ICD-10 Delay

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The recent extension of the ICD-10 deadline was greeted with mixed reactions throughout the healthcare industry. Some favored an extension, while others preferred to move ahead with the change. In this webinar, we look at the pros and cons of the delay and how it will affect providers and patients. Reactions from other vendors are also presented.

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  • 1.ICD-10Delay Wednesday,January29,2014 Disclaimer:Nothingthatwearesharingisintendedaslegallybindingorprescrip7veadvice.This presenta7onisasynthesisofpublicallyavailableinforma7onandbestprac7ces.

2. 1893-Ber7llonClassica7onofCausesofDeath 1900-Interna7onalClassica7onofCausesofDeath Version6Interna7onalSta7s7calClassica7onofDiseases, InjuriesandCausesofDeath 1948-TheWorldHealthOrganiza7onassumed responsibilitytomaintain 1975-adoptedthe3characterclassica7ontomaintain someconsistency-Interna1onalClassica1onofDiseases Manymodiersandadapta7onsalongtheway 1992-ICD-10waspublished 2017-ICD-11willbepublished ICDHistory 3. TheICD-10codesetsareNOTsimplyincreasedand renumberedICD-9codesets. TheICD-10codesetsincludegreaterdetail,changesin terminology,andexpandedconceptsforinjuries,laterality, andotherrelatedfactors. ThecomplexityofICD-10providesmanybenetsbecauseof theincreasedlevelofdetailconveyedinthecodes AmericanMedicalAssocia1on WhatisICD-10 4. HowICD-10DiersfromICD-9 5. Protec1ngAccesstoMedicareAct(H.R.4302) DOCFIX-TheSustainableGrowthRate(SGR)wassettoreduce Medicarephysicianpaymentratesby24%onApril1,2014. SGRwassetbytheCentersforMedicareandMedicaidServices (CMS)tocontrolMedicarespendingonphysicianservices. Congressintroduced"docx"includedaprovisiontodelaythe ICD-10compliancedatetoOctober1,2015. TheHousepassedthebilltopostponetheSGRanddelayICD-10on Thursday,March28,2014,andtheSenatepassedthesamebillon Monday,March31,2014. TheICD-10Delay 6. Whatdoesthismean.... TheGood: Ourclientsdon'tneedtoundertakethenancialhitofICD10whilealso absorbingthereducedMedicarefeescheduleandtheAordableCareAct(which isleadingtohigherpa1entpaysandMedicaidenrollment). TheBad: Everyonemusts1llupgradethisyearonallEHRs.The2011cer1ca1onsexpired on12/31/13andnew2014cer1edsystemsareneededforbothMU1andMU2. ClinicsshouldbelookingtoupgradenowandahestnolaterthanQ3(orlookinto thenewhardshipexemp1ons). Tosumitup: ICD-10delayatthispointisagoodtac1c,butpartofabadstrategy.Ifweare goingtochangetheen1relandscapeofhealthcare,letsdothesensiblethingand spreaditoutoveraperiodofyears,notaperiodofmonths. -BenQuirk QuirkResponse 7. Retes1ng Trainingandimplementa1onalreadysetup Shortcutsthatpreventedmorethoughkulchangesinordertomeetthe deadline StudentsinmedicalcodingcurrentlyenrolledarepreparingforICD-10and somedonothaveICD-9exposure Budgetedexpensesalreadyallocatedforexecu1on Mayslowsales Maydelayupgrades Thereduc1onof24%inpaymentswillincreaseifapermanentxisnot implemented Manyvendorshaveactedingoodfaithandinvestedsignicant 1me,energy,andresourcestocomplywiththe deadline.CMSes1matesthataone- yeardelayofICD-10couldcostbetween$1billionand$6.6billion Nega1veCri1cismoftheDelay 8. AvoidingCashFlowdisrup1onfornow TheCentersforMedicareandMedicaidServices(CMS)es1mates thatinearlystagesofimplementa1on,denialrateswillriseby100 to200percent,andthatdaysinaccountsreceivablewillgrow20to 40percent. Migra1ontoICD-10carriesariskduetoincompleteorinaccurate transla1onofexis1ngpolicies,benets,andpaymentruleswithin payersystems. Delaysinpaymentscanalsooccurbecauseofchallengesinclaim processingintheICD-10environment. Programmerslookatitasalongerrunwayor1metogetitright Othersfeelitisagood1metofocusonMU2andACOprograms Physiciansavoidinguptoa24%reduc1oninre-imbursementrates Allocatedfundscanbeinvestedasreservesandearninterest Posi1veCri1cismoftheDelay 9. Increasedfocusonclinicaldocumenta=onimprovement(CDI).s1llacri1calcomponentto qualityrepor1ngandimprovingcashow. Developlong-termcoderstrategy.Regardlessofadelaydecision,youwillneedastrategyto retainandincen1vizecoders Op=mizeyourrevenuecycleperformance.Thedelayprovidesanopportunitytoperforma deepdivethatwillexploreandimproveexis1ng EvaluateComputerAssistedCoding(CAC).Youcanusethedelaytodoasearchandselec1on andevaluatehowaCACop1oncanhelpachievetransi1ongoalswhilereducingcostsand increasingcoderproduc1vity. Con=nuedualcodingandtraining.Thedelaywillprovideyouwithmore1metoiden1fy poten1alriskareas/issuesbetweenICD-9andICD-10codes Comprehensivesystemremedia=on&tes=ng.Younowhave1meforamore comprehensiveplantoensureallITsystemsandpartnersarecapableofreceivingand producingICD-10codesforbillingandinternal/externalrepor1ngpurposes. Focusonphysicianeduca=on(employedandancillary).Itsimportantthatyoucon1nueas plannedwithCDItrainingforphysicians.Theaddi1onaltrainingwillallowthephysicians more1metobothlearnandadopttheincreaseddocumenta1onrequirements. -BeaconPartners Posi1veCri1cismoftheDelay 10. Whatthevendorsaresaying Prac1ceFusion Asaresultofthisoneyeardelay,Prac1ceFusionproviderswillnot berequiredtouseICD-10codesinhealthcareclaimsthisyear. However,ICD-10iss1llcoming,soitsimportantforallstakeholders inthehealthcareindustrytobecomefamiliarwithICD-10. Prac1ceFusionwaspreparedtohelpproviderscustomerstomeet the2014deadline,anddespitethedelay,wewillcon1nuetohelp ourproviderspreparewellinadvanceofOctober1,2015.Keepon thelookoutformoreblogposts,webinars,in-producttools,and othereduca1onalresourcestohelpwiththeICD-10transi1on. -RyanDonovan|VPCorporateCommunica1ons 11. Whatthevendorsaresaying Allscripts TheICD-10delaydoesnotchangeAllscriptsplans.Weveinformed ourclientsthateverythingiss1llonscheduleandhaveencouraged themtoupgradeastheyoriginallyplannedtoensuretheyre prepared. -ArianaNikitas|DirectorofClientCommunica1ons -RussCobb|VPofMarke1ngandCommunica1ons Forthefullstatement,pleasevisit:h4p://www.allscripts.com/en/resources.html 12. Whatthevendorsaresaying Greenway AllIknowisthatweareinfulldeploymentmodeandnothinghas changedonourside.Weencourageclientstofocusonexis1ng programsthatcreateastrongfounda1onforevolvingandfuture value-basedandalterna1vepaymentincen1vemodels,suchas accountablecareorganiza1ons(ACOs)andpa1ent-centeredmedical homes(PCMHs). -Jus1nBarnes|VPofGovernmentAairs 13. Whatthevendorsaresaying Athenahealth Guaranteedsuccesswithorwithoutthedelayoryourmoneyback. Theyfeelliketherearenoimpactstotheirsystem. Itisunfortunatethatthegovernmenthasonceagainchosentodelay ICD-10.athenahealthanditsclientsare/werepreparedfortheICD-10 transi1on,andinfactwehavena1onalpayerdatashowingthat78 percentofpayersarecurrentlyprovingreadinessinlinewiththe2014 deadline. -EdParks|COO Forthefullstatement,pleasevisit:h4p://www.athenahealth.com/blog/ 2014/03/31/icd-10-dismay/