ICD 10 Training

7 Tips for a Less Stressful ICD-10 Transition

<div dir="ltr" style="text-align: left;" trbidi="on">
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR8qMR02Q1QMHtctjXvvXPTIkjt4QA_TDnX_f8oFx3k7GHk3V-4skpPmwqDnosgos48ZSAAWdmvy5sACgQxW1lziFLAKyWx87g_NOnLWW4SEfytb5Nrx8tPJKV6COb4Wum7xhl_plMuw/s1600/icd-10-Transition.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto; text-align: justify;"><img alt="ICD-10 Transition" border="0" height="145" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR8qMR02Q1QMHtctjXvvXPTIkjt4QA_TDnX_f8oFx3k7GHk3V-4skpPmwqDnosgos48ZSAAWdmvy5sACgQxW1lziFLAKyWx87g_NOnLWW4SEfytb5Nrx8tPJKV6COb4Wum7xhl_plMuw/s320/icd-10-Transition.jpg" title="ICD-10 Transition" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>ICD-10 Transition</b></td></tr>
</tbody></table>
<br />
<div style="text-align: justify;">
<b>1. Know what is required.</b> The version of ICD-10 being adopted in the United States is not the same as in other countries. While the World Health Organization collaborated with the U.S. on a specific version for our country, it is not the same as the WHO version used in other countries. If vendors say they are ready for ICD-10 because they downloaded it from the WHO site, they are incorrect. You need ICD-10 PCS for procedure coding, billing of inpatient procedures and reimbursement.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>2. Improve physician documentation.</b> Physicians will need to improve clinical documentation on the front end. It will be a much more onerous task for coders to go back and retrieve information they were not provided with originally. Engage medical leadership now and have them strive for more thorough, detailed and complete documentation to ensure a smoother transition.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>3. Thoroughly communicate.</b> Share your ICD-10 code interpretation from testing with colleagues to minimize confusion and miscommunication. Involving all the necessary people and thoroughly communicating will cut down on problems once the new system goes lives.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>4. Check your EHRs compatibility.</b> If you already have a certified electronic health record system, make sure the ICD-10 upgrade is covered in your contract. Here are some questions to ask your vendor about options and pricing.</div>
<br />
<ul style="text-align: left;">
<li style="text-align: justify;">Will there be additional costs to accommodate ICD-10 codes?</li>
<li style="text-align: justify;">Will my contract need to be modified to include ICD-10 codes? What are the terms? </li>
<li style="text-align: justify;">Will my system be ICD-10 ready by 2013 so I can begin ICD-10 testing? </li>
<li style="text-align: justify;">What level of customer support and training is offered? Are those costs included in the contract?</li>
</ul>
<br />
<div style="text-align: justify;">
<b>5. Consult with decision makers in your organization. </b>Any big changes in a healthcare organization will require involvement from all levels of personnel. It's crucial to have executive decision-makers on board to affect any change. Have all necessary people involved from the start to ensure the smoothest, most cost-effective transition. Get their feedback and make sure it's incorporated as much as possible.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>6. Think about education and training now.</b> Despite the implementation deadline extension, don't put off employee training. Experts suggest starting education now and working with coders in small increments. Physicians will also need to change the way they document procedures. Starting now can help them slowly adjust until 2014.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>7. Prepare for initial glitches.</b> Expect that not everyone will be ready by the implementation date of October 2014, including vendors or payors. Prepare to have to use ICD-9 and ICD-10 simultaneously at first until all parties have completely transitioned. </div>
</div>

7 Tips for a Less Stressful ICD-10 Transition

ICD-10 Transition 1. Know what is required. The version of ICD-10 being adopted in the United States is not the same as in other countries. While the World Health Organization collaborated with the U.S. on a specific version for our country, it is n…

Practice Makes Perfect When It Comes to ICD-10

9:12 PM Deepak Rupnar 0

<div dir="ltr" style="text-align: left;" trbidi="on">
Though the implementation deadline delay for ICD-10 came as a disappointment to health information professionals, it may actually be a blessing in disguise. This extra year provides HIM and other industry professionals with a window of opportunity to perfect one’s ICD-10 skills.<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
According to AHIMA’s 2011 ICD-10-CM/PCS Transition: Planning and Preparation Checklist, “Hospital inpatient coding staff will require an estimated 50 hours of ICD-10 education because they will need to learn both ICD-10-CM and ICD-10-PCS.” CMS cited these same numbers in the proposed “HIPAA Administrative Simplification: Modifications to Medical Data Code Set Standards to Adopt ICD-10-CM and ICD-10-PCS” published January 16, 2009 in the Federal Register.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">Training is Not Enough</span></b></div>
<div style="text-align: justify;">
Many vendors are using this 50-hour inpatient training benchmark as the foundation for their ICD-10 training programs. However, training is not enough. Training teaches key concepts in ICD-10-CM and ICD-10-PCS. It does not teach a coder the application of these concepts to the ongoing coding of actual or simulated cases. That comes with practice.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
In order to become expert coders, HIM professionals will need to practice coding records as a part of weekly coding activities until ICD-10 is implemented. This practice should be planned and scheduled to ensure all coders have the opportunity to perfect their skills over the next 24 months.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>Coding managers have three options to provide this ongoing practice:</b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
    Option 1: Create a library of the facility’s records</div>
<div style="text-align: justify;">
    Option 2: Require the coders to perform parallel coding</div>
<div style="text-align: justify;">
    Option 3: Use a vendor’s practice tools</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">Vetting the Practice Options</span></b></div>
<div style="text-align: justify;">
Option 3 is the most cost-effective choice because it capitalizes on practice materials created and vetted by a vendor already proficient in ICD-10. When contracting with a vendor, the coding manager needs to ensure there is a significant number of inpatient and outpatient practice records encompassing the entire classification.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
The simulated records should be available through a web-based library or online practice module available to staff when they need them. The coding manager should verify the vendor’s solution provides access to each coder’s cases so the manager can identify areas of continuing weakness for each coder.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
One of the benefits of selecting option 3 is easy access to a library of simulated records or online practice modules and immediate feedback to coders as they are practicing. Another benefit is the coder will be more productive because the simulated records are structured to provide only documentation pertinent to coding the cases. The negative aspect is the vendor library cases are not formatted the same as the facility’s records.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>Option 1</b> can be achieved by a coding manager skilled in ICD-10 selecting ICD-9 coded cases, and then re-coding them in ICD-10 and creating a library of records with an answer key. For inpatient cases this may require 30 to 45 minutes per record.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Outpatient records may require 20 to 30 minutes per record. It is recommended that codes from all chapters of ICD-10-CM and the 31 root operations of ICD-10-PCS are included in the library. Case selections should include inpatient and outpatient cases. The coding staff can then code these cases in ICD-10 and compare their code assignments to the answer key.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>With option 2</b>, the coders can assign codes in ICD-10 at the same time as they are coding the record in ICD-9 for billing purposes. It is beneficial to have available a list of diagnoses and procedures including all chapters of ICD-10-CM and all root operations in ICD-10-PCS. A coding manager will need to check the ICD-10 code assignments and provide feedback regarding incorrect ICD-10 code assignments.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
The main benefit of selecting either option 1 or 2 is that the coder will be working with their own facility’s documentation. A negative aspect of option 1 is the considerable investment of time by the coding manager to select the records, code them in ICD-10, and create an answer key.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
A negative aspect of option 2 is, again, the time commitment by the coding manager to check all records coded in ICD-10 and provide feedback to the coders. These two options require the coding manager have expertise in ICD-10; otherwise, the coders could receive incorrect feedback on the coding of certain diagnoses or procedures.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
The coding manager should do a cost/benefit analysis of each of the three options in order to determine the most cost-effective option—the one producing the greatest results.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">Practice Now, Save Productivity Later</span></b></div>
<div style="text-align: justify;">
Another aspect to consider when deciding to provide the coding staff the opportunity for ongoing practice is productivity. Estimates of 20 to 50 percent reduction in coder productivity are documented in numerous articles regarding ICD-10 implementation. If the coding manager provides time for ongoing practice prior to the ICD-10 implementation, the impact on unbilled days in A/R due to loss of productivity will be greatly reduced.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Any one of these three options will provide the coding manager with the tools to support the coding staff in their ongoing development of <span class="Apple-style-span" style="font-weight: bold;">ICD-10 coding skills</span>. Once the choice is made, the manager needs to commit time on a weekly basis to practice, practice, practice.</div>
<br /></div>

icd 10 codes ICD 10 Training ICD 10 Updates ICD-10 coding skills Practice Makes Perfect When It Comes to ICD-10

Though the implementation deadline delay for ICD-10 came as a disappointment to health information professionals, it may actually be a blessing in disguise. This extra year provides HIM and other industry professionals with a window of opportunity t…

ICD-10 News: Improving Clinical Documentation

8:30 PM Unknown 0

<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div style="text-align: justify;">
<span class="Apple-style-span" style="font-size: large;">Simple Steps to Improve Clinical Documentation</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
On October 1, 2014, your practice and the clearinghouses, payers, and billing companies that you work with will need to use <span class="Apple-style-span" style="font-weight: bold;">ICD-10 codes.</span> One way to help your practice prepare for ICD-10 is to work on improving how you document your clinical services. This will help you and your coding staff become more accustomed to the specific, detailed clinical documentation needed to assign ICD-10 codes.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Take a look at documentation for the most often used codes in your practice, and work with your coding staff to determine if the documentation would be specific and detailed enough to select the best ICD-10 codes. For example, laterality is expanded in ICD-10-CM. Therefore, clinical documentation for diagnoses should include information on which side of the body is affected (i.e., right, left, or bilateral).</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Below are additional examples of the specific information needed to accurately code the following common diagnoses:</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-style-span" style="font-weight: bold;">Diabetes Mellitus:</span></div>
<br />
<ul style="text-align: left;">
<li style="text-align: justify;">Type of diabetes</li>
<li style="text-align: justify;">Body system affected</li>
<li style="text-align: justify;">Complication or manifestation</li>
<li style="text-align: justify;">If type 2 diabetes, long-term insulin use</li>
</ul>
<br />
<div style="text-align: justify;">
<span class="Apple-style-span" style="font-weight: bold;">Fractures:</span></div>
<br />
<ul style="text-align: left;">
<li style="text-align: justify;">Site</li>
<li style="text-align: justify;">Laterality</li>
<li style="text-align: justify;">Type</li>
<li style="text-align: justify;">Location</li>
</ul>
<br />
<div style="text-align: justify;">
<span class="Apple-style-span" style="font-weight: bold;">Injuries:</span></div>
<br />
<ul style="text-align: left;">
<li style="text-align: justify;"><span class="Apple-style-span" style="font-weight: bold;">External cause</span> – Provide the cause of the injury; when meeting with patients, ask and document “how” the injury happened.</li>
<li style="text-align: justify;"><span class="Apple-style-span" style="font-weight: bold;">Place of occurrence</span> – Document where the patient was when the injury occurred; for example, include if the patient was at home, at work, in the car, etc.</li>
<li style="text-align: justify;"><span class="Apple-style-span" style="font-weight: bold;">Activity cod</span>e – Describe what the patient was doing at the time of the injury; for example, was he or she playing a sport or using a tool?  </li>
<li style="text-align: justify;"><span class="Apple-style-span" style="font-weight: bold;">External cause status</span> – Indicate if the injury was related to military, work, or other.</li>
</ul>
<br />
<div style="text-align: justify;">
Remember, ICD-10 will not affect the way you provide patient care. It will just be important to make your documentation as detailed as possible since ICD-10 gives more specific choices for coding diagnoses. This information is likely already being shared by the patient during your visit—it’s just a matter of recording it for your coding staff. Good documentation will also help reduce the need to follow-up on submitted claims—saving you time and money.</div>
</div>

icd 10 codes ICD 10 Updates ICD-10 News Improving Clinical Documentation Steps to Improve Clinical Documentation ICD-10 News: Improving Clinical Documentation

Simple Steps to Improve Clinical Documentation On October 1, 2014, your practice and the clearinghouses, payers, and billing companies that you work with will need to use ICD-10 codes. One way to help your practice prepare for ICD-10 is to work on i…

Why you need to do more than convert ICD-10 codeso-more-convert-icd-10-codes

9:06 PM Unknown 0

<div dir="ltr" style="text-align: left;" trbidi="on">
The coming <b>ICD-10 transition</b> is about more than converting ICD-9 codes to ICD-10 codes. In many cases, this means changing workflow.<br /><br />John Halamka, Chief Information Officer of Beth Israel Deaconess Medical Center, outlines how he wants to change how clinical documentation is captured at the hospital. And it involves more than capturing more detail.<br /><br />What's interesting is that Halamka outlines a problem with clinical documentation that has nothing to do with medical codes. It's a problem based upon legibility and collaboration. The solution isn't just an electronic health record (EHR). He wants a "daily note" that's created and shared on a Facebook-like app. All the data on a patient is collected and locked into  a daily record by a physician. To make this happen, Halamaka breaks down the solution into five pieces:<br />
<ul style="text-align: left;">
<li>"Disease specific templates"</li>
<li>"Technology to capture free text and populate the templates i.e. my Wikipedia/Facebook concept describe above."</li>
<li>"Natural language processing to codify SNOMED-CT concepts"</li>
<li>"Mapping of SNOMED-CT concepts to ICD10 codes"</li>
<li>"Rules to ensure documentation is complete enough to justify the ICD10 codes"</li>
</ul>
<a href="http://www.icd10watch.com/blog/why-you-need-do-more-convert-icd-10-codes" rel="nofollow" target="_blank">Read full Article </a><br />
<div style="text-align: left;">
</div>
</div>

Why you need to do more than convert ICD-10 codeso-more-convert-icd-10-codes

icd 10 codes ICD 10 latest Articles ICD 10 Updates ICD-10 codes ICD-10 transition Why you need to do more than convert ICD-10 codeso-more-convert-icd-10-codes

The coming ICD-10 transition is about more than converting ICD-9 codes to ICD-10 codes. In many cases, this means changing workflow.John Halamka, Chief Information Officer of Beth Israel Deaconess Medical Center, outlines how he wants to change how …

Three action steps for ICD-10 implementation

1:54 AM Unknown 0

<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
With the compliance date for ICD-10-CM/PCS implementation finally set in stone, all that's left to do is plan, plan, and execute plans. To help you, we asked Deborah <b>Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, COBGC, CPCD, CCS-P, CDIP,</b> senior manager at Blue and Company in Indianapolis, an industry expert on ICD-10, for preparation tips and action steps for ICD-10 implementation.<br /><br /><b>Keep stakeholders informed of ICD-10 progress</b><br /><br />You have an ICD-10 steering committee and have set subcommittees. That's great. But are they active enough? Are they communicating with the true stakeholders?<br /><br />"In talking to many HIM directors, what I am finding is that these committees and subcommittees aren't always as active as they need to be," Grider says. "They need to stay engaged. Some hospitals have gotten together their stakeholders only once, and some others are doing a little bit but not really following key steps and following through."<br /><br />Keep your ICD-10 committees active and busy, meeting at least once a month. Help everyone understand the role of the steering committee.<br /><br />"They're the ones that are going to be driving ICD-10 implementation," Grider says. "That steering committee is in charge, and that committee's chair has to make final decisions and lead the implementation process. I don't think enough people understand what their true roles are."<br /><br />Stakeholders need to know that ICD-10 implementation doesn't just involve coding or information technology (IT). Your board of directors ultimately "holds the purse strings," Grider says, so educate the board as much as possible about what's involved and where your team is in the process.<br /><br /><b>Who's on the steering committee?</b><br /><br />Typically, the CFO is the chairperson since he or she drives the organization's dollars and has to approve spending. HIM directors and the information systems director form a solid comanaging team for the steering committee and project management. If that doesn't work at your organization, a consultant who project manages ICD-10 implementation may be helpful for those who have the budget for one.<br /><br /><b>Include staff from the following departments on a steering committee:</b><br /><br /><b>You'll also want to include the chief medical officer, physicians, and physician champions.</b><br /><br />As for subcommittees, organizations can choose, for instance, to have the radiology department manager head the communication committee. Staff members who don't serve on the steering committee can sit on these subcommittees.<br /><br /><b>Grider says organizations may want to set up these types of subcommittees:</b></div>
<ul style="text-align: justify;">
<li>Budget (allocating funds)</li>
<li>Forms (developing orders and templates in the EHR that may need to be changed, or tweaking paper orders)</li>
<li>Education (determining focus areas and training dates)</li>
<li>IT (assessing impact on all current systems)</li>
<li>Communication (developing and executing the communication plan)</li>
</ul>
<div style="text-align: justify;">
<b>Conduct monthly steering committee meetings</b><br /><br /><b>How should you run an effective steering committee meeting?</b><br /><br />First, there needs to be a clear agenda, Grider says. "I always like to start with what's going on with ICD-10 in the industry," she says. "Talk about what the AMA is up to and what the industry is talking about. It's the project manager's responsibility to find out and keep up."<br /><br />Stress that the meeting is mandatory and not optional. Failure to do so could result in a slow death of the committee itself.<br /><br />Some members may just not show, "and that's the best way to kill this whole process and kill the committee quickly," Grider says. "It's a good idea to create the meeting well in advance."<br /><br />Take minutes at each meeting, and review all action items from the prior meeting's minutes. If Mary Smith was identified as establishing the framework for an education plan at one meeting, have Mary Smith describe her efforts in that regard during the subsequent meeting.<br /><br />Review project plan timelines and next-meeting items. Leave a slot on the agenda for the steering committee chairperson to review the budget.<br /><b><br />"Always have a budget review," Grider says. "Each meeting should be fairly consistent."</b><br /><br /><b>Complete impact assessment and identify all areas/departments and systems affected</b><br /><br />Have you thought about sending out a survey to get the pulse of department systems and processes? You may not want to, Grider says, because you may never get the results back or it may take too long to get a response. Instead, create an interview schedule and meet with each department head for 20 or 30 minutes. Go over work flow, how staff use codes, and what reports and systems they use. Find out whether their documentation is effective.<br /><br />"From all your questions, more questions can evolve," Grider says. "We've found systems and process issues that could have been a compliance or Joint Commission issue and were able to fix them by interviewing department heads."<br /><br />Through the interviews, you'll be able to collect information on all the systems and software on which your organization operates. You'll be able to determine which departments see patients, who is responsible for checking patients into the facility, what type of orders the physician provides, whether the orders and the applicable codes assigned meet medical necessity, and how these various processes are carried out. You'll gather information about scheduling and whether the facility uses electronic forms or paper within their various workflows.<br /><br />Collect all the information from the interviews and develop summaries for each department. You may learn in these types of impact assessments that one department performs services without a physician order and one follows up to ensure a physician order came through. Create a list of all software and records which departments use in their operations. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Source: <span style="font-size: xx-small;">http://www.hcpro.com/HOM-287459-6962/Three-action-steps-for-ICD10-implementation.html</span></div>
</div>

Three action steps for ICD-10 implementation

icd 10 codes ICD 10 Updates ICD-10 implementation icd-10 implementation date cms icd-10 implementation project plan icd-10 implementation training steps for icd-10 implementation Three action steps for ICD-10 implementation

With the compliance date for ICD-10-CM/PCS implementation finally set in stone, all that's left to do is plan, plan, and execute plans. To help you, we asked Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, COBGC, CPCD, CCS-P, CDIP, senior mana…

ICD-10-PCS: Multiple Procedures with Same Root Operation, Different Body Part

1:39 AM Unknown 0

<div dir="ltr" style="text-align: left;" trbidi="on">
<div style="text-align: justify;">
The multiple procedure guidelines in ICD-10-PCS present possibilities for coder confusion. Several guidelines relate to the coding of multiple procedures, some under the heading of multiple procedures and others dispersed throughout the various root operation guidelines.<br /><br />One ICD-10-PCS multiple procedure guideline states coders can report multiple procedures when the same root operation is performed on different body parts as defined by distinct values of the body part character.<br /><br />Coders build an ICD-10-PCS code by using a ‘table’ format that will allow them to construct multiple codes from a single table. In some cases, coders can construct more than 200 possible codes from a single table.<br /><br />Within the various sections of ICD-10-PCS, each character of the seven-character alphanumeric code identifies ‘specific’ or ‘general’ values.<br /><br />In the Medical &Surgical section, if separate body part (character 4) values exist, then coders must report multiple codes.<br /><br />For example, if a physician performed an open total abdominal hysterectomy (removing both the uterus and the cervix), we would look at root operation Resection (cutting out or off, without replacement, all of a body part) in the alphabetic index. This leads us to table 0UT-.<br /><br />Character 4 contains ‘separate’ character values for the uterus (9) and the cervix (C). Therefore, in order to report the procedure we would need to report two codes:<br /><br /><span style="background-color: yellow;"><span style="color: red;">    0UT90ZZ<br />    0UTC0ZZ</span></span><br /><br />Also, if the physician removed tubes and ovaries, we would report additional codes for this procedure.</div>
</div>

ICD-10-PCS: Multiple Procedures with Same Root Operation, Different Body Part

ICD 10 latest Articles icd 10 pcs reference manual ICD 10 Training ICD 10 Updates ICD-10-PCS icd-10-pcs code structure ICD-10-PCS: Multiple Procedures with Same Root Operation, Different Body Part

The multiple procedure guidelines in ICD-10-PCS present possibilities for coder confusion. Several guidelines relate to the coding of multiple procedures, some under the heading of multiple procedures and others dispersed throughout the various root…