© 3M 2012. All Rights Reserved. 3M provides these slides to promote a better understanding of 3M's software and/or services. These slides contain 3M confidential.

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Presentation transcript:

© 3M All Rights Reserved. 3M provides these slides to promote a better understanding of 3M's software and/or services. These slides contain 3M confidential information and are for customer’s internal review only. 3M Health Information Systems ICD 10 Readiness New Jersey ICD-10 Task Force April 22, 2013 Innovating Health Language of the

2 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems AGENDA Introduction ICD 10 Overview Grouper Readiness (MS DRGs, AP DRGs, APR DRGs, CodeMapper) Coding & Reimbursement Readiness Contacts and Resources Questions

3 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems # Health Information Systems  Industry leader for, coding, classification and hospital payment systems used by federal agencies, 35 states, many commercial plans, and by 75% of the nation’s hospitals  Created Medicare DRGs—the original bundled payment system-CMS’ contractor for update of the Medicare inpatient system since 1983  Developed first outpatient Ambulatory Patient Groups (APGs)- modified into APCs for CMS in 2000-APGs fully upgraded in 2008  3M APR Suite (APRs, PPRs, PPCs)is widely used in government and commercial uality based payment programs  Quality Based Payment work expanded beyond inpatient hospital to all major care settings with creation of Potentially Preventable Event suite  Primary CMS Medicare contractor for ICD-10 translation and conversion—developed GEMS and ICD-10 Procedure Coding System

4 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems 3M ICD-10 Readiness  In the October 2012 release, 3M provided a version of each of the following grouping products that process either ICD-9-CM or ICD-10-CM/PCS code sets:  These products support a variety of methodologies including, but not limited to: CMS MS-DRGs 3M TM AP-DRGs 3M TM APR DRG CMS APCs 3M™ Enhanced APGs  Slide 22 contains links to the 3M ICD-10 Readiness Site PC-based products : Mainframe-based products : 3M™ Coding and Reimbursement Software3M™ APC Grouper Plus Software 3M™ Core Grouping Software 3M TM APR DRG Software 3M™ Grouper Plus System3M™ Clinical Claims Editor 3M™ Grouper Plus Content Services 3M TM Enhanced APG Software

5 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems MS-DRG: ICD-10 Readiness  Current MS-DRG ICD-10 version available in 3M products is v30  ICD-10 v30 is a pre-release version based upon replication from MS- DRG v30 ICD-9  Any future releases of MS-DRG ICD-10 prior to its official release has not been determined  Final replication in ICD-10 is ICD-10 v32 (10/2014) when ICD-10 is made official and the CMS IPPS final rule has been published  ICD-10 v32 will be the official MS-DRG version in 2014

6 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems Availability of MS-DRG ICD-10 Definitions Manuals  MS-DRG V30.0 ICD-10 Definitions Manual – Available in text and HTML versions  Posted on ICD-10 website at

7 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems AP-DRGs: Continued Maintenance in 2014  The last updated version of AP-DRGs with new codes and logic was v released in January  Since January 2011, AP-DRGs have been supported with the use of code mapping.  AP-DRGs will not be replicated in ICD-10  AP-DRGs will continue to be supported with the use of a code mapping bridge from v32 ICD-10 to v31 ICD-9 to v30 ICD-9 etc.

8 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems APR DRGs: ICD-10 Readiness  ICD-10 v30 and ICD-10 v31 are pre-release versions based upon replication from ICD- 9 which is still being refined ―Prior to official ICD-10 implementation  Final replication in ICD-10 is ICD-10 v32 (10/2014) when ICD-10 is made official ―ICD-9 v30 and ICD-9 v31: intended to be identical except for discharge statues added for ICD-9 v31 ―End RESULTS will be the SAME ICD-9 v30 and ICD-10 v30 will have discharge status mapped ICD-9 v31 and ICD-10 v31 will have discharge status embedded  ICD-10 v32 is the FINAL replication version of both ICD-9 v30 and ICD-9 v31 w/ discharge status refinements.  ICD-10 v32 will be the official version in 2014

9 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems CODEMAPPER: ICD-10 Readiness Grouper Readiness V24

10 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems CODEMAPPER: ICD-10 Readiness  In terms of code mapping between ICD-9 and ICD-10, 3M will: ―Support backward mapping from ICD-10 to ICD-9 for the supported methodologies ―Not support forward mapping from ICD-9 to ICD-10

11 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems Coding and Reimbursement Readiness

12 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems ICD-10 Milestones for the… … 3M™ Coding and Reimbursement System October 2014 ICD-10 Implementation Date October 2012 ICD-10 Compliant Coding and Dual Coding October M Readiness Tools and Interface 2010 – 2011 ICD-10 Comparison Report 3M Training Software and Training Module Today

13 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems Defining the Options for Coding in ICD-10 Coding using a process or program built for one classification system: ICD-9 or ICD-10 Native Coding Coding twice for two different classification systems. (i.e., coding the record once for ICD- 9, then coding the record again for ICD-10) Double Coding Coding both ICD-10 and ICD-9 codes simultaneously Dual Coding NOTE: “True” Dual coding will help with productivity as it will streamline the process of getting both ICD-10 and ICD-9 codes on the claim

14 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems Outline Transition Plan for ICD-10 What do you want to do? Financial impact analysis? Gather document insufficiencies while coding ICD-9? Coder productivity analysis? Workflow - double code, dual code, or both? What is your timing for each activity? ICD-10 Planning and Decisions For Example…

15 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems Taking Advantage of 3Ms ICD-10 Coding Options? ICD-10 Will Challenge Your Abstracting System ―Customer: Can Your Abstracting System… …Capture both ICD-9 and ICD-10 Codes Simultaneously? …Report on the Financial Impact of Coding Under ICD-10? …Determine Which Coders Can Perform Dual Coding? …Capture Which Codes Have Insufficient Documentation? …Identify Which Physician May Need Additional Training on ICD-10? …Measure the Coder Productivity Under ICD-10? 3M’s Database and Abstracting solutions can!!!

16 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems ICD-10 Financial Impact Analysis 1.The hospital’s abstracting system sends the appropriate interface tags to CRS specifying ICD-9 as the primary code set with ICD-10 as secondary 2.Coder uses existing process to derive ICD-9 codes (Classic or Auto-suggested) 3.To derive the ICD-10 codes, you can either: a.Use the translation tab to see the possible translations from ICD-9 and select the appropriate ICD-10 code, or b.Natively code in ICD-10 4.Coder computes the DRG for both ICD-9 and ICD-10 5.Both code sets and DRGs are interfaced back to the abstracting system 6.Reporting and analysis in hospital’s abstracting system Hospital’s Abstracting System Hospital’s Abstracting System 3M™ Coding and Reimbursement System (CRS)

17 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems ICD-10 Productivity Impact Analysis 1.The hospital’s abstracting system sends the appropriate interface tags to CRS specifying ICD-10 as the primary code set and that both ICD-10 and ICD-9 are wanted – Dual Coding 2.Coder uses existing process keyword logic to derive ICD-10 and ICD-9 codes simultaneously. 3.Coder computes the DRG for both ICD-10 and ICD-9 4.Both code sets and DRGs are interfaced back to the abstracting system 5.Reporting and analysis of productivity in hospital’s abstracting system 3M™ Coding and Reimbursement System (CRS) Hospital’s Abstracting System Hospital’s Abstracting System

18 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems Augment ICD-10 Training 1.Launch CRS either interfaced or standalone 2.Coder uses the ICD-10 Training button on the button bar to launch a second copy of CRS in ICD-10 (dual coding) mode. Codefinder only. 3.Coder uses existing process keyword logic to derive ICD-10 and ICD-9 codes simultaneously. 4.No computing of DRG’s 5.No interfacing of codes 3M™ Coding and Reimbursement System (CRS) Hospital’s Abstracting System Hospital’s Abstracting System

19 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems Contacts and Resources 19

20 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems 3M Contact Information  Margaret A. McGann, MS | Client Relationship Executive 3M Health Information Systems Northeast Region, Silver Spring, MD Office: | Mobile:  Marjorie C. Sexauer, RHIA | Solutions Sales Executive 3M Health Information Systems Northeast Region, Silver Spring, MD Office: | Mobile: | Fax:  Robert J. Trocchi | Northeast Regional Director 3M Health Information Systems, Inc. 3M HIS, Danvers, MA Office: | Mobile: | Fax: | |

21 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems Other 3M Products and Services for ICD-10  ICD-10 Financial Impact Analysis  ICD-10 Documentation Assessment  ICD-10 Web Education – Coder, CDI and Physicians  Coding Translation Tool – Translates I-9 to I-10 and I-10 to I-9  3M TM 360 Encompass ―Computer Assisted Coding for Coding and CDI

22 © 3M All Rights Reserved. 3M Confidential – for customer's internal review only. Further use or disclosure requires prior approval from 3M. 3M Health Information Systems ICD-10 Readiness Questionnaire  For information about 3M products' ICD-10 readiness: 1. Launch the customer website: 2. Log in. 3. Click the "Get Ready for ICD-10" link on the home page (Announcements, view all) --this takes you to the ICD-10 Ready page. 4. Select the link to "ICD-10 & 3M HIS Software." 5. Information is sorted by product. There are individual questionnaires for the different products affected by the transition to ICD-10.