1. ICD10 Hotfix Review EHR Transition Tools and Dual Coding
Presented by:
Carol Helminen –Support Specialist II
and
Gina Ehni- Training Consultant

2. Agenda
Hotfix review
Dual Coding
Transition Toolkit
Intercept Tool

3. Confused? Don’t know which direction to take? And running out of time?

4. ICD-10 Hotfix versions 8.3.0 HF1 8.3.1 HF1 8.3.2 HF1 8.3.3 HF2
8.3.8 OPH HF11
HF1
8.3.8 Base if never installed any hotfix
8.3.8 Cumulative if installed previously released hotfix
Mmic will be running CDL after upgrade

5. KBM ICD10 Hotfix Updated templates with hard coded ICD-9 codes
Fix defects associated with ICD-10 workflows
Update Dx Groups for My Plan order sets with ICD-10
KBM sub document to print dual coded information on documents
Clients can add this where needed
Sub report for crystal reports to print dual coded information
Available on - but can be added where needed
LabCorp
Radiology
Quest
Generic Lab

6. ICD 10 Hotfix Contents Corrected Defects in PM, EHR and KBM
Compatibility for ICD-10 checking -Medical Necessity
ICD Intercept Tool – To catch ICD-9 codes after mandate date to convert to ICD-10 prior to sending to PM
Transition Toolkit – Tool to identify templates, Dx Groups, Order Sets, Quick Notes, Quick Saves and Template default. As well as tools for favorites and for testing
Dual Coding Option – Prior to mandate date, map ICD-9 codes to ICD-10 per patient
Orders – Use Dual coding to map ICD-9’s to ICD-10’s for future and recurring orders from orders module

7. ICD 10 Hotfix - Other Tools
Optik – Leverage Charge Intercept for on-hold orders to prevent ICD-9 when save over transition
NextGen Shared ICD Reports – To identify memorized reports in which an ICD-9 code are utilized
Dashboard – Includes ICD-10 in addition to ICD-9’s
Nextgen Mobile –
Disable invalid codes from being selected
Utilize ICD-9 Intercept Tool
Utilize ICD Legacy lookup
View nextgen shared icd reports
Sub_document show and best practice recommendation is to add to Lab Requisition, Referral documents, Master IM

8. Dual Coding Available for all 5.8 versions Access to Dual Coding
Tools -> Enc Dual Coding
Top Toolbar
Order Module – new order
Best practice- use dual coding in Prod prior to 10/1/15
Encounters have both codes on them and can be updated after to 10/1/2015 to ICD10 code
Future or recurring orders- use dual coding to substitute ICD9 to ICD10 Code
Sub document and crystal report updates to display ICD9 to ICD10 mapping
Sub_ICD_dual_coding.ndx
White paper crystal report
Master IM document- Ariana Test for encounter date 07/23/2015

9. Transition Toolkit System Template
Tool to assist in identifying ICD-9 codes in your database
Templates, including triggers, variables and labels
Delete Provider Favorite codes ICD-9
Quick Saves, Quick Notes and Template Defaults
Diagnosis Groups
Functionality
Access Transition Toolkit
Run specific search
Optional export to spreadsheet
Analyze the results
Make corrections
This template needs to be downloaded from KE site.

10. Transition Toolkit Downloading and installing package
Importing templates
System / Practice templates checkbox
Copying of images to Nextgenroot\EMR\Templates\Images folder
Run stored procedure script against database
ICD20_Toolkit_Complied_SP.sql
MMIC will download and import this template for any client who wants us to do it.
Demo or view of Transition Toolkit in test db
Find download on KE

11. Nextgen Knowledge Exchange

12. Transition Toolkit Panel Review Hardcoded ICD Code Search Tool
Brings in anything with a *99.9 format, need to make sure is indeed an ICD code
Dx Groups and Template Defaults, Quick Saves, Quick Notes
Remove ICD-9 codes from Provider Favorites
ICD-10 Immunization and Dual Coding Scripts
ICD Intercept Tool
This tool can potentially identify character sequences that may not be diagnostic codes or could be ICD-10 codes making it very important to you to carefully review the results before taking any action.
Hardcoded DX Code Search
To Locate hardcoded dx codes on NG KBM or custom templates, regardless of whether or not you are using the NG KBM. Tool identifies all places in the KBM that may contain hardcoded ICD-9 codes that must be mapped to ICD10 code. You can run as many times as needed to locate all hardcoded codes.
Diagnosis groups, quick saves, quick notes and template default searches
Locate potential ICD-9 codes or locations that do not have required ICD-10 codes defined- DX groups search finds instances in dx group that have ICD-9 codes defined but not a corresponding ICD-10 code. Fix using DxGroups/Reference System practice template (NGKBM Common DX Framework). Template defaults, quick saves/quick notes- identifies all that contain ICD-9 instead of ICD-10. Use NGKBM Template Defaults template to correct. (System template NGKBM Template Defaults)
Remove ICD-9 codes from provider favorites
Locates invalid or expired dx codes within provider favorites. You can export and you may want to do this to distribute to the provider so they can address their own favorites.
ICD-10 Immunization and Dual coding Scripts
Can be used to run two scripts that perform critical updates to the database
ICD-10 Immunization Script- updates any ICD9 codes in pending immunizations orders to ICD-10 codes. Not only replaces those codes in associated dx for vaccine favorites and the dx contained in vaccine inventory.
Dual Coding Script- adds the ICD-10 codes mapped using the dual coding template to the patients dx history.
Activate the ICD Intercept Tool
Tool must be activated prior to the ICD-10 transition date to intercept residual ICD-9 codes submitted to superbill after the ICD-10 transition date- When active this detects ICD-9 codes and present the user with options for replacing the code or continue with ICD9 code

13. Transition Toolkit Making Corrections
Adding a Dx Group on the Practice Template Common Dx Framework
Assign an ICD-10 to a Diagnosis Group
Updating Triggers and Conditions within Template Editor
Field length for ICD-10 should be 10 characters for the code and 255 for the description
Show examples of fixing items within system/practice templates or the
Field length for ICD-10 should be 10 characters for the code and 255 for the description
This does check MR pop ups as well
Brings in anything with a *99.9 format, need to make sure is indeed an ICD code

14. Transition Toolkit Remove ICD-9 Codes from Provider Favorites
Click on Search button
Able to filter per User, Category and Dx Code
Remove ICD-9 codes from provider favorites
Locates invalid or expired dx codes within provider favorites. You can export and you may want to do this to distribute to the provider so they can address their own favorites.

15. Transition Toolkit ICD-10 Immunization and Dual Coding Scripts
ICD-10 Immunization Script
Updates the vaccine inventory from an ICD-9 code to an ICD-10 code
Dual Coding
If using Dual Coding prior to transition these will be added to the patient diagnosis list
Run Twice
On morning of Transition date ( ) with an end date ensuring all encounters up to that date are complete and locked
Second time run after all encounters up to are complete and locked with an end time of
ICD-10 Immunization and Dual coding Scripts
Can be used to run two scripts that perform critical updates to the database
ICD-10 Immunization Script- updates any ICD9 codes in pending immunizations orders to ICD-10 codes. Not only replaces those codes in associated dx for vaccine favorites and the dx contained in vaccine inventory.
Dual Coding Script- adds the ICD-10 codes mapped using the dual coding template to the patients dx history.

16. Transition Toolkit Activate the ICD Intercept Tool
Used to intercept ICD-9 codes submitted to Superbill after the ICD-10 transition date
Activate the ICD Intercept Tool
Tool must be activated prior to the ICD-10 transition date to intercept residual ICD-9 codes submitted to superbill after the ICD-10 transition date- When active this detects ICD-9 codes and present the user with options for replacing the code or continue with ICD9 code

17. ICD-9 Code Intercept Tool
Purpose: Catches the ICD-9 codes on submission. Displays the Procedure Charge Mapping dialog box to select an ICD-10 code on or after the compliance date.
3 Possible Scenarios
1 – 1 Match
1 – Many Match
You may need two or more ICD 10’s to be equal to 1 ICD-9 code
This happens when and ICD9 code is being used after 10/1/2015- system catches it and this tool pops up
Test Patient- Bobbi Test for encounter 8/6/2015