Author Archive for Doreen V. Bentley

Questions to ask your IT team

During a November 17 virtual meeting hosted by the American Health Information Management Association (AHIMA), co-presenter Laurine Johnson, MS, RHIA, CPC-H, director of HIM services at Ingenix, gave the following list of questions you should ask your information technology (IT) team to prepare for ICD-10 implementation:

• How does 5010 impact my ICD-10 implementation?
• Which databases contain ICD-9-CM codes?
• Which software packages include ICD-9-CM codes?
• Which interfaces include ICD-9-CM?
• What reports contain ICD-9-CM codes?
• How does ICD-10 impact my electronic health record?
• How many vendors are involved with the software, databases, connectivity, and interfaces?
• What are the vendor plans for implementing ICD-10 and how does it impact this organization?
• Should we convert data from ICD-9-CM to ICD-10? Should we convert ICD-10 data to ICD-9-CM codes?
• Does software need to be upgraded or replaced?
• What will be the capital and operating budget impact?
• What is the testing plan?

Have you already consulted with your IT team regarding ICD-10 implementation? Are there other questions you would add to this list? Were you surprised to hear any of the answers your IT team provided? Share your feedback, and post a comment!

Find answers to your ICD-10 questions

Over the last six months, I have noticed that the FAQ sections for different associations and organizations have increased in size and detail. Are you interested in learning the answers to the following questions:

• How soon after a code has been added or deleted will the General Equivalence Mappings (GEM) be updated to reflect these changes?
• Will there be a phase-in time period for ICD-10-CM and ICD-10-PCS where providers can use either ICD-9-CM or the ICD-10 based coding systems?
• Am I going to have to sit for my CPC (-H, -P) again to keep my AAPC credential once ICD-10-CM is implemented?

Check out the FAQ pages for the following organizations:

• CMS
• American Health Information Management Association
• American Academy of Professional Coders

Check out the latest ICD-10 resources

On November 12, the American Health Information Management Association (AHIMA) is hosting a virtual meeting titled, “ICD-10 Implementation for Hospitals.” According to AHIMA Web site, the program will help attendees:

• Discover how 5010 affects ICD-10-CM/PCS implementation
• Understand General Equivalency Mappings (GEMs) and mapping at an organizational level
• Determine how this implementation affects the HIM and coding professional
• Identify an appropriate impact assessment plan
• Recognize the extent of code set updates on the organization

A live question and answer portion immediately follows the meeting. For AHIMA members, you’ll have to pay $265 to attend, $315 for nonmembers. ICD-10 Watch will cover the highlights in a future blog.

Looking for a resource that is easier on the purse strings? On November 19, CMS is hosting a free national provider conference call to address the ICD-10-CM/PCS MS-DRG Conversion Project. This outreach call describes the preliminary exercise CMS undertook to convert data using the GEMs, which were developed to assist CMS and other data users who need to convert ICD-9-CM data or payment systems to the relevant ICD-10-CM/PCS codes and ICD-10-CM/PCS codes back to the relevant ICD-9-CM codes. CMS will discuss the following topics during the conference call:

• How ICD-9-CM based MS-DRG, version 26.0, were converted to ICD-10-CM and ICD-10-PCS codes
• The best way to use the GEMs in converting data

You must register to attend this call. Registration will close at 12:30 p.m. EST on November 18, or when available space has been filled. CMS will post written and audio transcripts shortly after the conference call on the CMS Web site.

Finally, the American Hospital Association (AHA) recently mailed members an executive briefing book to help hospitals prepare to transition to ICD-10. The resource covers aspects from organizing an implementation team to conducting an impact analysis and performing a post-implementation evaluation. AHA members can download additional copies of the guide on the AHA Web site.

Share you best resources on ICD-10 Watch! Post your comments, and tell us about the most interesting ICD-10 resource and tips you have encountered.

AAPC releases code translator tool

You’ll be happy to add this code translator to your collection of ICD-10 tools. The American Academy of Professional Coders (AAPC) released on October 20 a free ICD-10-CM online code conversion tool, which you can use to map ICD-9-CM codes to ICD-10-CM codes. The tool is based on the General Equivalency Mapping files CMS has posted on its Web site.

It’s incredibly easy to use the tool. First, you indicate whether you want to convert from ICD-9 to ICD-10, or from ICD-10 to ICD-9. Then you simply type in the code you want to look up.

For some codes, you’ll get fairly simple translations. Consider the following examples:

• When you look up ICD-9-CM code 277.81 (Primary carnitine deficiency), you get ICD-10 code E71.41 (Primary carnitine deficiency).
• When you look up ICD-9-CM code 577.2 (Cyst and pseudocyst of pancreas), you get ICD-10 codes K86.2 (Cyst of pancreas) and K86.3 (Pseudocyst of pancreas).

For other codes, the translations are more complex. When you look up ICD-9-CM code 424.0 (Mitral valve disorders), you get the following ICD-10 codes:

• I34.0 (Nonrheumatic mitral [valve] insufficiency)
• I34.1 (Nonrheumatic mitral [valve] prolapse)
• I34.2 (Nonrheumatic mitral [valve] stenosis)
• I34.8 (Other nonrheumatic mitral valve disorders)
• I34.9 (Nonrheumatic mitral valve disorder, unspecified)

As a disclaimer, the AAPC advises those using the tool to keep in mind that while many ICD-9 codes map directly to ICD-10 codes, some may require a clinical analysis to determine which code(s) should be selected for the appropriate mapping.

So give it a try, and post a comment to let us know what you think about the AAPC’s tool. Happy mapping!

AHIMA posts ICD-10 practice briefs

On October 2, the American Health Information Management Association (AHIMA) posted three new practice briefs related to ICD-10 on its Web site. Click on “All current practice briefs in chronological order by publication date, and then access the three briefs:

• ICD-10-CM/PCS Project Management Resources
• Transitioning ICD-10-CM/PCS Data Management Processes
• Planning Organizational Transition to ICD-10-CM/PCS

It can be a challenge sifting through all the ICD-10 information out on the Web these days,  deciding what’s fluff and what’s not. Trust me–you don’t want to miss out on these valuable nuggets from the AHIMA. For example, consider this excerpt from the “Planning Organizational Transition to ICD-10-CM/PCS” practice brief:

The transition and post-implementation period will likely require parallel coding support. Assessing coder workload and preparing for the compliance date will assist in reducing the variability and backlog as the transition occurs. To begin planning, management can assess the potential impacts and areas of weakness by determining:

• What to communicate to the medical staff about documentation
• What companies can be subcontracted for coding and when this process should begin
• What phasing out of just-in-time ICD-9-CM coding will mean to the organization
• The best coders to assist in phasing out cases up to September 30, 2013
• Any temporary changes to time-off policies and their implications leading up to the compliance date
• If one set of coders will conduct the phase out or if each coder participates once October 1, 2013, arrives

Check out AHIMA’s implementation preparation checklist

There are a number of ICD-10 checklists floating around out there in cyberspace, but this one created by the American Health Information Management Association (AHIMA) and included in a recent CMS presentation is one of the best ones I’ve seen. The AHIMA suggests the following checklist when performing an ICD-10  impact assessment:

• Establish interdisciplinary steering committee to oversee implementation
• Educate affected departments and individuals about the change in code sets and what it meansfor their area of responsibility (both in terms of
• preparation planning and benefits)
• Assess organizational readiness for the change to the ICD-10 code set
• Assess impact of change on organizational operations
• Assess staff education needs
• Identify reports and forms requiring modification (e.g., physician practice superbill)
• Assess extent of changes to systems, processes, policies/procedures
• Use code set change as opportunity to improve data flow, work flows, and processes
• Perform comprehensive systems audit for ICD-10 compatibility
• Determine vendor readiness and timeline for upgrading software to new code sets
• Assess quality of medical record documentation and implement documentation improvement program if necessary
• Develop implementation budget

But it’s good to look at this checklist as a skeleton upon which to build your own impact assessment because it’s easy to see how each one of these bullets could have its own subset of smaller checklists. Do you have a checklist you would like to share? Post a comment, your checklist, or the Web link to the checklist so we can all take a look!

AAPC opposes ICD-9 freeze prior to ICD-10 implementation

On its Web site, the American Academy of Professional Coders (AAPC) states that it does not support a freeze to ICD-9-CM coding updates prior to the October 1, 2013 implementation of ICD-10.

In a statement directed to members of the ICD-9-CM Coordination and Maintenance Committee, which met in Baltimore September 16 and 17, the AAPC stated that because medical science is continually evolving, the committee should limit any suspension of updates to diagnostic coding so it does not affect reporting accuracy.

However, the association does support a freeze to changes to ICD-10-CM and ICD-10-PCS beginning October 1, 2012. According to the AAPC statement:

Because all users will be setting up entirely new systems to accommodate ICD-10-CM and ICD-10-PCS in the year(s) prior to implementation, AAPC supports a freeze on changes to the ICD-10-CM and ICD-10-PCS code sets beginning Oct. 1, 2012 (one year prior to implementation) and continuing until Oct. 1, 2014 (one year following implementation). This will provide a 24-month hiatus from any changes to the new system, which will ease the burden of adoption for all participants.

What do you think about a potential code freeze? Would it help or hurt? Post a comment on ICD-10 Watch!

Do you have an ICD-10 tale to tell?

Although the U.S. healthcare community is bracing themselves for this massive switch to ICD-10 in 2013, many other countries have already been through it. For example, providers in Canada transitioned to ICD-10 in 2001. Are you a vendor, payer, provider, or other expert who experienced the transition to ICD-10 in Canada? We want to hear your story! What are your lessons learned, and what steps did you take to ensure a successful transition to this new coding system? Interested in sharing your experience with our ICD-10 Watch community? Please e-mail me at dbentley@hcpro.com.

CMS posts slide presentation explaining MS-DRG conversion project

I was poking around the CMS Web site today, in the ICD-10 section of course, and I noticed a brand new page devoted to the ICD-10 MS-DRG Conversion Project. While I’ve heard different CMS representatives discuss this conversion the agency has been working on for many months now, this page provides a great deal of specifics, including a slide presentation dated September 16, which details the project and a number of what it refers to as “resolved issues.”

In this section, you’ll also find a document that describes how CMS got to this point in the MS-DRG Conversion Project. The document states:

The project was an exercise to evaluate the effectiveness of the General Equivalence Mappings (GEMs) and to learn how best to use them in converting data. The GEMs are a tool that assist in converting ICD-9-CM codes to the relevant ICD-10-CM/PCS codes (forward mapping) and ICD-10-CM/PCS codes back to the relevant ICD-9-CM codes (backward mapping). The GEMs were developed to assist CMS as well as all other data users who would need to convert ICD-9-CM data or payment systems to ICD-10-CM/PCS codes.

CMS also provides the draft ICD-10-CM/PCS MS-DRG V26 Definitions Manual in the downloads section in both text and HTML versions with condensed and full title formats.

Final ICD-10 MS-DRG logic will be subject to rulemaking.

Two timelines plot out progress toward ICD-10 and 5010

The thought of sitting down and creating an ICD-10 transition timeline from scratch can be daunting. If you want some inspiration, check out these two timelines that are posted on the North Carolina Healthcare Information and Communication Alliance (NCHICA), Inc. Web site.

These timelines were discussed at the 17th National HIPAA Summit last week in Washington, DC, during a presentation given by Stanley Nachimson, principal at Nachimson Advisors, LLC,  in Resterstown, MD, and director of the WEDI-NCHICA Timeline Project, and a former senior advisor for HIT at CMS.

• ICD-10 timeline
• HIPAA 5010 timeline

Nachimson stressed that software vendors, payers, and providers all need to take an active role in planning for the transition to HIPAA 5010.

“The key is to take a look at how your business is going to have to change,” Nachimson said during the presentation. “It makes no sense to wait for the vendor to figure out how [the transition to HIPAA 5010] is going to impact your business. Look at the changes now, and make sure your vendors support these necessary changes.”

He said that providers should have already completed their impact assessment when it comes to ICD-10, adding that most will be amazed at the number of functions that the switch to ICD-10 will affect.

“You need to be able to report the codes, but you also have to have the right documentation to support the ICD-10 codes, so you have to think of other processes that must also change,” he said. “If you haven’t started planning, you’re already behind the curve.”