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What your EMR Vendor Should Provide in the ICD10 Transition. Julie Lundberg March 27, 2014. Pressures Applied From Multiple Directions. - PowerPoint PPT Presentation
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What your EMR Vendor Should Provide in the ICD10 TransitionJulie Lundberg
March 27, 2014
2
“As an independent physician, Dr. Ragland must carefully devise strategies to keep her three-person practice afloat amid rising overhead, flat or dropping reimbursement rates, and new federal rules, many of them related to the health care law.”
“If you don’t code properly, you don’t get paid.”
“Some physicians may end up paying nearly three times more for ICD-10 implementation than had been predicted just five years ago, according to a new report from the American Medical Association.”
Small practices: up to $83,290 (2008), now up to $226,105
Medium practices: up to $285,195 (2008), now up to $824,735
Pressures Applied From Multiple Directions
AgendaTechnology Platform• Software Updates• Code Selection Tools• Clinical Documentation Tools
Education/Expertise• Practice Portal• Webinars• Quick Guides
Consulting Services• Impact Analysis• Chart Audit• Historical Claims Analysis
Technology Platform
Certified EMR
Practice Management Software
ICD-10 code library
ICD9 & ICD10 Selectors in Charge Entry
837 electronic claim output in updated ICD10 compliant format
ICD10 Claims Testing
Submit test claims to your clearinghouse with ICD10 codes
If your vendor tests and passes with your current version, you may not need to go through this process!
EMR Software
DxCPT screen accepting both ICD-9 and ICD-10 [system guides the user per the setting dates]:
Here is an example of how other areas in the system will accept ICD-10. [Clinical Decision Support]
Transition Date
Global: Knows the date of service and presents proper code set to biller and provider
Payer Level Override: Set transition date at plan level to allow for those payers not ready on 10/1
May add setting to not respect payer override for doctor (so as to not distract away from new focus on ICD10)
Clinical Documentation Tools
ICD10 requires greater specificity in documentation. What charting tools can help?
Tags
Voice Recognition Dictation Software
Templates
ICD10 Code Selection Help!
GEM: Generic Equivalent Mapping: Maps from ICD9 to ICD10 (and possibly even Snomed)
PFT: Provider Friendly Terminology: Allows the clinician to say what he/she wants to say, then maps that to the proper ICD10 code
NLP: Natural Language Processing: Index free text and map provider terms to proper codes
Alert provider to need for greater specificity, present attributes (Encounter type, Severity Type, Laterality, FX healing) to guide selection of proper ICD10 code.
Education
Practice Portal
Just in time training
Learn at your own pace
Choose the learning style that works for you!
Webinars
Web-based seminars presenting industry and product knowledge in an interactive format
Pose questions to vendor experts
Documentation
Step-by-step instructions demonstrating key workflows
Services
ICD10 Consulting
Impact Analysis
Chart Audit
Is your charting specific enough for ICD10?
Services: Historical Claims Analysis
20
Determine most commonly used codes
Convert to ICD10
Case Study
Case Study: Turf Toe?
• Hallux Rigidus, right big toe• ICD9: 735.2• ICD10:M20.21
• Onycholysis• ICD9: 703.8• ICD10: L60.1
• Hammer Toe• ICD9: 735.4• ICD10: M20.41
Case Study: Place of Injury
ICD10:M20.21 (Squash Toe?)
E849.4 Accidents occurring in place for recreation and sport
Y92.311 Squash court as the place of occurrence of the external cause
Case Study: Place of Injury
ICD10:M20.21 (Cricket Toe?)
E849.4 Accidents occurring in place for recreation and sport
Y93.07 Cricket pitch as the place of occurrence of the external cause
Case Study: Place of Injury
ICD10:M20.21 (Curling Toe?)
E849.4 Accidents occurring in place for recreation and sport
Y93.2 Activities involving ice and snow