1 Transition to ICD-10 UC San Diego Health System 2015

2 ICD-10 Overview ICD-10 – International Classification of Diseases, 10th Edition Reference manual contains codes for diagnoses and inpatient procedures Standardizes ICD-10 codes/terminology for billing purposes Code sets not built by UC San Diego Health System or Epic – they are designated by CMS and endorsed by the World Health Organization (WHO) Why transition to ICD-10? ICD-9 codes provide limited data about patients’ medical conditions and hospital inpatient procedures ICD-10 codes allow for greater specificity and exactness Must convert to ICD-10 to receive reimbursements for services rendered TRANSITION TO ICD-10 IS NOT OPTIONAL Required by Centers for Medicare & Medicaid Services (CMS) for all HIPAA-covered entities in U.S.

3 Changes in our EMR system (Epic) for providers: Diagnoses in Epic were updated to be specific enough to assign ICD-10 codes System prompts for additional information when provider enters general diagnoses that aren’t specific enough for ICD-10 codes This means that all diagnoses in Epic after April 6 are mapped to both ICD-9 and ICD-10 codes “behind the scenes” The Clinical Go-Live prepares the system for the ICD-10 Compliance Deadline in October Apr. 6, 2015: Clinical Go-Live for ICD-10

4 ICD-10 Compliance Deadline (Final Go-Live) Epic configured to continue to send ICD-9 codes to payers until Oct. 1, 2015 No changes in Epic on Oct. 1: All changes occur on the back end with regard to how claims are sent to payers Claims will no longer go out with ICD-9 diagnosis codes; they will go out with ICD-10 diagnosis codes Oct. 1, 2015: ICD-10 Compliance Deadline

5 ICD-10 diagnosis codes are much more specific than ICD-9 Example: no code for just “asthma”; requires to specify severity (mild, moderate, etc.) Example: no code for just “wrist fracture”; requires to specify laterality (left or right) All Health System Staff: Key Points About ICD-10 Any staff entering diagnoses in our EMR (Epic) may see additional prompts that ensure the diagnosis is specific enough for ICD-10 purposes ALL STAFF are strongly encouraged to view the relevant e-learning module(s) available in the UC Learning Center MANAGERS are responsible for determining need and monitoring completion

6 Basic Awareness Module Recommended for staff that are not involved in any type of code assignment Human Resources Information Services Management Advanced Awareness Module Recommended for staff that do some code assignment or interpretation of codes, but do not need in-depth training Scheduling Patient Access Contract Management Billers ICD-10 Educational Modules Available in the UC Learning Center To access the ICD-10 Educational Modules, visit the UC Learning Center at mycourses.ucsd.edu and search using the “ICD 10” keyword. mycourses.ucsd.edu Managers are responsible for assigning the appropriate module(s) to staff.

7 Need more information? Visit the EMR User Resources emr.ucsd.eduemr.ucsd.edu Visit the Centers for Medicare & Medicaid View the e-learning modules hosted on the UC Learning Center mycourses.ucsd.edumycourses.ucsd.edu Contact Suzanne Forrest at Additional ICD-10 Resources

8 Thank You! Questions and Answers