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No more ICD-10 delay: Contact your local legislators today

ICD-10 implementation is not game. Tell your elected officials to stop playing around with the implementation date.

ICD-10 implementation is not game. Tell your elected officials to stop playing around with the implementation date.

Word has begun circulating throughout the healthcare industry that ICD-10 may face additional delay.

A letter drafted by Republican Michigan Representative Fred Upton and Republican Texas Representative Pete Sessions on behalf of the Medical Society of the State of New York seeks an additional two-year delay in the implementation of ICD-10 until October 1, 2017. You can read the letter here: http://www.mssny.org/MSSNY/Practice_Resources/ICD-10/ICD-10-Boehner-Letter.aspx

We at ACDIS strongly oppose further delay to ICD-10. Hospitals and CMS have already conceded with prior delays, at great cost: CMS estimated that the last delay cost the healthcare industry up to $6.8 billion in training, software, and other investments.

Further delay would result in additional costs, and also hurt patient care. The nation’s current coding and disease classification system, ICD-9, is out of date and desperately in need of the additional specificity that is the hallmark of ICD-10. Contrary to statements made in the above letter, improved coding specificity is not just tied to reimbursement, but also quality of care and patient safety.

It goes without saying that a further delay would also greatly damage the work already being done by CDI departments across the country, many of which have been diligently collaborating with their physician staffs with formal education and queries for the additional specificity needed under ICD-10.

ACDIS has received permission from our friends at the American Health Information Management Association (AHIMA) to share the following information with our members. It includes AHIMA’s recommended approach to contacting your local legislator and making your voice heard.

If you click this link, it will take you to Capwiz, a tool that makes it very easy to send letters directly to Congress: http://capwiz.com/ahima/issues/alert/?alertid=63887791. The form is pre-populated with reasons why the industry opposes efforts to delay ICD-10. This can be sent verbatim, or modified with your own thoughts and experiences with using ICD-10. The ACDIS advisory board stresses that you should urge Congress to act now, rather than wait to voice your opinion on the fate of ICD-10.

Congress is due to recess for the year on Friday, December 12. Time is of the essence, so please take action now.

If a delay is to occur, we all need to know in order to prepare and plan for 2015.

In addition, if you’d like to do more, consider the following course of action as recommended by AHIMA:

Call the leaders listed below TODAY and tell them that ICD-10 is needed in 2015.
Follow these 4 steps:

  1. Call Chairman Upton at 202-225-3761.
  2. Ask for the Health Legislative Aide
  3. Use the talking points below:
  • Do not delay ICD-10. We need the code sets in 2015!
  • According to a recent survey, small physician practices are expected to spend between $1,900—$6,000 to transition to the new code set. This is much lower than previous reports. The study can be found on www.coalitionforICD10.org.
  • Physician practices do not use all 13,000 diagnosis codes available in ICD-9. Nor will it be required to use the 68,000 codes that are in ICD-10. The majority of the code increases are due to laterality-which is not currently available in ICD-9.
  • CMS offers a robust plan for physician practices to transition to ICD-10. The Road to 10 can be found here: http://www.roadto10.org.

When you are done, call the other congressional leaders and Tweet also.

Name Phone                              Twitter Handle
Fred Upton 202-225-3761 @RepFredUpton
Pete Sessions 202-225-2231 @PeteSessions
House Speaker John Boehner 202-225-6205 @SpeakerBoehner
Minority Leader Nancy Pelosi 202-225-4965 @NancyPelosi
Kevin McCarthy 202-225-2915 @GOP Leader

Tweet your Representatives and be sure to use the following #s! #ICD10Matters #ICD10NoDelay

On behalf of ACDIS, thank you for making your voice heard on this important issue.

Sincerely,

Brian Murphy

Director, ACDIS

bmurphy@acdis.org

Advisory Board nominations due today

We are currently seeking four new ACDIS members to join our advisory board in 2015. ACDIS advisors are important, volunteer positions that help shape the direction of the association and provide leadership and expertise for the membership. The term of service is a maximum of three years.

The deadline for returning completed applications is Monday, November 17, 2014. A nominating committee and the ACDIS membership will make final selections by January 2015.

The role and expectations of ACDIS advisory board members is described on the advisory board page.

Please fill out and submit the application form by clicking here.

Call for Advisory Board nominations open

Join ACDIS. Get the Journal. Get informed.

Consider volunteering for the ACDIS Advisory Board.

We are currently seeking four new ACDIS members to join our advisory board in 2015. ACDIS advisors are important, volunteer positions that help shape the direction of the association and provide leadership and expertise for the membership. The term of service is a maximum of three years.

The deadline for returning completed applications is Monday, November 17, 2014.

A nominating committee and the ACDIS membership will make final selections by January 2015. The role and expectations of ACDIS advisory board members is described on the advisory board page. If interested, please fill out and submit the application form. Thanks for your consideration of this important opportunity to serve our association.

ACDIS Position Paper available: Defining CDI roles and responsibilities

CMS says new date for ICD-10-CM/PCS implementation set for 2015.

New Position Paper defines CDI roles and responsibilities.

Struggling to define the role of a CDI specialist in your facility? Let us help with this complimentary position paper from ACDIS. This position paper seeks to clarify the role of the CDI specialist and provide guidance in developing appropriate policies, procedures, and job descriptions for CDI departments. The CDI specialist’s role is complex and requires expert knowledge of clinical care and applicable coding guidelines, as well as an ability to communicate effectively with the clinical care team.

Click here to read the entire position paper now.

2014 Advisory Board open voting begins; deadline to vote January 31!

If you are an ACDIS member please vote for four new volunteers to represent you on the Advisory Board.

If you are an ACDIS member please vote for four new volunteers to represent you on the Advisory Board.

Voting is now open for four ACDIS advisory board positions, for terms of service starting in 2014 through the end of 2016. Log on to the ACDIS website to select the four candidates you believe are the best fit for the association, and then cast your vote. You may only vote once.

The results of the election will be announced in early February.

ACDIS advisors are important, volunteer positions that help shape the direction of the association and provide leadership, expertise, and representation for the membership. The term of service is a maximum of three years.

The voting page includes the nominees’ background in CDI and information on why they are seeking election. The vote will close end of business day on Friday, January 31.

If you have any questions, please e-mail ACDIS Director Brian Murphy at bmurphy@hcpro.com.

Understand how HCC changes relate to physician quality scores, reimbursement

Tips for ICD-10 queries.

Tips for ICD-10 queries.

By James S. Kennedy, MD, CCS, CDIP

Although most physicians have heard of DRGs with inpatient admissions, only those invested in accountable care organizations and independent practice associations are likely familiar with hierarchical conditions classifications (HCCs). Based on ICD-9-CM codes submitted by physicians or hospitals in a calendar year for documented diagnoses requiring assessment, management, or treatment, HCCs will significantly change in 2014 with additions and deletions as well as relative weight changes.

Physicians documentation will need to improve related to HCCs because one of the goals of the Patient Protection and Affordable Care Act (PPACA) is to encourage provider efficiency, defined by CMS as a ratio of observed to expected costs and outcomes for selected populations. And, to this end, CMS is developing efficiency measurement metrics that will influence reimbursement and may be reported on its Physician Compare website (http://tinyurl.com/ mnq89rh). These include:

  • CMS Episode Grouper for Medicare. Part of CMS’ Quality and Resource Use Reports, currently focused on cardiac conditions and pneumonia. Learn more at http://tinyurl.com/2013CMSEG.
  • CMS Physician Value-Based Payment Modifier. Applicable to groups of 100 or more providers in calendar year (CY) 2015, potentially groups of 10 or more providers in CY2016, and all others in CY2017, its calculation involves the total per capita cost measure for Medicare fee-for-service and the Medicare spending per beneficiary models using CMS’ HCCs. Read more in the CY2014 CMS Proposed Physician Fee Schedule, available at http://www.gpo.gov/fdsys/pkg/FR- 2013-07-19/pdf/2013-16547.pdf

Editor’s note: This article is an excerpt from the Featured Article on the ACDIS homepage and was originally published in the December 2013 edition of Medical Records Briefings. James S. Kennedy, MD, CCS, CDIP, is president of CDIMD.com. A past ACDIS Advisory Board member, Kennedy is a general internist and certified coder, specializing in clinical effectiveness, medical informatics, and clinical documentation and coding improvement strategies. Contact him at 615-479-7021 or at jkennedy@cdimd.com.