All Entries in the "Plan for implementation" Category
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:
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.
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.
Part 3: One coder shares list of cost-effective ICD-10 resources
Looking back a year later, I now feel relatively confident in my background knowledge of ICD-10. And I did not spend any money. Read more in Part 1 and Part 2 of this blog post about my cost-effective strategy to learn about ICD-10.
As soon as I know whether there will be a freeze date, I will make plans to create/update my own personal coding references and training materials accordingly.
One possible expenditure I would recommend would be the purchase of the American Health Information Management Association’s (AHIMA) practice exercise text on ICD-10, which is based on the 2009 code set and guidelines, and you can also take the proficiency assessments for validation of your self-education efforts.
I’m not too concerned about the possibility of the ICD-10 code set changing again a couple more times because I would just update the current desktop files that I use and just know that a few of the codes in the answers in the AHIMA text I reference above may be outdated. These potential changes will not significantly hamper your studies to the point that it would be worth purchasing an updated text. My personal plan is to not make any significant expenditures until I know about whether CMS will impose a code freeze.
So bottom line, you already know ICD-9 and the general coding conventions and guidelines, so it’s just a matter of understanding the differences in those guidelines and conventions in ICD-10 (Find out by reading the ICD-10-CM official guidelines and the ICD-10-PCS official guidelines found in Appendix B of the Reference manual.) and then download the files (one for the PCS and the index and tabular for ICD-10-CM) and start coding in ICd-10 what you code daily for practice.
If you need extra support and don’t have access to real patient records, then use AHIMA’s textbooks and/or create your own training materials. The textbooks on ICD-10 are the same books that the AHIMA will use in the Train the Trainer sessions. Yes, the AHIMA’s sessions will also have training slide presentations, but you can train your staff by just sitting down and coding your hospital records in ICD-10.
Because the AHIMA has copyrighted their training materials and slide presentations, you can’t take them back to your facility or school and incorporate them into your programs. When the question was raised in the Assembly on Education community of practice (member’s only discussion board) regarding whether the AHIMA’s training materials that attendees receive at the Train the Trainer programs could be used freely for any other setting or for any other entity even within your own organization, the AHIMA clarified that the training materials (e.g., Coding Training Manual with Exercises) are copyrighted and cannot be used internally or for any other purpose. Any entity that you teach using these materials must purchase multiple sets of these training materials at a bulk rate discount.
Familiarize yourself with ICD-10 by reviewing the following free information that I compiled. You will find overlap for some of the information, but one thing you will not want to miss is the AHIMAs’ field test project done in 2003 for ICD-10. Consider my list of must-have resources:
- AHIMA’s ICD-10 page: Includes a list of all the CodeWrite issues with the ICD-10 checkpoints in them as well as other articles on ICD-10)
- AHA ICD-10 resources
- AAPC’s Web site on ICD-10
- CMS’ conference calls on ICD-10: I listened to calls from 2008 and 2009, reviewed the presentations and transcripts, and even wrote up a summary on one of the latest 2009 calls
- Excellent article on ICD-10-CM: I used this article to get my first introduction to ICD-10-CM
- Excellent article on ICD-10-PCS: I used this article for a school paper on ICD-10-PCS
- ICD-10 Coding Corner: This has multiple coding scenarios that you can practice with for free, with answers from ICD-10-CM and ICD-10-PCS.
- International Federation of Health Records Organizations’ (IFHRO) international training on ICD-10 sponsored by AHIMA Foundation Of Research and Education
- Also, be on the lookout for local AHIMA chapter training programs or local AMA/AHA training programs or local Medicare contractor training programs.
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.
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.”
3M releases ICD-10 code translation tool
On September 16, 3M Health Information Systems announced that it had released the 3M™ ICD-10 Code Translation Tool, a new software application that helps convert ICD-9 based applications to ICD-10. The software assists providers and payers in translating ICD-9 codes from existing information systems into the language of ICD-10.
“Since patient care, revenue cycle, quality and coding functions must continue during the transition, it’s essential that organizations have a comprehensive strategy for converting existing ICD-9 applications to ICD-10 based applications,” said Tom Anastasio, senior vice president of provider markets for 3M Health Information Systems. “Translating systems, reports and records—any application where ICD-9 codes are used—will provide critical information that providers and payers can use immediately to educate staff, update processes, and prepare for a successful ICD-10 implementation.”
The 3M ICD-10 Code Translation Tool can be used to convert existing systems and software applications to ICD-10, or to create customized mappings for specific business needs. The 3M ICD-10 Code Translation Tool identifies all reasonable ICD-10 alternatives for the ICD-9 codes held in an information system, and performs automated mappings where a simple one-to-one map exists. The software then isolates the remaining complex codes and provides the user with reference data to assist in fine-tuning the final conversions to ICD-10.
Under contract with CMS, 3M developed the ICD-10 Procedure Coding System (PCS) and the General Equivalence Mappings (GEMs), and produced the initial conversion of MS-DRGs to ICD-10.
Learn more about the ICD-10 Code Translation tool by accessing the 3M Web site.
