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How to Plan a Smooth Transition to ICD-10
Today’s Host
Jana Macon, Vice President of Strategic Services
© 2015 Brightree
© 2015 Brightree
Avoid Cash Flow Crunch!
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Agenda
ICD-10 Basics
Brightree Product Plans
Brightree Services
Planning Guide
Suggested Resources
Future Brightree Communications
Q & A
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Today’s Speakers
Diana Dipierro VP, Customer Support HME
Steve Rogers VP, Product Management
ICD-10 Basics
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ICD-10 Basics
International Classification of Disease (ICD), 10th Rev
Effective Date: October 1, 2015 A new standard for diagnosis codes More Laterality, Specificity and Severity details
Required for claims with date-of-service (DOS), or From Date, on or after 10/1/2015 Recurring orders Documentation requirements Not all covered entities required to move to ICD-10
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http://www.cms.gov/ICD10
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ICD-10 Basics
Source: CMS https://implementicd10.noblis.org/understand_comparison/?guide= 10
Clinical Modification (CM) Codes
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ICD-10 Basics
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© 2015 Brightree
ICD-10 Basics
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ICD-9-CM ICD-10-CM
Field Length 3 – 5 characters 3 – 7 characters
Code Composition [A = Alpha N = Numeric]
_ _ _ _ _ N N N N N
A
_ _ _ _ _ _ _ A N A A A A A
N N N N N
HME
327.23 – Obstructive sleep apnea
G47.33 – Obstructive sleep apnea (adult) (pediatric)
Home Health 496.0 – Chronic Airway Obstruction not elsewhere
classified
J44.9 – Chronic Obstructive Pulmonary Disease, unspecified
Hospice 162.3 – Malignant neoplasm of upper lobe, bronchus, or lung
C34.10 – Malignant neoplasm of upper lobe, unspecified bronchus
or lung C34.11 – Malignant neoplasm of
upper lobe, right bronchus or lung
C34.12 – Malignant neoplasm of upper lobe, left bronchus or lung
Brightree Product Plans
© 2015 Brightree
Product Updates
Planning and Development well underway Support new CMS 1500 (02-12) form
No additional charge for upgrade Included as part of the release
Cloud platform advantages Support for both ICD-9 & ICD-10 Support OASIS-C1 changes System and Payer level Effective Dates Home Health & Hospice Start and Stop dates for Diagnosis codes
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Testing & Release Dates
Payer Testing Brightree is participating in all CMS testing Working with Clearinghouses for non-CMS
Brightree HME / DME / Pharmacy Beta testing in April Generally Available in May
Brightree Home Health / Hospice Beta testing in July Generally Available in August
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© 2015 Brightree
Brightree HME Tools
Report of Patients not updated with ICD-10 codes Start collecting ICD-10 codes on CMNs & PARs Brightree forms
Form to assist ICD-10 conversation with Physicians ICD-10 Work List Tool to assist in migrating the “whole” patient record Patient, Sales Orders, Sales Order Templates CMNs & PARs
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These tools will be available for core Brightree HME Customers
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Brightree HME Tools
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Brightree Services
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Brightree Training
Training will include: New Brightree application functionality as it relates to
ICD-10 Preparedness tasks that can be accomplished using
Brightree application Post 10/1 share findings, such as rejections or payer
activities
ICD-10 series of monthly webinars Additional Training Available
Classroom training (2 days) locations to be determined 19
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Brightree Revenue Cycle Management
A/R clean-up - Improve cash reserves
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Brightree Services for HME - Dashboard
ICD-10 Readiness Dashboard Summary and detail data on Provider Effort Required
Build actionable project plan to complete migration
Monthly “refresh” to manage project
Initial expert consultative review
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Brightree Services for HME - Prototype
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Brightree Services for HME – Work Effort
5000 total patients that need to be update 2000 have a 1 to 1 exact match 3000 require review 3 minutes for migration tool in Brightree 10 minutes to conduct the research
5000 * 3 = 15,000/60 = 250 hours – update codes 3000 * 10 = 30,000/60 = 500 hours – research
TOTAL 750 hours =1 person - 5 months
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© 2015 Brightree
Brightree Services for HME
Best Practices Cash Flow Protection Consulting Develop an ICD-10 migration timeline with milestones Monthly or weekly meetings to keep tasks ON TRACK
Code-Matching Tool Import Provider Requested ICD-10 codes into patient
charts
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© 2015 Brightree
Brightree Services for HME - Custom Forms
Custom Forms – CMNs, PARS’s, Delivery Tickets, Quotes, PO’s, Facility Bills
Will automatically populate with either ICD9 or ICD-10 codes as per cut-off date in Payer record
State Custom forms will do so as well
If there is a redesign, then an SOW will be required
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© 2015 Brightree
Brightree Services for HME
If interested in these tools and services: email: [email protected]
For continuous information on anything related to ICD-10 for Brightree HME Join the Brightree Community Subscribe to the ICD-10 board
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Planning Guide For Providers
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Preparing for ICD-10
“… a common estimate put forth by WEDI (Workgroup for Data Interchange) and others is that about 35 percent of the ICD-10 work will be handled by technology department workers…”
Why Y2K was no ICD-10 October 23, 2013 | Tom Sullivan, Editor
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Multiple Areas of Impact
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Planning Guide
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OCTOBER 1, 2015
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Planning Guide
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© 2015 Brightree
Planning Guide
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© 2015 Brightree
Planning Guide
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correlating ICD-10 codes
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Planning Guide
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© 2015 Brightree
Planning Guide
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© 2015 Brightree
Planning Guide
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© 2015 Brightree
Planning Guide
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© 2015 Brightree
Planning Guide
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OCTOBER 1, 2015
Suggested Resources
© 2015 Brightree
Suggested Resources
ICD-10 Website http://www.cms.gov/ICD10
Implementation Guides https://implementicd10.noblis.org
General Equivalence Mappings (GEMs) http://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-and-
GEMs.html
Reimbursement Mappings http://www.cms.gov/Medicare/Coding/ICD10/Downloads/Reimburse
ment_Mapping_dx_2015.zip
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Future Communications on ICD-10
Apr 28 – HME Product Webinar May 19 – Home Health and Hospice Product Webinar
© 2015 Brightree
Questions?
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© 2015 Brightree
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Thank you for attending!
For more information:
call 844.GET.BRTE (844.438.2783)
email [email protected]
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