1. No category

Transition to
ICD 10 CM Diagnostic Code Set
June 2014
Workshop Agenda - June 23rd 2014
• Highlights of the Previously Shared ICD10 CM Presentation
– http://www.shafafiya.org/Dictionary/Workshops/20140320_I
CD_10_Presentation.pptx
• Stakeholder Preparation for Transition
• Phases: Transition to ICD 10 CM
– http://www.shafafiya.org/Dictionary/Workshops.html
• Establishing ICD 10 Transition Working Group.
Workshop Agenda - June 23rd 2014
Providers and payers were invited to a 2 hour
workshop – about 100 members came
HAAD presented the “Transition to ICD 10 Diagnostic
Code Set presentation” and answered related
questions
HAAD invited volunteers to represent payers and
providers to create a working group to facilitate the
transition
Supporting material for each of the transition phases
is published on Shafafiya
http://www.shafafiya.org/Dictionary/Workshops.htm
Arial Stakeholders’ Transition Working
Group Representatives (pending contact emails*)
Providers
HAAD
Lina Jichi (Chair)  Public Providers:
Michelea Peech
• Seha
Marwan Al Naboulsi
• Mubadala Health Care
Mohammad Al Haj
 Private Providers
Luis Perfetti
• Al Noor
• Ahlia
• NMC
• Burjeel
• Oasis
• Advanced Cure Diag.
Ctr.
• Western Region??
Payers
Public Payers:
•Daman
Private Payers
•ADNIC
TPA
 NAS
Vendors and
others
• 3M
• Accumed
• Abu Dhabi
Police
Highlights
In the US as of 2014
 ICD-10-CM (Diagnosis)
 Will affect inpatient and
outpatient
ICD-10-CM/PCS:
•
•
•
ICD-10-PCS ( Procedures)
 Will only affect inpatient
in the U.S.
 NOT UAE -We have CPT
for outpatient & inpatient
reimbursement

•
•
•
Incorporates much greater
specificity and clinical information,
which results in:
Improved ability to measure health
care services;
Increased sensitivity when refining
grouping and reimbursement
methodologies;
Enhanced ability to conduct public
health surveillance; and
Decreased need to include
supporting documentation with
claims;
Includes updated medical
terminology and classification of
diseases;
Highlights
In the US as of 2014
 All software will be ICD
10 based
 All certified coders will
be ICD 10 based
 All RVU’s will be ICD 10
based
 ICD 9 CM will no longer
be updated after 2012
ICD-10-CM
• Provides codes to allow
comparison of mortality and
morbidity data; and
• Provides better data for:
• Measuring care furnished
to patients;
•Designing payment
systems;
• Processing claims;
•Providers making clinical
decisions;
• Tracking public health;
• Identifying fraud and
abuse; and
• Conducting research.
Upgrade to ICD 10 CM
June 2014
DSP voted to retain 1st
October, 2015 Deadline
EncouterStart date
1/10/2015 00:01
Is it a big change?
Comparison
ICD-10-CM
ICD-9-CM
Mechanical
complication of
other vascular
device,
implant and graft
1 code (996.1)
Mechanical complication of other vascular grafts
156 codes, including
T82.310 – Breakdown (mechanical) of aortic
(bifurcation) graft (replacement)
T82.311 – Breakdown (mechanical) of carotid
arterial
graft (bypass)
T82.312 – Breakdown (mechanical) of femoral
arterial
graft (bypass)
T82.318 – Breakdown (mechanical) of other
vascular grafts
T82.319 – Breakdown (mechanical) of unspecified
vascular grafts
T82.320 – Displacement of aortic (bifurcation) graft
(replacement)
T82.321 – Displacement of carotid arterial graft
(bypass)
T82.322 – Displacement of femoral arterial graft
(bypass)
T82.328 – Displacement of other vascular grafts
Comparisons
ICD-9-CM
14,025
ICD-10 Code Format
ICD-9 Code Format
X
X
category
X
ICD-10-CM
68,069
Diagnosis Codes
X
X
etiology,
anatomic site,
manifestation
X
X
X
category
X
X
X
X
extension
etiology,
anatomic site,
severity
Comparisons
Tentative Timeline
Make Your Plan to ICD 10 CM
• Phase 1: Implementation plan development
and potential impact assessments
– Establish interdisciplinary steering committee to develop
ICD‐10 implementation strategy
– Development of potential impact assessments
– Implementation budget
– Systems inventory
– Identifying the impact from vendors and payer contracts
– Vendors and Contracts
Make Your Plan to ICD 10 CM
• Phase 2: Implementation preparation
– Training/awareness on Codes and Code uses (data
etc) AND documentation
– Education on the available GEM and how to use
• Phase 3: “Go live” preparation
– Confirm with systems vendor(s)
– Finalize all systems - testing of systems changes,
and provide intensive ICD‐10 education to coding
staff.
– Complete all in‐house systems changes and testing.
– Claims on or after Deadline must use ICD‐10‐CM
Make Your Plan to ICD 10 CM
ICD-9-CM to data coded under ICD-10-CM due to the
differences in the code sets. This will impact reports that
compile statistical data for trend analysis
Download GEM from CMS website
http://www.cms.gov/Medicare/Coding/ICD10/2014-ICD-10CM-and-GEMs.html
Any Questions Please Contact
•
[email protected]