ICD-10 CHANGE AHEAD Change is HARD 1)ICD-9 CM implemented in )Other countries using ICD-10 since the 1990’s: UK 1995, France 1997, Germany 2000, Australia )Canada has used ICD-10 since 2001

More Codes More Detail Greater specificity Ability to measure healthcare services Refinement of grouping and reimbursement methodologies Enhancement of public health surveillance Decreased need to include supporting documentation with claims

Other Features Includes updated medical terminology and classification of diseases Provides codes to allow comparison of mortality and morbidity data Provides for better data for: Measuring care furnished to patients Designing payment systems Processing claims0

Further Enhancements Making clinical decisions Tracking public health Worldwide: WHO Identifying Fraud and Abuse Conducting research

Implementation Date extended to October 1, 2014 More time to prepare physicians Staff Vendors Systems

Education Allow at least months for education of coding staff Recommend review of ICD- 10 chapters by body system Review of rules changes in sequencing of diagnoses

ICD-10 Chapters 21 chapters From Infectious Disease through factors Influencing Health Status and Contact with Health Services. Sense Organs, Eye and Ear are separate chapters (7 & 8) Chapter 16 is Conditions originating in the Perinatal Period—Newborn only

Other Chapters Chapter 17 Congenital malformations, deformations and Chromosomal abnormalities

Other Chapters Chapter 20 External Causes of morbidity Includes transport accidents, Slipping, tripping and falls Exposure (contact with animals causing injury) Drowning, near drowning Smoke, fire, flames

Chapter 20 continued Assault Legal intervention Operations of war and Military operations Terrorism Coders should review all coding guidelines listed for ICD-10, as coding clinics will no longer be applicable.

POA Present on Admission POA Guidelines will be reported. Inpatient admissions principal and secondary dx as well as external cause of injury.

Clinical Documentation Improvement Concurrent coding Queries Involve and Educate other staff: Nursing Case Managers Allied Health Cardiopulmonary Laboratory Pharmacy Rehab staff

Concurrent will expedite Concurrent moves the process more quickly Education of Medical Staff New Physicians/New Grads have already used ICD-10 --How do we help the senior members of our Medical Staff?

Use Existing Opportunities Medical Staff Meetings Develop an ICD-10 minute or section for each Medical Staff meeting (just like Safety Moments) The accuracy and specificity will assist the physician/practitioner, as much if not more than the Facility.

What Vendors/Programs use Codes Check systems Test Systems State Reporting Registries Billing and Collection Systems Testing should be scheduled by the vendor. ASK 2013 or early 2014 to work out bugs!

Prepare Coders should begin to use ICD-10 in actual accounts 1) Use ICD-9 and ICD-10 2) Determine what documentation may be needed in addition to what your physicians are usually documenting 3) Educate as needed

Computerized Coding Systems CAC: Computer assisted coding Electronic record/scanned record Will still need coders to edit

Reimbursement Prediction of some variation in payment Mapping will need further review

Websites AHIMA.org CMS WVHIMA.org