Agenda All Blue Workshops 2014 gt ICD10 Provider Readiness Steps for Provider Preparedness BCBST Readiness Summary BCBST ICD10 Testing Information Questions amp Next Steps 3 ICD10 Provider Readiness ID: 722256
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1
ICD-10 Update
All Blue 2014 WorkshopsSlide2
Agenda
All Blue Workshops 2014 >
ICD-10
Provider
Readiness
Steps for Provider
Preparedness
BCBST Readiness
Summary
BCBST ICD-10 Testing
Information
Questions & Next Steps
3Slide3
ICD-10 Provider Readiness
All Blue Workshops 2014 >
ICD-10
4
WEDI survey
showed
roughly 80% of
health care
providers
had not completed business
changes
or begun
testing before
2014. Twenty percent of
vendor respondents
said they
were halfway or less than halfway complete with product development in support of
ICD-10
Thirty-seven percent of
today’s documentation is ready for the
transition,
according to the American Association of Professional
Coders
Roadmaps are available at CMS.gov that include the
following
:
Small and Rural clinical practices
Small Hospitals
Large Practices
Communications Plan guidance
ChecklistsSlide4
Activities for Provider Preparedness
All Blue Workshops 2014 >
ICD-10
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Assess
Workflow and Systems
C
omplete
a gap analysis on the expected workflow and process changes
Include
IT
systems
Assess
System Vendor Readiness
Upgrade
or
replace the
practice’s IT systems
Include forms and reports
Documentation
Considerations
Assess
whether current clinical documentation will support the level of specificity necessary
P
riority
list of diagnoses requiring more detailed
documentation
Revenue and Cash Flow Considerations
Know
which payers have fully transitioned to ICD-10-CM
Professional
services are paid based on the procedure code, but the diagnosis code supports medical necessity
Train on New Processes and Systems
Ensure staff can be trained prior to the compliance date on all changes
Slide5
BlueCross Preparedness
All Blue Workshops 2014 >
ICD-10
7
BCBST Systems Testing
Quality Assurance Testing is complete for Core Systems
System Integration Testing and
End-to-End
testing is
in
process
UAT Testing is in process
Provider Testing
Pilot Testing began
October
2013
Provider Testing Tools are being
im
plemented
Provider
Testing is open for professional and institutional providers
Provider Communications
Provider Administration Manual updates throughout the year
BlueAlert
SM
articles for the remainder of the year will focus on ICD-10
updates
Compliance statement on BCBST.com and
FAQs
Training of BCBST Employees
Training began in 2013 and will
continue in 2014 and 2015
ICD-10 Delay Planning has concluded Slide6
Professional
Testing Tool – W
eb-Based Self Help
Browser Requirements (Chrome, Safari, Internet Explorer, or FireFox)
Give health care providers
(physicians, etc.) pre-defined,
clinically based medical scenarios to
review and determine the ICD-10 codes
Enter
the data in an easy, efficient manner
Provide peer reports and/or notification of the correlation between input and output codes
Provider Steps for tool registration and testing
Provider Registers on the website
Provider users access applicationProvider completes scenarios
Provider reviews results
To
express interest in
testing, send email to ICD10_GM@BCBST.com
ICD-10 Provider Testing Tool
All Blue Workshops 2014 >
ICD-10
9Slide7
Each
Specialty
has a maximum of ten narratives available.
Each
Narrative defines a specific healthcare encounter
(Narratives include Chief Complaint, Past M
edical History and Office Visit Notes pertaining to a Patient)
Providers
register via a website, and will receive an email inviting them to participate with an embedded link to the testing tool
ICD-10 Provider Testing Tools - Narratives
All Blue Workshops 2014 >
ICD-10
9Slide8
ICD-10 Provider Testing Tools – Provider Report Sample
All Blue Workshops 2014 >
ICD-10
9
Chief
Complaint :
Pt presented to the E.R. with chest pain and shortness of breath
Cardiology
Narrative 1
Past Medical History:
Pt. takes Crestor 10 mg. daily and Zestril 30 mg daily for HTN. Pt is a 1 -2 pack/day smoker who has smoked for about 35 years.
Office Visit Notes:
I was consulted to see this patient who was admitted to the hospital yesterday with chest pain that radiated down his left arm and shortness of breath. Pt. was tachycardic, hypertensive and complaining of pain at an 8 on a scale of 1-10. CBC was normal, pt. has a history of hyperlipidemia and poor diet. He smokes 1 - 2 packs/cig/day and doesn't exercise. Pt was given Nitro yesterday and oxygen @ 2l/NC with minimal relief, so was placed in ICU on a continuous Nitroglycerin drip. He has also been given 2mg Morphine Sulfate I.V. prn pain. A cardiac catheterization was performed and found that the patient has atherosclerotic heart disease of one native coronary artery. His LAD coronary artery is blocked over 80%, so after discussion with the patient and his wife, it was decided that the best option will be to undergo a Coronary bypass in the am. Will continue to monitor vital signs and nursing staff is to call if there is any change in patient's status.
Total Providers:
3
Total Unique Answers:
3
Your Answer:
R0789
SAMPLESlide9
ICD-10 Provider Testing Tool – Provider Specialties
MedTenn Conference 2014 >
ICD-10
9
Specialty
Total
Narratives
Specialty
Total
Narratives
Allergy/Immunology
9
Obstetrics & Gynecology
10
Audiologist
6
Occupational Therapist in Private Practice
9
Cardiovascular disease
9
Ophthalmology
9
Certified Nurse Midwife
6
Optometry
9
Chiropractic
9
Orthopedic Surgery
9
Clinic or Group Practice
9
Otolaryngology
9
Dermatology
9
Pediatric Medicine
10
Emergency Medicine
9
Physical Medicine and Rehabilitation
9
Endocrinology
9
Physical Therapist in Private Practice
9
Family Practice
10
Plastic and Reconstructive Surgery
10
Gastroenterology
9
Podiatrist
10
General Practice
9
Psychiatry
9
General Surgery
10
Psychologist
9
Hematology
9
Psychologist, Clinical
9
Hematology-Oncology
9
Pulmonary Disease
9
Infectious Disease
9
Radiation Oncology
9
Internal Medicine
10
Rheumatology
9
Nephrology
9
Thoracic Surgery
9
Neurology
10
Urology
9
Nurse Practitioner
10
Vascular Surgery
9
Grand Count
363Slide10
Facility
Testing Tool – Web Based Self Service
Browser Requirements (Chrome, Safari, Internet Explorer or FireFox)
Providers can test scenarios with DRG code being
returned (Grouper 30)
Scenarios
can be selected by the testing provider
Largely based upon DRGs of
interest
Evaluation of results
To express interest in testing send e-mail to ICD10_GM@BCBST.com
Provider Steps for tool registration and testing
Provider contacts BCBST, BCBST loads claim scenariosProvider Registers on the website
Provider users access application
Provider completes scenarios
Provider reviews results
Provider can express
interest in testing by sending an email to ICD10_GM@BCBST.com
ICD-10 Provider Testing Tool - Institutional
10
ICD-10 ProgramSlide11
Questions & Next Steps
All Blue Workshops 2014 >
ICD-10
10Slide12
Appendix
All Blue Workshops 2014 >
ICD-10
11
Useful Links
Tennessee Hospital Association (THA)
www.THA.com
Tennessee
Medical Association (TMA)
www.tnmed.org
BCBST ICD-10 Page (BCBST.COM)
www.bcbst.com/providers/icd-10.page
American Association of Professional Coders (AAPC)
www.aapc.com/icd-10/index.aspx
American Health Information Management Association (AHIMA)
www.ahima.org/icd10
Implementation Planning (CMS
)
www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/
ICD10/02b_Latest_News.asp
CMS “Road to ICD-10” Toolkit
http://www.roadto10.org
/Slide13