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Transition to ICD 10 CM Diagnostic Code Set June 2014.

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Presentation on theme: "Transition to ICD 10 CM Diagnostic Code Set June 2014."— Presentation transcript:

1 Transition to ICD 10 CM Diagnostic Code Set June 2014

2 Workshop Agenda - June 23rd 2014 Highlights of the Previously Shared ICD10 CM Presentation –http://www.shafafiya.org/Dictionary/Workshops/ _I CD_10_Presentation.pptxhttp://www.shafafiya.org/Dictionary/Workshops/ _I CD_10_Presentation.pptx Stakeholder Preparation for Transition Phases: Transition to ICD 10 CM –http://www.shafafiya.org/Dictionary/Workshops.htmlhttp://www.shafafiya.org/Dictionary/Workshops.html Establishing ICD 10 Transition Working Group.

3 Workshop Agenda - June 23rd 2014 Providers and payers were invited to a 2 hour workshop – about 100 members came HAAD presented the “Transition to ICD 10 Diagnostic Code Set presentation” and answered related questions HAAD invited volunteers to represent payers and providers to create a working group to facilitate the transition Supporting material for each of the transition phases is published on Shafafiya

4 Arial Stakeholders’ Transition Working Group Representatives (pending contact s*) HAAD Lina Jichi (Chair) Michelea Peech Marwan Al Naboulsi Mohammad Al Haj Luis Perfetti Providers  Public Providers: Seha Mubadala Health Care  Private Providers Al Noor Ahlia NMC Burjeel Oasis Advanced Cure Diag. Ctr. Western Region?? Payers  Public Payers: Daman  Private Payers ADNIC  TPA  NAS Vendors and others 3M Accumed Abu Dhabi Police

5 Highlights In the US as of 2014  ICD-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;

6 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 Highlights ICD-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.

7 Upgrade to ICD 10 CM June 2014 DSP voted to retain 1 st October, 2015 Deadline EncouterStart date 1/10/ :01

8 Is it a big change? Comparison ICD-9-CM Mechanical complication of other vascular device, implant and graft 1 code (996.1) ICD-10-CM Mechanical complication of other vascular grafts 156 codes, including T – Breakdown (mechanical) of aortic (bifurcation) graft (replacement) T – Breakdown (mechanical) of carotid arterial graft (bypass) T – Breakdown (mechanical) of femoral arterial graft (bypass) T – Breakdown (mechanical) of other vascular grafts T – Breakdown (mechanical) of unspecified vascular grafts T – Displacement of aortic (bifurcation) graft (replacement) T – Displacement of carotid arterial graft (bypass) T – Displacement of femoral arterial graft (bypass) T – Displacement of other vascular grafts

9 Comparisons X X X X X X X X X X X X X X X X X X X X X X X X categoryetiology, anatomic site, manifestation categoryetiology, anatomic site, severity extension ICD-9 Code Format ICD-10 Code Format ICD-9-CM 14,025 ICD-10-CM 68,069 Diagnosis Codes

10 Comparisons

11 Tentative Timeline

12 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

13 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

14 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 analysis Download GEM from CMS website CM-and-GEMs.html Any Questions Please Contact Make Your Plan to ICD 10 CM


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