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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