Copyright Gap Consulting, Inc A Practical Guide to Navigating the ICD-10 Waters Northeast Ohio HFMA July 28,

Agenda Introductions The Visible Clinical Aspects of ICD-10 ICD-10 Imperative and Call to Action Impact of ICD-10 Among Stakeholders Summary Q&A 2

The Speakers Nabil Chehade, MD, MSBS, CPC Assistant Medical Director, Medical Specialties Chief Medical Informatics Officer Ohio Permanente Medical Group Lynn Eckendorf, MBA, CCP Senior Associate Gap Consulting Gail Kovacs, RN, MBA,CLNC Healthcare Business Advisor Kovacs and Associates 3

The Visible Clinical Aspects of ICD-10 4

Overview of Kaiser Permanente Founded 1945 Serves > 8.7 Million Members 8 Regions Across the United States: –Colorado, –Georgia, –Hawaii, –Mid-Atlantic States (VA, MD, DC), –Northern California, –Northwest (Oregon/Washington), –Ohio and –Southern California 35 Hospitals 454 Medical Offices, 15,129 Physicians, 64,098 Employees Total Revenue for 2010 = $44.2B 5 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

According to the American Association of Professional Coders 6 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Kaiser’s Organizational Imperative Kaiser Permanente As a Complex Organization: Insurer, Care Delivery, Hospital System, IT, Vendor Relationship Kaiser Permanente as a Leader in Integrated Care Delivery Kaiser Permanente As the Largest Non-Governmental Deployment of EMR in the World Kaiser Permanente Will Have to Take a Multi-Year and Multi-Disciplinary Approach for ICD-10 Readiness 7 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Kaiser Permanente’s Approach Organization Wide Assess impact Plan approach Complete systems readiness Execute plan 10/1/2013 ICD-10 compliance 5010 Systems identified to size impact Draft systems approach IT Vendor Readiness survey Business Review: impacted apps, processes and policies Business Refine plan. Remediate, retire, replace applications in line with compliance approach. Testing/ Deployment / Transition Coordination with and tracking of vendor readiness activities Coordinated vendor testing; risk mitigation Readiness for business-supported apps; revision of policies and procedures; organizational readiness Program Multi-year plan framework National and Regional Governance structures General awareness, communications and training Role-specific trainingPrerequisites trainingCoP: Curriculum and approach Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Example ICD-9 to ICD-10 9 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Comparisons of the Diagnosis Code Sets ICD-9-CMICD-10-CM 3-5 Characters in Length3-7 Characters in Length Approximately 13,000 Codes Approximately 69,000 Available Codes First Digit May Be Alpha (E or V) or Numeric; Digits 2-5 Are Numeric Digit 1 Is Alpha; Digits 2 and 3 Are Numeric; Digits 4-7 Are Alpha or Numeric Limited Space for Adding New Codes Flexible for Adding New Code Lacks DetailVery Specific Lacks LateralityHas Laterality (i.e., Codes Identifying Right Vs. Left) 10 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

ICD-10 Code Structure ICD-10-CM CM = Clinical Modification of the WHO Diagnostic System for the US –Characters 1-3 – Category –Characters 4-6 – Etiology, anatomic site, severity, or other clinical detail –Characters 7 – Extension ICD-10-PCS PCS = Procedural Coding System (Inpatient Hospital Use) Only the US Uses PCS –Character 1- Name of Section –Character 2- Body System –Character 3- Root Operation –Character 4- Body Part –Character 5- Approach –Character 6- Device –Character 7- Qualifier 11 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Clinical Example, ICD-10-CM A Provider Sees a Patient in a Subsequent Encounter for an Age Related Pathological Fracture to Left Humerus with Delayed Healing: ICD-9-CM Code: One Code PATHOLOGICAL FRACTURE OF HUMERUS ICD-10-CM Takes into Account Several Elements to Get More Granular Code M G : –In ICD-10-CM Many Choices for the First 3 Characters Depending on the Category (M80) Osteoporosis with current pathological fracture –ICD-10-CM Presents Several Other Choices Dependent on the Clinical Information (022): M Aged related osteoporosis with current pathological fracture, humerus, right M Aged related osteoporosis with current pathological fracture, humerus Left M unspecified –ICD-10-CM must identify encounter and healing status, this is the extension code (G) A) initial encounter for fracture D) subsequent encounter for fracture with routine healing G) subsequent encounter for fracture with delayed healing K) subsequent encounter for fracture with non-union healing P) subsequent encounter for fracture with malunion healing S) sequela 12 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

ICD-9-CM Vs. ICD-10-CM Prior Example of Age Related Pathologic Fracture Yields 18 codes in ICD-10-CM Vs. One Code Available in ICD-9-CM If We Were to Compare and Code for Traumatic Fracture Instead of Pathologic Fracture: –26 Codes in ICD-9-CM Vs. 966 Codes in ICD-10-CM 26 codes (13 closed fracture and 13 open fracture) in ICD x 966 codes (138 codes x 7 alpha extensions includes Initial Open and Initial Closed) in ICD-10 - S42.2xx to S42.49xx 13 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Impact on Documentation by the Clinician How Specific Do We Need to Be When Documenting in ICD-10? Is More Specific Better for Patient Care, Quality Initiatives or Revenue Impact? Can Extreme Request for Specificity Backfire and Lead to Vague Data and Sometimes Outright Incorrect or Erroneous Data? What Would the Impact Be on Provider Productivity? 14 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Impact and Optimization of EMR Mapping for ICD-10 and Making Display Names and Synonyms Available for Easy Retrieval Implementation of New Coding Tools in EMR to Help Selecting Correct Codes Remediation and Mapping of: –Structured Data (Problem List, PMH, Decision Support Tools) –Existing Documentation Tools –Quality Reports –Utilization Management Reports –Clinical Protocols –Population Registries 15

Kaiser’s Expectations Kaiser Permanente, Kaiser Hospitals and Permanente Medical Group Will Be Ready for an October 2013 Transition to ICD-10 –All Impacted Systems Will Be Remediated –People Impact Will Be Minimized –Training and Workflows Will Be Optimized For a Smooth Transition with a Minimal Disruption Progress to Date: –Completed Inventory of Impacted System Program Wide –Significant Progress on People Impact and Training Program Wide –System Remediation, Mapping and Crosswalk of Codes Already in Progress 16 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

ICD-10 Imperative and Call to Action 17

Where It All Came Together… 18

Timeline/State of Readiness Key Dates –9/30/13: Last date to use ICD-9 –10/1/13: Effective Date ICD-10 –Delay potential due to MU Stage 2 delay? Coordination with 5010 (Comply with 5010 First) Preparation / Assessment –EHR Upgrade Synchronization –Workflow Improvements Benefits of ICD-10 –Data Precision –Discrete Cost Analysis –Improved Payer / Provider Discussions / Negotiations –Improved Portfolio Management 19

Benefits of ICD-10 More Specific Coding / More Accurate Reimbursement Faster Reimbursement / Fewer Denials (Long-Term) Able to Accommodate Treatments Post-ICD-9 Better EMR Support Improved Safety, Medical Management and Quality of Care Improved Portfolio Management Redesign Clinical and Administrative Operations Enhance Integration with Payers and Providers 20 Source: Accenture: “Preparing Payers for ICD-10”

Industry Benefits of ICD-10 Summary of Estimated Benefits over a Ten-Year Period CategoryBenefit ($ Million)Largely Due To More Accurate Payment for New Procedures 100-1,200ICD-10 PCS Fewer Rejected Claims200-2,500Both Fewer Fraudulent Claims100-1,000Both Better Understanding of New Procedures 100-1,500ICD-10 PCS Improved Disease Management200-1,500ICD-10-CM 21 Source: “The Cost and Benefits of Moving to ICD-10 Code Sets” by Rand Science and Technology

Potential Provider Business Opportunities 22 Redefine eligibility/verification process Integrate ICD-9/10 codes into payer/ provider process Scheduling/ Registration Optimize clinical quality and improve documentation Improve mitigation processes for complications, HACs, RACs, readmits Clinical Care/ Quality Improvement Improve tracking/care Refine episode of care protocols Improve ability to analyze and report disposition impact on outcomes Post – Hospital Care Redefine provider contracts Improve process for temporary dual ICD-9/10 management and detailed information PFAS/ Collection Management Refine reporting and improvement metrics Prioritize and improve critical outcomes Public Reporting ►Improved portfolio management ►Improvement opportunity - Clinical and Operational Redesign ►Improvement opportunity - Clinical Documentation by Physicians ►Increased patient/provider loyalty ►Improved payer/provider integration ►None to minimal impact to bottom line Business Benefits Courtesy of: 3M

Source: Trizetto Presentation 2010 Potential Payer Business Opportunities 23 Redefine benefit contracts Support Value-Based Benefits Product Development Re-evaluate business rules Redefine pend rules and reasons Update product configuration Reimbursement Management Apply care guidelines Refined evidence-based protocols Increased ability to analyze and report Care Management Redefine provider contracts Support Value-Based Reimbursement and Medical Home initiatives Network Management Refine population segments Improved risk management results Underwriting / Actuarial ►Improved quality of care ►Reduced cost of claims ►Increased member satisfaction ►Increased provider satisfaction ►Improved administrative cost Business Benefits Courtesy of: 3M

ICD-10 Projected Impact The Move to ICD-10 Is Expected to Cost $1.64 Billion Dollars The Centers for Medicare & Medicaid Services Estimate That the Transition from ICD-9 to ICD-10 Will Cost the Healthcare Industry $1.64 Billion Also in 2008, Nachimson Advisors, LLC Estimated These Impacts of ICD-10: – Typical Small Practice: Total Cost Impact $83,290 Per Practice – Typical Medium Practice: Total Cost Impact $285,195 Per Practice – Typical Large Practice: Total Cost Impact $2.7 Million Per Practice 24 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Date Impacts Claims That Cross the 10/1/13 Boundary Discharges –Services Provided Prior to 10/1/13: No Change –Services Provided On or After 10/1/13: All Use ICD-10; Convert from ICD-9 Code Freezes –10/1/11: Last Regular, Annual Updates to Both ICD-9-CM and ICD-10 –10/1/12: Only Limited Code Updates to Both ICD-9-CM & ICD- 10 Code Sets To Capture New Technology And New Diseases –10/1/13: Only Limited Code Updates to ICD-10 Code Sets to Capture New Technology And New Diseases Define Your Approach Organization-Wide 25

Where Are You with ICD-10 Planning? ICD-10 Steering Committee Comprehensive Assessment Completed with Issues Identified –5010 Readiness –IT Systems-System Inventory –Decision Support –Case Management –Utilization Review –Managed Care/Payer Contracts –Quality Department –Functional Areas That Use ICD- 9 Codes Today That Need Translation –Educational Needs Within Organization –Documentation Assessment Claims Analysis to Identify Top Specialties Impacted the Most Vendor Readiness – Testing Schedule Managed Care/Payer Contract Readiness Implemented Education Plan Implemented Documentation Improvement Plan for ICD-10 –CDI Program w/ I-10 Concepts –Identified Top Specialties and Education to Physicians Roadmap Completed for Implementation 26 Courtesy of: 3M

Implementation of ICD-10 HIMSS ICD-10 Playbook –Reviews Known Risks—Direct/Avoidable –Reviews Hidden Risks—Indirect and Complex: Can Cause Irreversible Damage Payer Readiness Variability Necessary Payer Conservatism –Assume Miscoding—Increased Denials –More Diligent In Validating Appeals—Cash Flow Delays –Evaluate Contracts Based on Assumptive Trend Data Inevitable Lender Uncertainty –Delays in Cash Flow Will Result in Decreased Net Revenue, Results in More Scrutiny of Margin –Get Approved Lines of Credit In Place Now Payer Will Need Extensive Modeling, Will Adjust Rules as They Gain Experience Configuration Mistakes Will Lead to Re-Billing 2013 Is Just The Beginning. If You Get Behind, You Stay Behind! 27

What You Need to Be Addressing Today Comprehensive Assessment of Functional Areas Impacted –Vendor/Payer Gap Analysis –Identify Functional Areas and Processes That Will be Impacted –Develop Roadmap for Successful Implementation Begin Translation Process –Translate Lists of Codes for Appropriate Applications (Software/ Paper) –Assess Payer Contract Implications and Begin Translating/Working with Payer Regarding Future Contractual Agreement for Transition to ICD-10 Documentation and Current Claims Assessment –Review of Claim/Code Volume of Codes that Cannot be Translated –Identify High Volume Trends (Codes, Specificity, etc.) –Documentation Review of These Codes for Accuracy and Specificity Begin Process of Changing Physician Documentation Behavior –Utilize Trends from Documentation and Claims Assessment to Begin to Educate and Change Physician Behavior Now 28 Courtesy of: 3M,

ICD-10 Implementation: Critical Success Factors Knowledge Transfer/Education Provided to Key Leadership/Teams Staged According to Fully Integrated Program Plan Development and Execution. Fully Integrated IT And Other Systems Currently Containing ICD-9 Codes Across All Hospital, Vendor, Payer and Other Integrated Systems (Electronic and Other) Comprehensive Internal And External Communication Strategy/Plan Detailed Contracts with Other Providers, Payers and Vendors with Clear Identification of Timing, Integration and Conversion/Translation Applications Comprehensive Modeling and Integrated Functional Testing Plan Across the Continuum of Care 29 Courtesy of: 3M

Tools: Conversion / Crosswalk Activities General Equivalence Mappings (GEMs) Assist in Converting Data from ICD-9-CM to ICD-10 Forward and Backward Mappings –Information on GEMs and Their Use – (Click on ICD-10-CM or ICD-10-PCS to Find Most Recent GEMs) –Description of MS-DRG Conversion Project Conversion_Project.asp Conversion_Project.asp 30

Best Methods To Reduce Claims And Coding Errors  Increased Specificity Makes Accurate Documentation Critical Garri Garrison, 3M  ICD-10 Could Turn Revenue Cycle Management Upside Down Doug Brilbrey, SSI Group  There Are 2 Reasons Mistakes Happen Greg Larson, TriZetto  Info Is Missing or Inconsistent;  Diagnosis & Procedural Codes Are Inappropriate for Type/ Level of Care  Successful Transition Requires Planning and Collaboration Lisa Nolan, PatientKeeper  Key to Reducing Errors Is Education Ken Bradley, Navicure  Control the Accuracy of Coding Where It Matters Kimberly Labow, Navinet  Correct Coding Begins with Thorough DocumentationKr isten Weinberger, Edifecs  Need to Evaluate the CAC (Computer Assisted Coding)Mark Morsch, A-Life Systems Medical, part of Ingenix  Key is Remediation Ray Desrtochers, HealthEdge  Must Have Detailed Contracting Arrangements Ravi Sabharwal, Infosys Technologies 31

Best Methods To Reduce Claims And Coding Errors Mobile Solutions Are Important Paul Adkison, IQMax Whole Practice Must Embrace the Challenge Rex Stanley, Unicor Medical Important to Identify Early Opportunities to Optimize William Shea Systems Cognizant Business Consulting Best Approach Will Start with an Impact Assessment Rob Culbert, Culbert Health Solutions Education, Training and Support Are Keys to Avoiding Steve Sabino, DST Costly Errors Health Solutions Create an Acceptance Test that Defines the Expected Sal Novin, Health Care Outcome Productivity Automation Education Will Remove Barriers to ICD-10 Success Deborah Nevill, Elsevier 32

Impact of ICD-10 Among Stakeholders 33

According to the American Association of Professional Coders 34 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Steering Committee Components Executive Sponsor : Often the CFO –Governance –Leadership: IT / HIM/ CMO / CNO –Broad Stakeholder Participation –PMO Office Message: High Level Engagement and Commitment of Senior Management Consider: Payer Perspective as a Stakeholder 35

Steering Committee Role / Responsibilities: Develop / Implement –Goals –Schedule / Milestones Assign Tasks / Resources Oversee Organization-Wide Training Assess Impact/Modify Course –Of Implementation –On Functional / Other Areas Communications (e.g., Awareness, Status) 36

Kaiser Permanente’s Approach National vs. Regional 37 Executive Sponsors (Regional) Steering Group (Regional) Executive Sponsors (National) Steering Group (National) Org Readiness National Lead(s) For Each Functional Area Compliance PMO Reg. Business Lead(s) Reg. IT Lead Additional team structures to be determined by each region Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Sample Organization Structure 38

Physician Impact Appreciate Time, Complexity, & Level of Difficulty –Documentation Will Change –Will Take Longer; May Need To Be Repeated; Delinquent Charts –Also Being Impacted At The Office Level AND –Need To Take Care Of Patients!! Engage & Train Physicians On Importance Of Changes –Address Adoption Issues, Training Sessions, Tools Conduct Workflow Analysis –Potential Gaps –Redesign Workflows And Documentation Products Prepare To Minimize Impact –Consider Preparation Of Billing Under Both Coding Systems 39

Nursing Impact Appreciate Time, Complexity, & Level of Difficulty –Same Organizational Change Issues as Physicians –Awareness of Impact Initiative in Other Departments –Physicians, Utilization & QA Review, Agency Personnel!! –Training Needs –Forms & Orders Will Change; Documentation Will Need to Be More Specific: EG. Pressure Ulcers: ICD 9 = 9 codes; ICD 10 > 125 codes Don’t Underestimate the Value of a Nurse –Critical to engage: understand A & P, disease process, can read surgical reports and can explain what happened/how treated –Can serve as translators between Physicians and HIM Consider Role for Nursing Specialists/Informaticists, RN- Coders: : meaningful-use.aspx 40

Operational / Functional Impact Productivity will be effected in Real $$ Productivity Decreases Expected, Beyond Transition Cash Flow Impact Resulting from Lowered Productivity: –Claims Submissions –Reimbursements –Slowed Revenue Stream –A/R Drop –Audit Impact of Changes in Documentation –Increase in Cost Per Case for a Period of Time –Delays in Chart Completion Secondary to Physician Documentation –Charge capture Processes May Need Modifications Utilization Review / Case Management Impact Stop Loss Initiatives Needed? –Collaborate with Payers as Well 41

Productivity Impact on Coding Pre1 Year Post2 Year Post Inpatient (47%) 3.75 (81%) Day Surgery (36%) 8.53 (80%) Emergency (63%) 8.83 (85%) Canada Implemented ICD-10 in 2001 –Coders Did Not Return to Post Implementation Productivity Levels –Use of Pre-defined Coding Lists Within Ambulatory Care Settings Mitigated Drop Sample of Canadian Coding Productivity Pre- and Post-ICD-10 –Expressed as Charts Completed Per Hour 42 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Technology Impact Software Programs & Testing Efforts Clinical Documentation Programs will need Review – Required to Support Accuracy – Lead to Enhanced Reimbursement and Severity- Adjusted Clinical Outcome Measures 1 Multiple Sites –May Each Have Locally Customized Software ( Even If Using the Same Applications) Forms Will Likely Change 43

Who Requires Training? Coders Other HIM Clinicians (Physicians, Nurses) Senior Management Information Systems Quality Management Utilization Management Claims Analyst Performance Improvement Compliance Data Quality Management Data Security Data Analysts Accounting Business Office Auditors & Consultants Patient Access & Registration Clinical Department Managers Ancillary Departments 44 Courtesy of: Kaiser Foundation Health Plan of Ohio Ohio Permanente Medical Group

Impact on Software Programs HIM –DRG Grouper-Encoding Software –Abstract Systems-Compliance Software –Medical Necessity-Support Systems –Case Mix Systems-Utilization Management –Quality Management-Case Management –Performance Management 45

Impact on Software Programs Financial –Billing –Financials –Claim Submission –Compliance Checking –National And Local Coverage –Determinations Reporting –Provider Profiling –Quality Management –Utilization Management –Disease Management Registries / Other Registries –State Reporting Systems –Fraud Management –Patient Assessment Data –Data Sets –Aggregate Data Reporting –Managed Care Reporting 46

Impact on Software Programs Clinical Systems –Clinical Protocols –Test Ordering Systems –Clinical Reminder Systems –Decision Support Systems –Disease Management Systems Internal Home Grown -Systems and Customizations –Clinical Systems –Pharmacy Systems –Lab System –Radiology Systems –EKG Registration –Registration/Scheduling –Advance Beneficiary Software –Medical Necessity Edits 47 Anywhere a Code or Diagnosis Resides or is Utilized WILL be Effected!!

Ancillary /Other Impact Ancillary –Pharmacy (V and E Codes Will Still Be Alphanumeric) –Lab (Codes Change) Quality Measures and Reporting Public Health / Compliance Impact –Data Is More Clearly Defined –Potential to Improve ACO Data Reporting 48

Vendor Interface Impact Create Inventory of Systems –Define Those Impacted (Systems, Vendors) Coding Vendor –Compliance / Readiness of 5010 & ICD-10 –Release / Implementation of System Updates –Costs Testing Interfaces (Bidirectional) –Affected Systems and Third-Party Recipients / Providers –Claims, Clearinghouses, Reference Labs, Affiliated Physicians, Etc. –Costs 49

Payer Impact Consider: Testing with Payers and Clearinghouses E ffects That ICD-10 Will Have on Explanation of Benefits (EOB) Statements Changes to Submitted Claims Changes in Communications to Patients –Handling of Questions / Calls from Patients –Who will they view as the cause of their anxiety and frustration ? 50

Competition for Essential Resources Funding Actual Project Costs Ongoing Costs Other Projects Diversion of Funds & Other Resources to ICD-10 from Other Projects (CMS and Internally-Originated) –Resistance –Delays Due to Fund Diversion Time Project Planning & Timing People HIM Staff, Physicians, Nurses, IT, Educators 51

Budget –Changes and Implementation Costs of all Organizational / System Changes, Training, and Lost Productivity Impacts Ongoing Costs –Denials and Delayed Payables –Reserves All Costs Are Higher Than You Think The Longer You Wait, the More It Will Cost You Financial Impact 52

The Road is Going to Be Bumpy 53

On October 1, 2013, Where Will YOU Be? Here? 54

On October 1, 2013, Where Will YOU Be? Or Here? 55

Summary 56

Summary Critical Success Factors: Plan Budget Train Obtain Detailed Input Through Work Sessions –Payers / Providers Coverage Guidelines, Contracts/Policies, Technology, People Create Focus for Strategic Decisions –Leverage ICD-10 As an Enabler to Future Direction –Establish Framework for When to Comply and/or Optimize within a Business Domain/ Service Line –Establish a Path for Benefit and Reimbursement Strategies (i.e., Value Based Benefits/ Reimbursement/ Purchasing) –Identify Drivers for Portfolio Management Closely Coordinate Communicate, Communicate, Communicate 57

Informational Resources / Links AHIMA –ICD-10-CM/PCS Transition: Planning and Preparation Checklist HIMSS –ICD -10 Playbook –ICD-10 Task Force: ICD -10 Implementation Cost Prediction Modeling Tool Predicts Financial Impact Post Implementation Covers Incremental Costs vs. Status Quo Excel Format –ICD- 10 CM/PSC Tools and Resource Guide –5010/D.O & ICD-10 Interrelationships (crosswalk table) 58

Informational Resources / Links AAPC –ICD-10 Impact on Productivity on productivity –ICD-9 to ICD -10 Reference Sheet CMS AMA -resources for physicianswww.ama-assn.org – managing-your-practice/coding-billing-insurance/hipaahealth- insurance-portability-accountability-act/transaction-code-set- standards/icd10-code-set.page? 59

Informational Resources / Links AHIMA –ICD-10-CM/PCS Transition—Planning and Preparation Checklist HIMSS –ICD-10 Initiation & Planning –ICD-10 Implementation –ICD-10 Implementation Cost Prediction Modeling Tool Ingenix –ICD-10-CM: Diagnostic Coding for the Future Experis –ICD-10 Identified Generic Risks Benchmark –ICD-10 Checklist 60

Are You Ready? Now That You’ve Seen What’s Needed: Are You Prepared? Have You Started Yet? Will You Be Able to Do Everything in Time? 61

Questions & Answers 62

Contact Information Dr. Nabil Chehade Phone: Lynn Eckendorf Phone: Gail Kovacs Phone: