ICD 10 Training: ICD 10 latest Articles

Getting Ready for ICD-10’s Impact on Meaningful Use

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<b>Stage 2 of the electronic health records 
meaningful use program begins in October 2013 for hospitals and January 
2014 for eligible professionals, and right after that comes the October 
2014 compliance date for the ICD-10 code sets. A session during the 
ICD-10 Symposium on March 3 before HIMSS13 in New Orleans, “ICD-10 and 
Meaningful Use: When Worlds Collide,” will explore the coming 
convergence of the two initiatives.</b></div>
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ICD-10 by itself will be a major challenge for all stakeholders, but 
those participating in meaningful use also will face a transition in 
diagnostic-driven meaningful use quality measures from ICD-9 to ICD-10, 
says Stephen Spain, M.D., the session presenter, a practicing family 
physician and CEO at Doc-U-Chart, a Tyler, Texas-based consulting firm.</div>
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That means changing the coding and documentation of quality measures 
in the meaningful use program, possibly sometime during Stage 2 but 
certainly by Stage 3.  Unlike changes to the HIPAA financial and 
administrative transactions, providers cannot assume their vendors will 
do most of the work to be ready for ICD-10, Spain warns. If an EHR 
system isn’t properly documenting with ICD-10 when required under 
meaningful use, achieving meaningful isn’t going to happen. For now, 
providers should ensure that coders and clinicians are well represented 
on teams to prepare for ICD-10 and meaningful use preparation, as well 
as overseeing vendor performance. “You can’t count on your EHR vendor to
 make sure all the processes are done and work properly, he adds.”</div>
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As ICD-10 progresses, there will be guidance developed to help 
providers navigate the necessary tweaks to their meaningful use 
programs, Spain says. The National Quality Forum, for instance is 
reviewing meaningful use criteria to assess the needed changes. And 
medical specialty societies are working to update their quality measures
 to support the coming convergence of meaningful use and ICD-10, 
including deciding which of competing codes within ICD-10 would be the 
most appropriate to measure.</div>

Stage 2 of the electronic health records meaningful use program begins in October 2013 for hospitals and January 2014 for eligible profe...

ICD-10 Spotlight: Know the codes (Coding Convention/Guideline: Excludes1 and Excludes2, and Borderline Diagnosis Codes)

4:08 AM Unknown 1

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Each month, AmeriHealth will feature an example of how ICD-9 codes will translate to ICD-10 codes. We will present coding examples from different specialties and popular disease categories to demonstrate the granularity that the new ICD-10 code set will provide.<br />
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<b><i>CODING CONVENTION/GUIDELINE</i></b>: <b>Excludes1 and Excludes2, and Borderline Diagnosis Codes</b></div>
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<b><br /></b></div>
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Similar to ICD-9, there are coding conventions, general guidelines, and chapter-specific guidelines in ICD-10. These conventions and guidelines are rules and instructions that must be followed to classify and assign the most appropriate code. As with ICD-9, adherence to these guidelines is required under the Health Insurance Portability and Accountability Act (HIPAA). Many of the conventions and guidelines in ICD-9 are the same in ICD-10. This article will focus on a new Coding Convention: Excludes1 and Excludes2, and a new General Coding Guideline: Borderline Diagnosis Codes.</div>
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Excludes1 and Excludes2</div>
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As in ICD-9, a variety of notes appear in both the Alphabetic Index and Tabular List of ICD-10. These types of notes consist of inclusion notes, excludes notes, code first notes, use additional code notes, and cross reference notes. ICD-10 incorporates two types of excludes notes: Excludes1 and Excludes2. Each type of note has a different definition for use but are similar in that they indicate codes excluded from each other are independent of each other.<br />
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EXCLUDES1</div>
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<ul>A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" It corresponds with what the current ICD-9 Excludes note indicates. An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 note is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.</ul>
<ul><b>K51.4 - Inflammatory polyps of colon</b><br /><b><br /></b>
<b><i>EXCLUDES1:</i></b><br />
<ul type="disc">
<li>adenomatous polyp of colon (D12.6)</li>
<li>polyposis of colon (D12.6)</li>
<li>polyps of colon NOS (K63.5)</li>
</ul>
</ul>
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<b>EXCLUDES2</b></div>
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<ul>A type 2 Excludes note represents "Not included here." An Excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.<br /><b>J37.1 - Chronic laryngotracheitis</b><br />
<b><i>EXCLUDES2:</i></b><br />
<ul type="disc">
<li>acute laryngotracheitis (J04.2)</li>
<li>acute tracheitis (J04.1)</li>
</ul>
</ul>
<div class="subhead2">
<i><b>Borderline Diagnosis*</b></i></div>
<div class="subhead2">
<i><b><br /></b></i></div>
If the provider documents a "borderline" diagnosis at the time of discharge, the diagnosis is coded as confirmed, unless the classification provides a specific entry. If a borderline condition has a specific index entry in ICD-10, it should be coded as such. Since borderline conditions are not uncertain diagnoses, no distinction is made between the care setting (inpatient versus outpatient).<br />
<br />
<b><i>Examples of Specific Borderline Entries:</i></b><br />
<ul type="disc">
<li><b>F60.3</b> Borderline personality disorder</li>
<li><b>R41.83</b> Borderline intellectual functioning</li>
<li><b>H40.021</b> Open angle with borderline findings, high-risk, right eye</li>
</ul>
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For additional information related to the AmeriHealth transition to ICD-10, please visit the <a href="http://www.amerihealth.com/icd10" rel="nofollow">ICD-10</a>section of our website. On this site you will also find other examples of how ICD-9 codes will translate to ICD-10 codes in the <a href="http://www.amerihealth.com/pdfs/providers/claims_and_billing/icd_10/icd_10_spotlight_ah.pdf" rel="nofollow">ICD-10 Spotlight: Know the Codes </a>booklet<span style="font-family: Arial;">.</span></div>
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</tbody></table>
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ICD-10 Spotlight: Know the codes (Coding Convention/Guideline: Excludes1 and Excludes2, and Borderline Diagnosis Codes)

icd 10 codes ICD 10 latest Articles ICD 10 Training ICD 10 Updates ICD-10 codes ICD-10 coding skills ICD-10 Spotlight: Know the codes (Coding Convention/Guideline: Excludes1 and Excludes2, and Borderline Diagnosis Codes)

Each month, AmeriHealth will feature an example of how ICD-9 codes will translate to ICD-10 codes. We will present coding examples from di...

Putting ICD-10 into Practice: Coding exercises and scenarios

4:03 AM Unknown 0

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The ICD-10 Spotlight: Know the codes feature that appeared throughout Partners in Health Update last year was designed to communicate various coding conventions, general guidelines, and chapter-specific guidelines in ICD-10. These conventions and guidelines are rules and instructions that must be followed to classify and assign the most appropriate code. As with ICD-9, adherence to these guidelines is required under the Health Insurance Portability and Accountability Act (HIPAA).</div>
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As announced in the January 2013 edition of Partners in Health Update, we have introduced a new feature called Putting ICD-10 into Practice: Coding exercises and scenarios. Each month this feature will help you put the new guidelines and conventions you learned about last year into practice. If needed, use the ICD-10 Spotlight: Know the codes booklet for assistance with these exercises. An answer key is provided below so you can verify if your answers are correct. In addition, a list of code narratives is included to describe each ICD-10 code.</div>
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<b><i>Coding exercises</i></b><br />
<b><i><br /></i></b>
<b><i>Code the following conditions according to ICD-10 coding conventions and guidelines:</i></b><br />
<br />
    Borderline glaucoma<br />
    Congestive heart failure due to hypertension<br />
    HIV positive status without symptom<br />
    Urinary frequency<br />
    Morbid obesity with a BMI of 42 in an adult<br />
    Congenital red cell aplastic anemia<br />
    Cleft palate involving both the soft and hard palate with bilateral cleft lip<br />
    Severe persistent asthma with acute exacerbation<br />
    Fatigue fracture of vertebra, lumbar region, and subsequent encounter for fracture with delayed healing<br />
    Interstitial cystitis due to E. coli with hematuria<br />
    Sleep-related teeth grinding<br />
    Non-conclusive HIV-test finding in infants<br />
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<b><i>Coding scenario</i></b><br />
<b><i><br /></i></b>
<b><i>Code the following scenario according to ICD-10 coding conventions and guidelines:</i></b><br />
<br />
 Jane and John Doe were shopping at the mall the day after Thanksgiving to take advantage of the sales. While rushing for the newest iPhone, John fell down the stairs. Thankfully, John sustained only minor abrasions to his right elbow.<br />
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<b>Narratives</b><br />
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The following are the corresponding code narratives for each of the ICD-10 codes in the answer key for the coding<br />
exercises and coding scenarios:<br />
<div style="text-align: left;">
<br />    H40.001: Preglaucoma, unspecified, right eye<br />    I11.0: Hypertensive heart disease with heart failure<br />    Z21: Asymptomatic human immunodeficiency virus [HIV] infection status<br />    R35.0: Frequency of micturition<br />    E66.01: Morbid (severe) obesity due to excess calories<br />    Z68.41: Body mass index (BMI) 40.0 – 44.9, adult<br />    D61.01: Constitutional (pure) red blood cell aplasia<br />    Q37.4: Cleft hard and soft palate with bilateral cleft lip<br />    J45.51: Severe persistent asthma with (acute) exacerbation<br />    M48.46xG: Fatigue fracture of vertebra, lumbar region, subsequent encounter for fracture with delayed healing<br />    N30.11: Interstitial cystitis (chronic) with hematuria<br />    B96.20: Unspecified Escherichia coli [E. coli] as the cause of diseases classified elsewhere<br />    G47.63: Sleep-related bruxism<br />    R75: Inconclusive laboratory evidence of human immunodeficiency virus [HIV]<br />    S50.311A: Abrasion of right elbow, initial encounter<br />    W10.9xxA: Fall (on) (from) unspecified stairs and steps, initial encounter<br />    Y92.59: Other trade areas as the place of occurrence of the external cause</div>
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For additional information related to the AmeriHealth transition to ICD-10, please visit the ICD-10 section of our website. On this site you will find examples of how ICD-9 codes will translate to ICD-10 codes in the ICD-10 Spotlight: Know the codes booklet. In addition, you will find examples of ICD-10 coding exercises and scenarios in the Putting ICD-10 into Practice: Coding exercises and scenarios booklet.<br />
<br />
<br />
<span style="font-size: x-small;">Answers to coding exercises:</span><br />
<span style="font-size: x-small;">1) H40.001 2) I11.0 3) Z21 4) R35.0 5) E66.01, Z68.41 6) D61.01 7) Q37.4 8) J45.51 9) M48.46xG 10) N30.11, B96.20 11) G47.63 12) R75</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: x-small;">Answer to coding scenario:</span><br />
<span style="font-size: x-small;">S50.311A, W10.9xxA, Y92.59</span><br />
<span style="font-size: x-small;"><br /></span>
<span style="font-size: xx-small;">Source: http://provcomm.amerihealth.com/ProvComm/ProvComm.nsf/a1bebce7a0e985578525791f006068b2/9f5ff82dcbd251bf85257b05005125a8!OpenDocument</span><br />
</div>

icd 10 codes ICD 10 latest Articles ICD 10 Updates ICD-10 codes ICD-10 coding skills Putting ICD-10 into Practice: Coding exercises and scenarios

The ICD-10 Spotlight: Know the codes feature that appeared throughout Partners in Health Update last year was designed to communicate var...

ICD-10 Impact Assessments: How ready are you to assess vendor readiness?

3:54 AM Unknown 0

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<b>At some point, you're going to have to inventory your healthcare vendors for ICD-10 readiness.</b></div>
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That means listing all the products and determining if they use ICD-9 codes. Those will be the software and equipment that need to be upgraded or replaced in order to work after Oct. 1, 2014.</div>
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<b>You're also going to have to contact the makers of those products and find out a few things:</b></div>
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<ul style="text-align: left;">
<li style="text-align: justify;">    Is this product ICD-10 compliant? (Incredibly likely not but you have to ask.)</li>
<li style="text-align: justify;">    Will this product ever  be compliant? (You're going to be surprised by how many vendors say no.)</li>
<li style="text-align: justify;">    What is your timetable to make your product(s) ICD-10 compliant?</li>
</ul>
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<b>Pretty easy, right?</b></div>
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Kerry Martin, CEO of VitalWare, says not always. VitalWare has made a business of talking to healthcare vendors about their products and reporting what it means to clients. "Everyone of those hospitals takes its inventory in whatever state it's in and gets it to us. We work with their department directors and anybody on the ICD-10 committee or task force," says Martin. "We then match it up to our master index of products."</div>
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<b>Again, sounds easy.</b></div>
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Except the healthcare industry has a pretty active history of acquisitions. One company buys another. Changes the names of products for consistent branding. Or kills the product line because they have a competing product on the market. So it's not always easy figuring out who to call.</div>
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And Martin says hospital staffs tend to have multiple names for products and systems they use. The name being used during every day practice may not be the one the vendor recognizes.</div>
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Not to mention that vendors and hospitals tend to have their own languages. So translating questions and responses add complexity to the process.</div>
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Once they know who they need to talk to and about what they need to discuss, Martin says VitalWare asks about 100 questions about the product and its development. For the free VitalVendors tool in the HIMSS ICD-10 playbook, they share five of those questions:</div>
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<br /></div>
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<ul style="text-align: left;">
<li style="text-align: justify;">    "When do you plan to start and complete your ICD-10 internal testing?"</li>
<li style="text-align: justify;">    "When do you plan to start and complete customer review and/or beta testing?"</li>
<li style="text-align: justify;">    "What is the product version of your software that will be ICD-10 compliant?"</li>
<li style="text-align: justify;">    "When do you plan to start and complete customer training on these updates?"</li>
<li style="text-align: justify;">    "What is your estimated release date for customer use/installation?"</li>
</ul>
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Martin says VitalWare has about 100 questions, and they keep asking those questions every 60 days. The vendors don't answer all those questions each time. Just the ones that have different answers since the last survey because they're making progress towards readiness.</div>
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Note that some of the questions listed focus on how the vendor plans on working with the customer. That means there's a bit more to the implementation that installing software or equipment and flipping on the switch in 2014. It's a process that needs managed.</div>
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It's not impossible for a hospital or medical practice to do this kind of work internally. But it needs time and the skills of a project manager. "Do they have the right people inside the organization to poll the vendors for the information? Do they ask the right questions.?" asks Martin. "How do they (IT personnel) know what to ask vendors? How do they know if that makes sense, if that's going to work right?"</div>
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It's tempting to say a hospital's IT department doesn't need to ask 100 questions of every vendor. But someone needs to be vigilant and monitor vendors' progress towards ICD-10 compliance. There just may be 100 questions asked by Oct. 1, 2014.</div>
</div>

icd 10 codes ICD 10 latest Articles ICD-10 implementation ICD-10 Impact Assessments: How ready are you to assess vendor readiness?

At some point, you're going to have to inventory your healthcare vendors for ICD-10 readiness. That means listing all the product...

Assembling an ICD-10 Project Team

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 Assembling an ICD-10 Project Team to oversee your organization's shift 
to ICD-10 is instrumental to a successful transition. This team will be 
responsible for overseeing the ICD-10 planning and implementation 
process.<br />
 <br />
 <strong>Select Your Team</strong><br />
 Since ICD-10 will affect nearly all areas of your practice, project 
teams should consist of representatives from key areas of your 
organization, including:  </div>
<ul>
<li style="text-align: justify;">
  Senior Management</li>
<li style="text-align: justify;">
  Health Information Management/Coding</li>
<li style="text-align: justify;">
  Billing/Finance</li>
<li style="text-align: justify;">
  Compliance</li>
<li style="text-align: justify;">
  Revenue Cycle Management</li>
<li style="text-align: justify;">
  Information Systems and Technology</li>
</ul>
<div style="text-align: justify;">
 This multi-disciplinary team provides the cooperative environment 
necessary to address your organization's needs. If you run a small 
business or practice, several of these functional areas may rest with 
the same individuals, making your transition team smaller.<br />
 <br />
 <strong>Appoint a Project Manager</strong><br />
 Once members of the project team have been selected, appoint one team 
member to serve as the project manager. As the manager, he or she will 
be responsible for establishing accountability across the ICD-10 
implementation team and making business, policy, and technical 
decisions.<br />
 <br />
 <strong>Your Team's Initial Tasks</strong><br />
 With an established project team and a designated project lead, you'll 
be ready to begin planning for ICD-10 implementation. Project teams 
should: </div>
<ul>
<li style="text-align: justify;">
  <strong>Establish regular check-in meetings to discuss progress and address any issues. <br />
  </strong></li>
<li style="text-align: justify;">
  <strong>Conduct an ICD-10 impact assessment to help you determine how the transition to ICD-10 will affect your organization</strong>, and allow you to schedule and budget for all ICD-10 activities. </li>
<li style="text-align: justify;">
  <strong>Plan a comprehensive and realistic budget.</strong> This should include costs such as software upgrades and training needs. </li>
<li style="text-align: justify;">
  <strong>Identify and ensure involvement and commitment of all internal and external stakeholders.</strong> Contact vendors, physicians, affiliated hospitals, clearinghouses, and others to determine their plans for ICD-10 transition. </li>
<li style="text-align: justify;">
  <strong>Develop and adhere to a well-defined implementation timeline</strong> that makes sense for your organization. </li>
</ul>
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 <strong>Communicate Regularly</strong><br />
 Remember to communicate regularly with your entire ICD-10 project team!
 Keeping the lines of communication open will help make sure everyone is
 kept up to date on the implementation progress. It may be helpful to 
establish and circulate a calendar of internal tasks, milestones, and 
deadlines to help keep day-to-day activities running smoothly and on 
schedule.</div>
</div>
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icd 10 codes ICD 10 latest Articles ICD 10 Training ICD 10 Updates ICD-10 implementation ICD-10 implementation in 2012 icd-10 implementation project plan Assembling an ICD-10 Project Team

Assembling an ICD-10 Project Team to oversee your organization's shift to ICD-10 i...

How to Prepare For Documentation Changes and Improvements with ICD-10

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Although the final rule on the proposed ICD-10 deadline change has not 
been published yet, it is important to continue planning for the 
transition. ICD-10 will require an increased granularity and 
specificity in documentation of patient encounters. This change will 
mean that providers and payers need to adjust how they document patient 
visits but will create more detailed data that can be used to improve 
patient care. More specific code sets can also assist providers avoid 
delays in reimbursement payments by identifying why certain claims are 
being rejected or denied by payers.<br />
<br />
<b>You will need to prepare for these changes in clinical documentation by taking certain steps:</b></div>
<ol>
<li style="text-align: justify;">
  <b>Inventory Systems and Identify Discrepancies:</b> You 
should review your systems that currently use ICD-9 in order to identify
 areas in your revenue cycle, reimbursement rates, health information 
management, electronic medical records, and clinical systems that will 
eventually use ICD-10.  These systems will be affected by the increased 
specificity of documentation as well as the increase in number of codes 
used in ICD-10. Your systems inventory will need to evaluate any 
potential gaps in clinical conditions or work flow processes that could 
be affected by increased documentation. Once you have identified any 
discrepancies, you can update and modify your systems and processes 
prior to transitioning to the new code sets. This will save your 
organization time by finding incomplete or non-specific data and 
ensuring that they do not cause a delay with coding and billing when you
 finalize implementing ICD-10. <br />
   </li>
<li style="text-align: justify;">
  <b>Evaluate Current Software Systems:</b> As you conduct 
your systems inventory, you may realize that some of your systems have 
become out-of-date or are redundant. You will need to determine if it is
 more cost-effective and efficient to upgrade these systems or 
centralize and replace them before ICD-10 implementation.<br />
   </li>
<li style="text-align: justify;">
  <b>Train and Educate Staff:</b> Your organization should 
identify staff members, from providers to coders, who currently use 
ICD-9 codes. Staff who will now be using ICD-10 will need training to 
become familiar with the increased documentation standards necessary 
with the new code sets. Training will help staff members become 
comfortable with both the heightened specificity and increased number of
 code sets that they will be using frequently.  <br />
   </li>
<li style="text-align: justify;">
  <b>Test the Documentation Process: </b>Finally, your 
organization will need to test each stage of the new documentation 
process in a trial setting. Staff members should simulate a typical 
patient encounter in its entirety to ensure that data is being 
documented thoroughly and consistently. This will also help identify any
 areas that still require improvement in the coding process.</li>
</ol>
</div>
</div>

How to Prepare For Documentation Changes and Improvements with ICD-10

ICD 10 latest Articles icd 10 pcs reference manual ICD 10 Training ICD 10 Updates ICD-10 codes ICD-10 coding skills icd-10 implementation training How to Prepare For Documentation Changes and Improvements with ICD-10

Although the final rule on the proposed ICD-10 deadline change has not been published yet, it is important to continue planning for the ...

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

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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 />
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</div>
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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 ...

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

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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>
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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 mult...