33
Current Status on ICD-10 Implementation Presented By Victoria, thepracticebridge

Status on icd 10 implementation

Embed Size (px)

DESCRIPTION

What is the status on ICD-10? In this Infographic I bring you the facts you always wanted to know & 6 foundation blocks for successful ICD-10 implementation.

Citation preview

Page 1: Status on icd 10 implementation

Current Status on ICD-10 Implementation

Presented By Victoria, thepracticebridge

Page 2: Status on icd 10 implementation

We will be using ICD-10 another 19 days. Before that I will make you to walk through the status on ICD-10 implementation.

Page 3: Status on icd 10 implementation

I have few questions in my mind

Does the claims errors will Increase? Will A/R could rise? Will there be a rise in claim denial rates?

Page 4: Status on icd 10 implementation

2015 survey was intended only for healthcare providers. 60% responded on behalf of a hospital or health system. Hope we will get more clarifications if we go through the survey.

Page 5: Status on icd 10 implementation

According to the survey, just 7% of physicians said they have started transitioning to ICD-10 extensively.

31% of respondents said they had not started the transition at all.

Among solo physicians, 82% said they have not started the transition at all or have made only limited

42% of respondents said they are "not at all confident" that the implementation of ICD-10 will cause no serious disruptions.

83% of respondents expect the transition to result in delayed or denied claims;

36% expect to face disruptions that require them to draw from personal funds;

Page 6: Status on icd 10 implementation

32% said they might reduce staff size, work hours or benefits; and

30% said they might retire early because of anticipated cash-flow issues related to the transition

65% said they are capable of processing ICD-10 codes;

52% said their practice management software was capable of processing ICD-10 codes

1% said they will need to completely replace their IT systems to comply with ICD-10.

Page 7: Status on icd 10 implementation

A recent survey of 1,100 organizations found:

#More than half of respondents were uncertain of the actual ICD-10 deadline.

#And more than half had not yet completed end-to-end testing.

#Some providers still believe the switch to ICD-10 isn't going to happen this year.

Page 8: Status on icd 10 implementation

"This is an off-election year, and if I was a politician, I would roll ICD-10 out during an off-election year rather than delay it," says Mr. Joshua Berman, Relay Health ICD-10 Director.

Page 9: Status on icd 10 implementation

Provider organizations that haven't adequately prepared for the switch are going to have issues with the processes that ICD-10 requires. However even organizations that have prepared may still have problems.

Page 10: Status on icd 10 implementation

This isn't a technology change, it's a process change

The switch to ICD-10 requires coding staff, physicians and all others who document conditions to be properly trained to ensure billing is done correctly.

Page 11: Status on icd 10 implementation

All providers are likely to encounter some issues with the switch to ICD-10, including an increase in claim denials and the amount of time it takes payers to process claims

Page 12: Status on icd 10 implementation

For small practices Road to 10 from CMS has primer for clinical documentation, clinical scenarios, and other specialty-specific resources to help with implementation.

Page 13: Status on icd 10 implementation

Medicare claims processing systems will not have the capability to accept ICD-9 codes for dates of services after September 30, 2015

Page 14: Status on icd 10 implementation

6 foundations for ICD-10 implementation you can’t ignore!

ICD-10 CM/PCS Communication  Coding Education  Clinical Documentation Initiatives

IT Plan

Revenue Cycle Plan  Post "Go Live" Health Information Management & coding activities

Page 15: Status on icd 10 implementation

Communication

Concise Messaging

Vision Statement

Partners & Roles

Timelines

Defined Methods of Communication

Page 16: Status on icd 10 implementation

ICD-10 CMS/PCS Vision Statement

Clarity-steering the team in the right direction

Inspiring and meaningful versus compliance driven

Expected outcomes-how we will be working differently following ICD-10 implementation

Page 17: Status on icd 10 implementation

Partners and Roles

Identify

Internal groups

External groups (Partners)

Agreed upon communications

Page 18: Status on icd 10 implementation

Have a timeline that outlines milestones, secondary tasks and deadlines keep implementation teams on task.

Multiple communication methods should be used Thumb of rule says, “seven times, seven ways”

Page 19: Status on icd 10 implementation

Coding Education

Self assessment goals checklists

Rate your self on a scale 1(Goal not accomplished at all) to 5(Goal accomplished)

Are you aware of your foundational knowledge strengths related to A&P, disease processes, pharmacology, etc.?

Are you completing tasks to improve your weaknesses related to A&P, disease processes, pharmacology, etc.?

Page 20: Status on icd 10 implementation

Are you networking with a subject matter expert and peers?

Are you practicing and applying codes to “real world” documentation?

Are you working to understand the ICD-10-CM/PCS coding guidelines?

Are you gaining a deeper understanding of the clinical documentation improvement protocols?

Do you work collaboratively with clinical documentation specialists when a clarification or query is needed?

Page 21: Status on icd 10 implementation

Clinical Documentation Improvement

The success for this includes

#physician involvement

#communicating documentation gaps

#Other key data findings

Which agree upon goals of a CDI improvement process and ongoing focused reviews with feedback.

Page 22: Status on icd 10 implementation

Medical staff, CDI staff & the coding staff will need education on the findings from documentation reviews

Findings should include discussion of the documentation elements needed to support ICD-10 codes through use of specific examples.

The value of more concise data capture for high quality data should be emphasized.

Page 23: Status on icd 10 implementation

IT Block

For the most part, IT plans for the transition to ICD-10 are well underway, due in part to the conversion to 5010 compliance.

Important elements of the IT building block for ICD-10 readiness to be monitored throughout the implementation include.

Page 24: Status on icd 10 implementation

Communications to and from vendors

Testing of system capabilities

The costs associated with IT implementations

Necessary upgrades and system maintenance.

Decisions around how ICD-9 and ICD-10 databases will be accessed and maintained will need to be made.

Page 25: Status on icd 10 implementation

Revenue Cycle BlockThe 9 pieces of advice from Government Health IT practices must consider

Practices should develop a budget and strategy to provide for additional cash reserves should delays in payment occur.

Practices should conduct financial modeling to understand the impacts of moving from ICD 9 to ICD 10 – the impacts should be looked at by provider, by facility, by service line, and by geography if applicable.

Page 26: Status on icd 10 implementation

The potential for backlogs in medical Coding, billing, and claim edits should be analyzed and a strategy developed to work the backlogs.

A strategy for pre and post ICD 10 denials management should be developed.

Assess the readiness of external vendors who support coding, billing, follow up and denials.

Any audits currently performed (compliance, RAC, etc.) should be reviewed to determine ICD 10 impact.

Page 27: Status on icd 10 implementation

Managed care contracts should be reviewed and if necessary, renegotiated to decrease negative impacts to the bottom line.

The readiness of high volume payers should be assessed to determine their ability to process claims. Many payers are now posting readiness information on their web sites.

Conduct CDI reviews using ICD 10 code sets to determine if documentation contains the specificity necessary for ICD 10.

Page 28: Status on icd 10 implementation

Post Go Live HIM/Coding Activities.

Most important block for ICD-10 implementation is to plan the activities to undertake following the deadline. As Sir Walter Scott said, “I can give you a six-word formula for success: Think things through – then follow through”

Page 29: Status on icd 10 implementation

Practices must follow through and monitor coding accuracy and productivity following go live.

When problems are identified, strategies should be implemented to address workflow problems, process problems, and resource issues.

Determine if further education and training is needed and provide it expeditiously to prevent future issues.

Page 30: Status on icd 10 implementation

Monitor for opportunities to improve data integrity through EHR enhancements, monitoring of alerts, and communication with physicians & clinical documentation improvement staff.

Finally, monitor productivity to manage responding to staffing needs.

Go live will be a challenging time for all and retention of highly trained, skilled coding staff will be essential.

Page 31: Status on icd 10 implementation

Which of these building blocks needs more attention in your organization? Which has been successful?

Page 32: Status on icd 10 implementation

Share Your Views With Us atwww.thepracticebridge.com

and if you like it, kindly subscribe to our blog updates!

Page 33: Status on icd 10 implementation