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1、Preparing for ICD-10-CM/PCS: What does a coder need to do now?,Presented by: Jennifer McManis, RHIT,ICD-10-CM/PCS,Compliance Timeline Training Timeline Continuing Education Requirements Myth Busters Code Structure Coding Fundamentals Case Studies Resources,Implementation Date,ICD-10-CM/PCS Complianc
2、e Deadline October 1, 2013 Claims for services provided on or after this date must use ICD-10 codes CPT codes will continue to be used for outpatient services,Compliance Timeline,January 1, 2010 Internal testing of Version 5010 for electronic claims December 31, 2010 Internal testing must be complet
3、e January 1, 2011 External Testing of Version 5010 claims CMS begins accepting Version 5010 Version 4010 continue to be accepted January 1, 2012 All claims must use Version 5010 Version 4010 no longer accepted,Outpatient Coder Training,Outpatient Coder Training Approximately 16 hours 2011-2012 Revie
4、w code Structure & Coding Conventions. Learn the fundamentals Analyze & practice applying the ICD-10-CM guidelines Review and refresh knowledge of A & P concepts,Outpatient Coding Training,2012-2013 Become an expert in applying ICD-10-CM codes to outpatient cases in the six to nine months preceding
5、October 1, 2013. Practice using ICD-10-CM codes each week leading into “go live” on October 1, 2013. Network with peers to seek answers to cases and confirm application of ICD-10-CM codes. Take advantage of component MHIMA training opportunities,Inpatient Coder Training,Approximately 50 hours 2011-1
6、2 Review code structure and coding conventions for ICD-10-CM and ICD-10-PCS. Learn the fundamentals of the ICD-10-CM and ICD-10-PCS systems. Analyze and practice applying the ICD-10-CM and ICD-10-PCS Coding Guidelines. Continue to study ICD-10-PCS definitions (memorize the definitions of approaches
7、and root operations). Continue to review and refresh knowledge of anatomy and physiology concepts,Inpatient Coder Training,2012-13 Become an expert in applying ICD-10-CM and ICD-10-PCS codes to inpatient cases in the 6 to 9 months preceding October 1, 2013 Practice using ICD-10-CM and ICD-10-PCS cod
8、es each week leading into “go live” on October 1, 2013 Network with peers to seek answers to cases and confirm application of ICD-10-CM/PCS codes Take advantage of MHIMA training opportunities,Continuing Education Unit (CEU) Requirements,Required to participate in a predetermined number of mandatory
9、 baseline educational experiences specific to ICD-10-CM/PCS. *Can Begin Earning CEUs January 1, 2011 thru December 31, 2013 2009 or 2010 ICD-10 CM Academy,CEU Requirements,Total number of ICD-10-cm/PCS CEU required, by AHIMA Credential CHPS- 1 CEU CHDA; RHIT;RHIA- 6 CEUs CCS-P- 12 CEUs CCS; CCA- 18
10、CEUs If you hold more than one credential, only report the highest number of CEUs,CEU Requirements,CEU requirements will be included within the total number of CEUs required for a given CEU Cycle. For example, if you hold an RHIA credential, you will obtain 6 CEUs that are in relation to ICD-10-CM/P
11、CS along with the additional 24 CEUs to complete your recertification cycle. Reporting of the CEUs will be made available by Fall of 2011,Myths,October 1, 2013 is considered a flexible date Implementation planning should be undertaken with an assumption that DPHHS will grant an extension Workers com
12、p & auto insurance companies may choose not to implement ICD-10-CM/PCS State Medicaid Programs will not be required to update their systems in order to utilize ICD-10-CM/PCS The increased number of codes will make the new coding system impossible to use Developed without any clinical input There wil
13、l no hard copy of ICD-10-CM/PCS All coding will be done electronically,Myths,Developed a number of years ago, so it is out of date Unnecessarily detailed medical record documentation will be required Implementation can wait until after electronic health records and other health care initiatives have
14、 been established ICD-10-CM based super bills will be too long or too complex The GEMs are intended to facilitate the process of coding medical records Each payer will be required to develop their own mappings, GEM have been developed for CMS use only Medically unnecessary diagnostic tests will need
15、 to be performed in order to assign an ICD-10-CM code CPT will be replaced by ICD-10-CM/PCS,ICD 10-CM Code Structure,ICD 10-CM Contains more than 68,000 codes Compare this to ICD-9-CM which contains 13,000 codes Consists of 3-7 characters First digit is alpha All Letters are used except U 4th,5th,6t
16、h & 7th Digits can be numeric Decimal placed after the 1st three characters,ICD-10-CM Code Structure,ICD-10-CM Code Structure XXX.XXX X 1st 3 Characters- Category 4th 5th 6th Characters-Etiology, Anatomic Site, Severity 7th Character-Extension (Visit Encounter, Sequelae, External Causes) ICD-9-CM Co
17、de Structure XXX.XX 1st 3 Characters-Category 4th 5th Characters- Etiology, Anatomic Site, Manifestation,ICD-10-CM,Structure Index & Tabular List Two Parts of the Index Disease & Injury Table of Drugs & Chemicals Neoplasm Table External Causes Coding Guidelines Some changes from ICD-9 Fractures- Default Displaced 2 Categories for Acute MI Acute MI is 4 weeks instead of 8 weeks Osteoporosis with current pathological fracture V codes are now Z Codes,
