CPSE Portal ICD10 Implementation

ICD10 begins October 1, 2015  ICD10 goes into effect October 1, 2015  This transition is based on date of service, not date of entry  This means for every entry for a date of service on or after October 1, 2015 must use ICD10.  When entering for service dates prior to 10/1/15, you must still use ICD9

Medicaid Alert International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM)  Medicaid alerts are available on NYSED’s website  Alert discusses ICD10  SED states that there are several options to get the ICD10 for a particular entry These options may include: requesting that the ordering practitioner provide the numeric or alphanumeric code, requesting that the attending practitioner ‘translate’ the reason/need wording or ICD-9-CM code to an appropriate ICD-10-CM code, consulting coding books and resources, consulting coding professionals with adequate experience, or contacting physicians or other health professionals.  The SLP, OT, PT, etc. are the attending practitioner and are also considered health professionals

Translating ICD9 to ICD10  Several websites available (search for “convert ICD9 to ICD10”)    ….  CPSE Portal  ICD9 To ICD10 GEMS

ICD9 To ICD10 GEMs (GEMs = General Equivalence Mapping)  This is NOT the definitive guide, this is a tool  It comes from Centers for Medicare and Medicaid Services (CMS)( gems.html ) gems.html  The professional needs to use their knowledge and training to determine the appropriate code  Two types of mappings  Direct – the mapping is a direct map from ICD9 to ICD10  Approximate – the mapping(s) listed is an approximate map from ICD9 to ICD10

GEMs – Direct example

GEMs – Approximate Example 1 – multiple matches

GEMs – Approximate Example 2 – single match

ICD10Data.com

ICD Lookup

ICD on Favorites

Entering ICD on Attendance  New field (not same type of drop down)  Type part of code and it will auto populate a list and you can then choose the code)  The code will show recent history  You can enter up to 4 diagnosis in the one field  Works for either ICD9 or ICD10 as determined by service date

Default ICD for Enrollment  For the time being we removed the pre-fill of the default ICD for the enrollment. This was to prevent auto filling ICD9 on 10/1/15 and after  We understand people liked this feature  We will put something in place, but may only be for ICD10 (Service dates 10/1/15 and later)  Users should still consciously ensure the correct diagnosis on the service  Children may have multiple diagnosis and the codes may be different from session to session