessment and Planning Services- A combination of tools, processes and services for ICD-10 assessment and planning Impact Analysis- An automated tool will provide comprehensive assessment of home grown applications Remediation Service- Includes a dual remediation approach with application remodeling and enhancement, data migration and post-implementation support and maintenance Testing-Complete manual and automated testing to ensure 100% implementation. Implementation Translator-Tool to help your organization to do parallel processing. Training-Training to help your staff in learning the new codes and it’s usage in the new system
PowerPoint Presentation:
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