1. CAPSTONE Project implementing icd-10 frank skwierc
Good Morning My Name is Frank Skwierc and I will be doing this presentation on the implementation of ICD-10.
CAPSTONE Project implementing icd-10 frank skwierc
Instructor/Kara Slivers Course/CAPS 265 Career Development III

2. Objectives
Overview of ICD-10 History of ICD-10 Adoption Comparison to ICD-9 Benefit of ICD-10 National Adoption Date and Requirements Timeline of Implementation of ICD-10 Training Requirements
Some of the things I will be drawing your attention to, is a brief overview of the history of ICD-10 adoption, comparison to ICD-9, the benefits of ICD-10, The date ICD-10 was implemented, and the requirements. I will also show you a diagram of the timeline of implementation, and point out some of the training requirements, and finally a summary of everything.

3. History of ICD-10 Adoption
1990 –Endorsed by World Health Assembly (diagnosis only)
•1994 –Release of full ICD-10 by WHO
•2002 (October) –ICD-10 published in 42 languages (including 6 official WHO languages)
•Implementation138 countries for mortality
99 countries for morbidity
•January 1, 1999 –U.S. implemented for mortality (death certificates)
In 1990., The world health Association endorsed the new coding system for diagnosis is only been in 1994 a full release of ICD 10 was released by the World Health Organization in 2002 that already published the ICD 10 manual and 42 languages including six official languages approved specifically for the use by the World Health Organization. By the end of 2002, ICD 10 had already been implemented and 138 countries for mortality and 99 countries for morbidity. It was not until January 1, 1999 that the United States implemented it step into ICD 10 by adopting mortality (death certificates) to be used as reporting to the World Health Organization. This was the start of the use of ICD 10 coding in the US.

4. History of ICD-10 Adoption
2003 National Committee for Vital and Health Statistics (NCVHS) voted to recommend that the secretary of Health and Human Services move forward to adopt ICD-10-CM and ICD-10-PCS under HIPAA standards
2008 August: Notice of proposed rule making (NPRM) published in the Federal Register with a proposed implementation date of October 1, 2011, and a 60-day public comment period October: Analysis of public comments to NPRM
2009 January: HHS publishes final rule (CMS 0013F 45 CFR, parts 160, 162) in the Federal Register, adopting ICD-10-CM and ICD-10-PCS effective October 1, 2013, with implementation timeline for version electronic transactions and ICD-10.
In 2003 the national committee for vital and health statistics voted to recommend the adoption of ICD 10 CM and ICD 10 PCS to be used for HIPAA standards. In 2008 there was a notice of proposed rulemaking in the Federal Register to have ICD 10 implemented in the United States as an official coding system by October 1, In 2009 a final ruling was made for adopting ICD 10 CM and ICD 10 PCS to be effective no later than October 1, 2013 for the final implementation of version 5010 for all electronic transactions dealing with ICD 10.

5. History of ICD-10 Adoption
2012 September: On September 5, HHS issues final rule issued changing the compliance date for the International Classification of Diseases, 10th Revision (ICD–10–CM and ICD–10–PCS) Medical Data Code Sets from October 1, 2013 to October 1, 2014
2014 April: On April 1 Congress passes the Protecting Access to Medicare Act of 2014 (PAMA). Section 212 of PAMA, titled ‘‘Delay in Transition from ICD–9–CM to ICD–10 Code Sets’’ is the legal authority for the regulatory action to delay implementation of ICD-10 from the previously established date of October 1, 2014 to October 1, 2015.
August: On August 4, HHS issues final rule changing the compliance date for the International Classification of Diseases, 10th Revision (ICD–10–CM and ICD–10–PCS) Medical Data Code Sets To October 1, 2015
October 1, ICD-10 compliance date – DELAYED
October 1, ICD-10 compliance date
Because of the unforeseen cost for insurance agencies, hospitals, physicians offices, and clinics to obtain the software necessary to operate the new coding system in 2012 they change the October 1, 2013 deadline to October 1, At that time in 2012 the government offered incentives to those organizations implementing this costly software by giving them financial aid. However they had to meet the timeline for implementation to have the software and training of personnel in place by October 1, Again in 2014 Pres. Obama signed one final waiver for compliance and gave those agencies that were not in compliance with the utilization of ICD 10 and the software that surrounds it one more year of compliance and that October 1, 2015 would be the last time any submissions to Medicare or Medicaid could be made utilizing ICD-9 codes. Any ICD-9 codes submitted after October 1, 2015 can be accepted however they will come with a penalty cost and those companies that make claims to Medicare and Medicaid may lose licensing to do so unless they come into compliance before the next fiscal revision in April As of this date, no ICD-9 codes can be accepted as a report for reimbursement to Medicare or Medicaid services.

6. Comparison to ICD-9 ICD-9-CM ICD-10-CM 3-5 characters in length
Only V and E codes start with a letter
All codes start with a letter
Second, third, fourth, and fifth digits are always numbers
Second and third digits are numeric, but fourth, fifth, sixth, and seventh digits may be alpha or numeric
Decimal placed after the first three characters
Decimal still placed after the first three characters
Limited space for adding new codes
Flexible for adding new codes
Cannot identify laterality (left, right, bilateral)
Can identify laterality
If we can impair ICD-9 to ICD 10 you will find completely new coding structure while ICD-9 had a maximum of 3 to 5 characters in length and only utilized to be an E codes as a letter base in left a limited amount of digital coding that would properly diagnose the conditions that patients suffer from. Because ICD 10 can utilize 37 characters as well as letters we are capable of now being more specific in our diagnosis of a patient. In the old ICD-9 procedure coding most angioplasties were coded as code 39.50, however with the new ICD 10 PCS coding coding angioplasty can now be coded to the specific body part, approach, and device. Here are just a few examples of what that coding can be. –
047K04Z Dilation of right femoral artery with drug-eluting intraluminal device, open approach
047K0DZ Dilation of right femoral artery with intraluminal device, open approach
047K0ZZ Dilation of right femoral artery, open approach
047K24Z Dilation of right femoral artery with drug-eluting intraluminal device, open endoscopic approach
047K2DZ Dilation of right femoral artery with intraluminal device, open endoscopic approach
As you can see it is apparently clear how coding procedures with ICD 10 PCS can paint a clearer picture of what was actually done by the surgeon rather than a general description of an angioplasty that needs to be backed up only by submitting documentation that clearly defines the complete surgery. Here the code alone describes the work done making it easier for other physicians to recognize the work that was done without having to go over the entire documentation for this case.

7. Benefit of ICD-10 Provides detailed information on procedures
Ample space for capturing new technology and devices
Logical structure with clear, consistent definitions
As I already pointed out one of the great benefits of ICD 10 is our can provide more detailed information on procedures besides that the implementation of the new software gives physicians and coders alike the ability to obtain the necessary medical records from a variety of new technical logical devices. Besides that the new coding system explains in such great detail to provide a more logical structure to identify conditions in a clearer and consistent form.

8. Adoption Date and Requirements
October 1, ICD-10 compliance date
Create a New Compliance Program
Obtain Access to ICD-10 Codes
Contract with a Clearing House to Submit Claims
Train your Staff on ICD-10
Target your Top ICD-9 Codes and Convert them
Update Hard-copy Electronic Forms
Call your Vendors to Confirm ICD-10 Readiness
In October 2015 ICD 10 made its debut because of all the new policy changes that surround ICD 10 many organizations need to rewrite their compliance program to conform to these new policies. Along with obtaining the software needed to obtain a complete listing of the new ICD 10 codes which can of course be contained in book form but would be more efficient to use software as such as encoder Pro. For those organizations that do not code in-house they will also need to obtain an outside organization such as a clearinghouse to submit their claims. For those companies that do their own coding they will need to train their staff to the changes of ICD-9 to ICD 10 and is recommended that they familiarize themselves with the top ICD-9 codes they use often and convert those codes immediately to ICD 10. It is imperative that they upload the necessary electronic forms that will be used for ICD 10 coding as well as inform their vendors of all the changes that apply to the new regulations and policies governing the purchase of equipment.

9. Timeline for Implementation of ICD-10
The first step to setting up the ICD 10 in your organization is to find a company that will provide the software you will be utilizing for the reimbursement and coding as well as the records keeping. Often 360 is one solution for this the timeline they recommend to fully implement and test the product will span approximately 2 years to ensure that meets all the standards you need to meet all the regulations and compliance laws set forth by the government. The system itself can be set up within your organization within only six months however that would only supply you with the basic needs. To know that the system is functioning adequately and protecting your reimbursement properly will take a year and a half of constant auditing to ensure that the coders are not just using routine codes and are coding properly for you.

10. Training Requirements
Train the Trainer
Collaboration with State hospital associations
Training and education
Overview versus in-depth training, depending on individual role and timing
Prudent purchase of educational resources
Trusted source
In-depth training of coders 3 –6 months prior to implementation
The first person you will want to train is your trainer. You will also want to collaborate with other state hospitals and associations that are affiliated with you to ensure that they know and understand your policies and the policies are known and understood by your staff members. For training and educational purposes you want your trainer to train other individuals and you'll want to ensure that you purchase educational resources from trusted sites like the AAPC and the AHIMA. Most of these training courses from these organizations may last anywhere from 3 to 6 months so you'll need to do that prior to setting up your implementation program for ICD 10. Some of these agencies offer your coders a chance to get certified at their local library instead of going to a state agency.

11. Training Requirements
Cross-functional team membership
Collaboration among departments necessary to identify information systems affected
Members across clinical, financial, and information systems areas
Get support from administration
Involve HIM department leaders as well as coders
Of course, your training program should include cross functional team membership training. You'll want the leaders of your groups and departments share in the training process to ensure that everyone follows the compliance and policies set forth by the AMA and the AHIMA. It is also a great idea to get help from the administration department in setting up training programs within the organization, by bringing and representatives from the software companies to teach all the employees on how to use the product properly.

12. References
Pickett, D. (2009). ICD-10 Overview. CMS/Centers for Medicare & Medicaid Services. Retrieved 7 August 2016, from Contracting/ContractorLearningResources/downloads/ICD- 10_Overview_Presentation.pdf
History of ICD10: ICD-10 Implementation Dates-Optum360Coding. (2016). Optum360coding.com. Retrieved 7 August 2016, from
Comparison Between ICD-9-CM and ICD-10-CM. (2016). Tacomacc.edu. Retrieved 7 August 2016, from t1/Unit12.html
Miller, J. (2016). ICD-10 Requirements: Transition Strategies & Compliance | RelayHealth. Relayhealth.com. Retrieved 7 August 2016, from
Conclusion to course, lecture, et al.