Transition to ICD 10 CM Diagnostic Code Set
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Transcript of Transition to ICD 10 CM Diagnostic Code Set
Transition to
ICD 10 CM Diagnostic Code Set
June 2014
Workshop Agenda - June 23rd 2014
•Highlights of the Previously Shared ICD10 CM Presentation–http://www.shafafiya.org/Dictionary/Workshops/20140320_IC
D_10_Presentation.pptx•Stakeholder Preparation for Transition•Phases: Transition to ICD 10 CM–http://www.shafafiya.org/Dictionary/Workshops.html •Establishing ICD 10 Transition Working Group.
Workshop Agenda - June 23rd 2014
Providers and payers were invited to a 2 hour workshop – about 100 members cameHAAD presented the “Transition to ICD 10 Diagnostic Code Set presentation” and answered related questionsHAAD invited volunteers to represent payers and providers to create a working group to facilitate the transitionSupporting material for each of the transition phases is published on Shafafiya http://www.shafafiya.org/Dictionary/Workshops.htm
Arial Stakeholders’ Transition WorkingGroup Representatives (pending contact emails*)
HAADLina Jichi (Chair)Michelea PeechMarwan Al NaboulsiMohammad Al HajLuis Perfetti
Providers Public Providers:
• Seha• Mubadala Health Care
Private Providers• Al Noor• Ahlia• NMC• Burjeel• Oasis• Advanced Cure Diag.
Ctr.• Western Region??
PayersPublic Payers:
• DamanPrivate Payers
• ADNICTPANAS
Vendors and others
• 3M• Accumed • Abu Dhabi
Police
HighlightsIn the US as of 2014ICD-10-CM (Diagnosis)Will affect inpatient and outpatient
ICD-10-PCS ( Procedures)Will only affect inpatient in the U.S.NOT UAE -We have CPT for outpatient & inpatient reimbursement
ICD-10-CM/PCS:• Incorporates much greater
specificity and clinical information, which results in:
• Improved ability to measure health care services;
• Increased sensitivity when refining grouping and reimbursement methodologies;
• Enhanced ability to conduct public health surveillance; and
• Decreased need to include supporting documentation with claims;
• Includes updated medical terminology and classification of diseases;
In the US as of 2014 All software will be ICD
10 based All certified coders will
be ICD 10 based All RVU’s will be ICD 10
based ICD 9 CM will no longer
be updated after 2012
HighlightsICD-10-CM• Provides codes to allow comparison of mortality and morbidity data; and• Provides better data for:
• Measuring care furnished to patients;
• Designing payment systems;• Processing claims;• Providers making clinical
decisions;• Tracking public health;• Identifying fraud and abuse;
and• Conducting research.
Upgrade to ICD 10 CM
June 2014 DSP voted to retain 1st October, 2015 Deadline
EncouterStart date 1/10/2015 00:01
Is it a big change? Comparison
ICD-9-CMMechanical
complication of other vascular device,
implant and graft1 code (996.1)
ICD-10-CMMechanical complication of other vascular grafts156 codes, includingT82.310 – Breakdown (mechanical) of aortic(bifurcation) graft (replacement)T82.311 – Breakdown (mechanical) of carotid arterialgraft (bypass)T82.312 – Breakdown (mechanical) of femoral arterialgraft (bypass)T82.318 – Breakdown (mechanical) of other vascular graftsT82.319 – Breakdown (mechanical) of unspecifiedvascular graftsT82.320 – Displacement of aortic (bifurcation) graft(replacement)T82.321 – Displacement of carotid arterial graft (bypass)T82.322 – Displacement of femoral arterial graft(bypass)T82.328 – Displacement of other vascular grafts
Comparisons
X X X XX X XX X XX X
category etiology,anatomic site,manifestation
category etiology,anatomic site,
severity
extension
ICD-9 Code Format ICD-10 Code Format
ICD-9-CM 14,025
ICD-10-CM 68,069Diagnosis Codes
Comparisons
Tentative Timeline
• Phase 1: Implementation plan development and potential impact assessments– Establish interdisciplinary steering committee to develop
ICD‐10 implementation strategy– Development of potential impact assessments– Implementation budget – Systems inventory – Identifying the impact from vendors and payer contracts– Vendors and Contracts
Make Your Plan to ICD 10 CM
• Phase 2: Implementation preparation– Training/awareness on Codes and Code uses (data etc)
AND documentation– Education on the available GEM and how to use
• Phase 3: “Go live” preparation– Confirm with systems vendor(s)– Finalize all systems - testing of systems changes, and
provide intensive ICD‐10 education to coding staff.– Complete all in‐house systems changes and testing.– Claims on or after Deadline must use ICD‐10‐CM
Make Your Plan to ICD 10 CM
ICD-9-CM to data coded under ICD-10-CM due to the differences in the code sets. This will impact reports that compile statistical data for trend analysisDownload GEM from CMS website
http://www.cms.gov/Medicare/Coding/ICD10/2014-ICD-10-CM-and-GEMs.html
Any Questions Please Contact• [email protected]
Make Your Plan to ICD 10 CM