The Ins and Outs of ICD10 in Centricity™ Group ManagementMay, 2015

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Agenda

Constants Review

Obtaining and Loading ICD-10 Codes

Mapping

Charge Posting and Claims Submission

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The Constants

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Insurance Codes

‘Hidden’ Default Date is 10/01/2015

Workers Comp claims will not require ICD-10s

Update the ICD10 Date to 6/30/2029

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Diagnosis Code Constant

Alpha-numeric field (7 characters)

ICD-10 Y/N flag

Mapping fields

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How to get the ICD-10 codes (without mapping)Create your own Spreadsheet – Use CONSTANTS

Purchase the ICD10 codes from GE Healthcare – Use XCPT4

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Create a SpreadsheetAccess the CMS Websitehttp://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-and-GEMs.html

Download to PC as .txt files

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Create a Spreadsheet

Open CMS Code Description file in Microsoft® Excel® using Text Import Wizard• Change all fields to TEXT

• Import only columns you need

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Create a SpreadsheetTransfer Diag_Template.txt from /gpms

Open in Excel using Text Import Wizard

Create a Spreadsheet

You have 2 Spreadsheets open

Copy/Paste into Diagnosis Template for Code and Description

Create a SpreadsheetFile – Save As

Text (Tab Delimited) (*.txt) – Selected from Drop Down

Create a Spreadsheet

Save Spreadsheet as .txt (icd10codes)

Transfer to Server

Upload using CONSTANTS

Upload the Codes

Using CONSTANTS program • Access Optional Programs (8, 5)

• Type constants <enter>

Enter option 13

Upload the Codes

Run in TEST MODE

Review reports in Printer Management

Run in LIVE MODE

Option 2 – Purchase codes from GE HealthcareContact Support Services – 1-888-436-8491, Opt. 3

Approve quote via eService ($500)

GE Healthcare transfers to system

Use XCPT4 to upload (instructions provided)

No Mapping included

Using XCPT4Access Optional Programs (8, 5)

Type xcpt4 <enter>

NOTE: No TEST mode

and no Reports

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ICD-9 Mapping

CMS’ GEMs Reimbursement Mapping Guide

95% of codes one to one translation

5% of codes map to a cluster code

Handful of Duplicates

Mapping ICD-9 codes

Layout based on CMS Reimbursement Mapping File

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Create a Spreadsheet

Open CMS Reimbursement Mapping file in Excel using Text Import Wizard• Change all fields to TEXT

• Import only columns you need

Create a New Spreadsheet

Create a Spreadsheet

Save Spreadsheet as .txt (icdmap)

Transfer to Server

Upload using CONSTANTS

Upload the Codes

Using CONSTANTS program

Access Optional Programs (8, 5)

Type constants <ente

Enter option 13

Upload the Codes

Run in TEST MODE

Review reports in Printer Management

Run in LIVE MODE

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Posting Charges

Posting ChargesWhen date of service is equal to or greater than compliance date

User enters ICD-10 codes for services

Mapped ICD-9 codes will default on charge when defined within constants

No mappings defined, user can manually enter ICD-9 code(s) on the charge

ICD-9 code(s) will be required if payer is not ready

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Posting ChargesPrimary Insurance is ICD-10 Ready

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Posting ChargesPrimary Insurance is ICD-10 Ready, Secondary is not

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Posting ChargesPrimary Insurance is ICD-10 Ready, Secondary is not

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What is stored on the Charge?

What is stored on the charge?

Both ICD-10 and ICD-9 codes

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What about the Claim?

What about the Claim?

Who is being billed

Is the payer ready for ICD-10 codes?

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What about the Claim?

TestingContact GE Healthcare

Set up Test Practice

Create Test Charges

Work with Centricity™ EDI Services to send Test Claims

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Final Thoughts

Final Thoughts – Get started now

Download the ICD-10 code set

Map the ICD-9 codes

Upload spreadsheet into your class/test practice

Get out there and Play!

Contact GE Healthcare for Payer Testing

Thank you!

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