Presentation is loading. Please wait.

Presentation is loading. Please wait.

ICD-10 What’s Ahead. What is it? A renovation of coding, requiring field size expansion, change to alphanumeric digits, and complete redefinition of code.

Similar presentations


Presentation on theme: "ICD-10 What’s Ahead. What is it? A renovation of coding, requiring field size expansion, change to alphanumeric digits, and complete redefinition of code."— Presentation transcript:

1 ICD-10 What’s Ahead

2 What is it? A renovation of coding, requiring field size expansion, change to alphanumeric digits, and complete redefinition of code values and structure. Mandatory as of October 1, 2013

3 Overview: Diagnosis Codes 68,000 alphanumeric diagnosis codes Always start with a letter, 3-7 digits Examples: –J14 H. Flu Pneumonia –L23.2 Allergic Contact Dermatitis, Cosmetics –K11.20 Sialoadenitis, unspecified –L03.115 Cellulitis, right lower limb –S01.01xA Laceration scalp, w/o FB, Initial encounter

4 Procedure Codes (PCS) 72,000 alphanumeric codes, starting with a number or a letter, 7 characters Example: Lysis of adhesions of pleura 0BNN0ZZ Section (med/surg -0) Body System (respiratory -B) Root Operation (release -N) Body Part (pleura -N) Approach (open -0) Device (no device -Z) Qualifier (no qualifier -Z)

5 GEMS General Equivalence Mappings: designed to enable DRG formation before new system in place, and to allow data comparisons from year to year. Problem: 68,000 diagnosis codes in ICD-10 mapping to 14,000 ICD-9 codes 72,000 ICD-10 PCS procedure codes mapping to 4,000 ICD-9 codes Not a one to one translation; not able to easily verify we were paid correctly

6 Training considerations HIM Data Quality/Risk Management IS Compliance Ancillary Services Physician Practice Staff Finance – case mix index Physicians - documentation

7 Impacts Payers – ability to accept and recognize data, contract renegotiation Providers – training and education of all who code, and all who read and write reports Information Systems – interfaces to other systems, report-writing, testing of modules, maintaining of dual systems, computerized edits Finance – budget projections, case mix index, annual comparisons of data Software vendors – data realignments, code structure changes

8 Also Affects Quality Improvement – HACs, comparisons of quality data; core measures Human Resources - employee benefits & data to determine costs of insurance, WC Clearinghouses – massage data from billing system to insurance companies Laboratories, pharmacies Audits, medical necessity, RAC Division of Healthcare Finance & Policy

9 What stays the same CPT coding on hospital outpatients, physician office billing Need for better documentation Need for trained coders

10 Next Steps ICD-10 Task Force to determine needs Sub-committees to work on special tasks such as working with vendors to identify changes needed, assessing flow of coded data, assessing financial impact of changes. Educate physicians on specificity of documentation needed – they are affected as well.


Download ppt "ICD-10 What’s Ahead. What is it? A renovation of coding, requiring field size expansion, change to alphanumeric digits, and complete redefinition of code."

Similar presentations


Ads by Google