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ICD-10 Prep

ICD-10 Prep

Preparing Your Agency for ICD-10

CMS has recently announced that the ICD-10 CM coding system will be implemented on October 1, 2014. Considering the efforts required for completing this project, fall of 2014 is right around the corner. It’s important to involve all members of your agency in preparing for a successful ICD-10 implementation. A detailed plan is imperative and should identify specifications, duties, responsibilities, and deadlines for everyone involved. Your success will depend on everyone’s knowledge of the current processes, procedures, budgets, education plans and communication methods. Ensure you and your staff identifies needs and resources early in the process. 

Top 10 ICD-10 Agency Prep Steps:

Step 1: Assign a lead person: This person will spear head the program.
Step 2: Communicate with software vendor: Lead person should make initial contact and keep communication lines open.
Step 3: Review the ICD-10 Proposed and Final Rule: Discover areas that will impact your agency.
Step 4: Obtain senior management support.
Step 5: Complete preliminary analysis of current system:  Decide on necessary changes.
Step 6: Prepare briefing material. Do this for all staff members and include expectations.
Step 7: Set preliminary deadlines.
Step 8: Establish regularly scheduled meetings: Use this time to discuss progress.
Step 9: Schedule formal training sessions:
Team leaders (recommended one year prior to beginning staff training)
Staff members (recommended six to nine months prior to implementation date)
Step 10: A&P Review: Clinician and non-clinician coders should review this material.

Resources needed:

a. Preliminary ICD-10 books
b. Keep up to date with “What’s New with ICD-10”
c. Current Anatomy and Physiology Manual

 

PPS Plus Software’s Preparation for ICD-10

Top 10 ICD-10 PPS Plus’ Prep Steps:

Step 1: ICD-10 Proposed Rule Reviewed: Our team of nurses and coding specialists has thoroughly reviewed the Rule to become more aware of changes.
Step 2: CMS Sponsored Calls Attendance: We’ve been to several educational seminars sponsored by CMS which have been related to ICD-10.
Step 3: Coding Summit Attendance: We attended the 2011 and 2012 coding summits to involve ourselves in detailed ICD-10 discussions.
Step 4: Plans Set for 2013: We will also attend the 2013 coding summit for further continuing ICD-10 education.
Step 5: GEMS (Crosswalk) Reviewed:  This has been thoroughly reviewed by our tech staff.
Step 6: Obtained preliminary editions of ICD-10 coding manuals for our staff to review.
Step 7: Formal Training Plans for Team Leaders: We are establishing a plan of action to formerly train our team leaders on the ICD-10 coding system.
Step 8: Formal Training Plans for Staff Members: We are also establishing a plan of action to formerly train our staff members on the ICD-10 coding system.
Step 9: Looking Ahead: We are keeping watch for the draft of the ICD-10 HHRGs. This is set to release in spring of 2013.
Step 10: Analysis Preliminary Work: We’ve already taken the initial steps in updating the analysis for ICD-10. Here’s an analysis example:

A patient with Hypertension, Alzheimer’s dementia and chronic kidney disease (Stage III) falls frequently. The last time the patient fell, she broke her right hip. It was decided the best treatment for this fracture was a total hip replacement. Upon discharge from the hospital, skilled nursing is ordered for routine post-op care including dressing changes. A physical therapist is also ordered for gait training and safety measure education.

Before analysis:

M1020a – Z47.1 Aftercare following joint replacement surgery
    M1024a3 – S72.001D Fracture of unspecified part of neck of femur
M1022b – R26.9 Unspecified abnormality of gait
M1022c – I10 Essential hypertension
M1022d – F02.80 Dementia in diseases classified elsewhere without behavioral disturbances
M1022e –N18.3 Chronic kidney disease (Stage III)
M1022f – R29.6 Repeated falls

1. The diagnosis indicates that the patient has had a joint replacement. The status code for the joint (Z96.6xx) should also be reported on the OASIS and/or plan of care. Please verify your response.
2. Coding guidelines assume a relationship between hypertension and chronic kidney disease. Please use the appropriate combination code (I12.x), followed by the appropriate CKD code (N18.x).
3. This is a manifestation code (F02.80). Please verify that you have first reported the correct etiology code to identify the underlying disease process.

After Analysis:

M1020a – Z47.1 Aftercare following joint replacement surgery
    M1024a3 – S72.001D Fracture of unspecified part of neck of femur
M1022b – R26.9 Unspecified abnormality of gait
M1022c – I12.9 Hypertensive kidney disease (Stage I-IV) or unspecified
M1022d- N18.3 Chronic kidney disease (Stage III)
M1022e – G30.9 Alzheimer’s disease, unspecified
M1022f – F02.80 Dementia in diseases classified elsewhere without behavioral disturbances
Other1 – 48.01 Encounter for change or removal of surgical wound dressings
Other2 – R29.6 Repeated falls
Other3 – Z96.641 Presence of right artificial hip joint

Make sure your agency takes the right steps in preparation for the ICD-10 implementation. Request a workshop today to gain valuable knowledge and useful tips to properly prepare for this significant coding change.

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