GE Healthcare. ICD-10 Prep: ICD-10 Services Centricity Practice Solution v12 and Centricity EMR v9.8

Transcription

1 GE Healthcare ICD-10 Prep: Centricity Practice Solution v12 and Centricity EMR v9.8 Denise Goble, Clinical Functional Lead Terri Drury, Revenue Cycle Functional Lead Lynn Wasielewski, Service Marketing Manager

2 2014 General Electric Company All rights reserved. This does not constitute a representation or warranty or documentation regarding the product or service featured. All illustrations are provided as fictional examples only. Your product features and configuration may be different than those shown. Information contained herein is proprietary to GE. No part of this publication may be reproduced for any purpose without written permission of GE. DESCRIPTIONS OF FUTURE FUNCTIONALITY REFLECT CURRENT PRODUCT DIRECTION, ARE FOR INFORMATIONAL PURPOSES ONLY AND DO NOT CONSTITUTE A COMMITMENT TO PROVIDE SPECIFIC FUNCTIONALITY. TIMING AND AVAILABILITY REMAIN AT GE S DISCRETION AND ARE SUBJECT TO CHANGE AND APPLICABLE REGULATORY CLEARANCE. Customer is responsible for understanding and meeting the requirements of achieving meaningful use through use of HHS certified EHR technology and associated standards. Customer is responsible for understanding applicable GE documentation regarding Meaningful Use functionality and reporting specifications, and for using that information to confirm the accuracy of meaningful use attestation. Customer is responsible for ensuring an accurate attestation is made and GE does not guarantee incentive payments. Use of the product does not ensure customer will be eligible to receive payments. * GE, the GE Monogram, Centricity and imagination at work are trademarks of General Electric Company. General Electric Company, by and through its GE Healthcare division. Centricity Practice Solution v12.0 and Centricity EMR v9.8 are certified ONC 2014 Edition compliant complete and modular EHRs. For additional certification and transparency information, visit 2

3 Topics ICD-10 features and preparation for Centricity Practice Solution (CPS) v12 and Centricity EMR (CEMR) v9.8 3

4 Clinical Prep for ICD-10

5 Clinical ICD-10 Areas of Focus Chart documentation Clinical documentation Problem custom lists Patient problem lists Form Components that send diagnosis codes directly to the patient s problem list

6 Chart Documentation Audit current documentation Does documentation provide information needed to code to the correct level of specificity? (size, # of occurrences, location, etc.) Identify workflows causing failure points What workflows are contributing to the failure of recording the necessary level of specificity? 6

7 Clinical Documentation Ask staff to write down every where they see a diagnosis code in your practice Be sure you have plans in place to replace those identified ICD-9 code locations with the appropriate ICD-10 codes Begin documenting NOW for level of specificity that will be required later 7

8 Problem Search Pre CPS11/CEMR **Add Webinar Title Here Also Month X, 2014

9 Smart List Problem Search is based on the user not the organization Out-of-the-box contains commonly used diagnoses and descriptions based on usage of MQIC members Search looks at first letters of description to bring back a result. Previous search would look for a string of letters anywhere in the description 9

10 How does the search learn? If a user is using the Smart Search and they select a code from the list then modify the description more than once that description will move higher in the priority order on the search. 10 ICD-10 Servcies

11 Formal descriptions vs. custom descriptions Custom descriptions will display in the Problem List Formal ICD descriptions will display when the user hovers the mouse over a code - Will display when bypassing the smart search and using the full search - Once selected a user can modify the description in the patient problem list 11

12 Problem List Strategy Prior to Upgrading to CPS 12 or CEMR 9.8 Practices will need to decide on their Problem List strategy: Smart List, Custom Problem Lists or both Custom Problem Lists For existing customers on CPS v11, the existing custom lists will need to be updated to correct ICD-10 codes For customers not on CPS v. 11, use existing custom lists and create a list of appropriate ICD- 10 codes on paper; a new custom list will be created after upgrade 12 ICD-10 Servcies

13 Problem Custom lists display both ICD-9 and their base mapped ICD-10 Review custom problem lists (CPS 11 Customers) Existing ICD-9 problems are mapped to the base ICD-10 Some codes will not have a base ICD-10 13

14 Patient problem lists will display both ICD-9 & the base mapped ICD-10 The base mapped ICD-10 is intended as a starting point and educational tool It is not intended to determine what ICD-10 code users will select after their ICD-10 transition date 14

15 Preparing patient problem lists for the transition to ICD-10 Practices will need to have a policy/process in place to update patient problem lists for the ICD-10 transition date Practices may choose to review the problem lists for patients scheduled in advance to determine the appropriate ICD-10 problem Practices may choose to create Custom Problem Lists, modify the descriptions for the ICD-10 problems and add an identifier such as a * to indicate a problem is ICD-10 specific 15

16 ICD-9 and ICD-10 Codes in forms When an ICD-9 code is selected from a CCC form, the corresponding base code will also be displayed in Problems For custom content built to select a specific ICD-9 code, the system will send corresponding ICD-10 code if there is a match For custom content not sending appropriate ICD-10 code, MEL data symbols can be changed to push 10 codes when ready MEL_ADD_PROBLEMS, etc. Custom forms will need to be tested to see if the appropriate ICD-10 code is pushed to the problem list as expected 16

17 Clinical Workflow Summary Providers will be able to utilize smart search or custom lists Providers can begin to become familiar with mappings of commonly used codes Once the ICD-10 go live date is determined, providers will need to select ICD-10 codes when ordering services Providers can start practicing ICD-10 selection early 17

18 ICD-10 Revenue Cycle Features

19 Revenue Cycle ICD-10 areas of focus Enterprise ICD-10 Implementation Date Carrier ICD-10 Implementation Date ICD-10 Diagnosis Codes / GEMS Mapping 19

20 Enterprise Implementation Date The Enterprise Implementation Date determines whether visits will contain ICD-9 or ICD-10 Visits with a date of service on or after this date must be coded in ICD-10 in the Billing Module 20

21 Enterprise Implementation Date and Selection of Diagnosis Code in Visit Visit Date is before Implementation Date 21

22 Enterprise Implementation Date and Selection of Diagnosis Code in Visit Visit Date is after Implementation Date 22

23 Enterprise Implementation Date related preparation tasks Contact vendors you exchange diagnosis codes with to ensure readiness to send/receive ICD-10 Arrange for coders to be certified/recertified for ICD-10 Arrange for general ICD-10 Code training for all staff who use diagnosis codes Conduct end user training on ICD-10 related features Identify custom reports that contain diagnosis codes and modify them for ICD-10 Review forms that CPS prints diagnosis codes to and work with forms vendor to increase field space, if needed Review/revise forms that contain pre-printed diagnosis codes (Referrals, Superbills, etc.) 23

24 Carrier ICD-10 Implementation Date Insurance Carrier Date will determine whether the claim sends an ICD-10 or an ICD-9 code electronically or paper Provides the ability to designate payers that are not yet ready for ICD-10 codes The Carrier ICD-10 Implementation date cannot be prior to the Enterprise ICD-10 Implementation date 24

25 Carrier ICD-10 Implementation Date and Diagnosis Code for Claim 25

26 Carrier ICD-10 Implementation Date and Diagnosis Code for Claim Date of Service is before Carrier Implementation Date 26

27 Carrier ICD-10 Implementation Date and Diagnosis Code for Claim Date of Service is after Carrier Implementation Date 27

28 Carrier ICD-10 Implementation Date preparation tasks Identify Carriers that are exempt from ICD-10 requirements (Work Comp, Liability, etc.) Identify Carriers that will not be ready to accept ICD-10 codes on the Enterprise Implementation date (phone calls, websites) Update Carrier Implementation Date to date certain far in the future (Example: 12/12/9999) 28

29 Load ICD-10 Codes CAUTION: 1. Large ranges of codes may take a long time to load. Plan this work after hours. 2. Be sure to associate all specialties you will bill for before loading 3. Codes are displayed in the clinical search even if they have not been loaded. These codes are not active for billing. If selected they will appear as??? in the visit The PM Load Code Feature in Administration has been updated to support ICD-10 29

30 Tool for understanding chapter content 30

31 ICD-10 diagnosis codes preparation tasks Review ICD-10 code structure and determine what ranges of codes to load Load ICD-10 codes and attach to all specialties (perform this task after hours if loading all codes or large ranges of codes) Review top 100 diagnosis codes to ensure GEMs mapping exists and is to correct level of specificity 31

32 Determine your ICD-10 go-live date Don t let the regulation date drive your business Let the system do the work Train your teams to meet your timeline for ICD-10 Work with interface vendors to ensure readiness Update carriers to send ICD-10 or ICD-9 codes based on their individual readiness Set the Enterprise date to reflect your readiness date Healthcare professionals are responsible for making independent clinical decisions and appropriately billing, coding, and documenting their services. 32

33 ICD-10 Preparation Checklist

34 Tasks to begin NOW Establish a transition team or ICD-10 project coordinator, who will lead the transition to ICD-10 for your organization* Develop a plan, include a timeline that identifies tasks to be completed and crucial milestones/relationships, task owners, resources needed, and estimated start and end dates* Review how ICD-10 will affect clinical documentation requirements and electronic health record (EHR) templates* Communicate the plan, timeline, and new system changes and processes to your organization, and ensure that leadership and staff understand the extent of the effort the ICD-10 transition requires* * These are selected excerpts from the Centers for Medicare and Medicaid Services (CMS). Source: 34

35 Tasks to begin NOW Plan and schedule Upgrade to CPS version 12 or CEMR 9.8 (If PM Only, consider upgrading to version 11) Ask staff to keep a log of every place they see a diagnosis code Review ICD-10 Code Structure and determine what ranges of codes to load Contact vendors you exchange diagnosis information with and ensure their readiness to send/receive ICD-10 Conduct Insurance Carrier Audit Identify carriers that are exempt from ICD-10 requirements Confirm non-exempt carriers' ICD-10 Readiness date 35

36 Tasks to begin NOW Identify the top 100 diagnosis codes billed in the past year Perform documentation audit: Does documentation provide information needed to code to ICD-10 level of specificity? Identify workflows that contribute to failure to document and code to required level of specificity Begin documenting NOW for level of specificity that will be required later Review forms that print Diagnosis Codes from CPS and work with forms vendor to increase field space, if applicable Review/revise forms that contain pre-printed diagnosis codes (Referrals, Superbills, etc.) Prepare list of Custom reports that print diagnosis codes 36

37 Tasks to begin once on an ICD-10 ready CPS release Load ICD-10 Codes (check all specialties and load in ranges or load in evening or over weekend if loading all codes) Review top 100 Diagnosis Codes for specificity/accuracy of GEMS mapping Update Carrier ICD-10 date to 12/12/9999 for exempt carriers and carriers who will not be ready by Enterprise Implementation date Measure current performance and establish benchmarks for key metrics (Rejections & Denials, AR Days, Charge Entry lag time, Claims per FTE, etc.) Revise Custom reports that print Diagnosis Codes to include ICD-10 Create new custom lists with appropriate ICD-10 codes 37

38 Ongoing tasks to begin after ICD-10 implementation Measure performance on key metrics against baselines -- Measure early, measure often Perform random chart audits to determine coding accuracy and compliance with documentation standards Retrain staff and modify workflows where indicated based upon performance measures and audit results 38

39 FAQs The following are answers to some frequently asked questions around ICD

40 How does CPS address both ICD-9 and ICD-10 throughout the transition period? With the introduction of CPS 11, the application will update existing patient problem lists to display both the ICD-9 codes and the mapped ICD-10 codes Providers can begin familiarizing themselves with ICD-10 codes prior to the transition date CPS 11 and future versions will ship with a System Enterprise ICD-10 Effective Date, which is set to October 1,

41 ICD-10 FAQs Will CPS be able to manage different effective dates for different payers? Yes, the system provides an ICD-10 payer date to determine whether the payer is ready to accept ICD-10 How long will dual use of ICD-9 and ICD-10 codes be supported? Some payers fall outside of the HIPAA definition of covered entity and are not required to use ICD-10 codes. ICD-9 codes will continue to be used by these payers There are no plans to discontinue support of both ICD-10 and ICD-9 codes. When will the ICD-10 compliant system be available? Compliance with ICD-10 is addressed with CPS Version 11. CPS 11 has been in General Availability since December 13,

42 Inbound & Outbound Interfaces How will inbound interfaces be affected by the ICD-10 code sets? CPS will accept HL7 files containing ICD-9 and ICD-10 codes for claims The system will determine appropriate code based on the system date If an ICD-9 code is the only code sent after the transition date, the system will import the ICD 9 into the claim as an inactive code, thus allowing the billing administrator to determine the appropriate ICD-10 code How will outbound interfaces be affected the ICD-10 code sets? CPS will send both ICD-9 and ICD-10 codes leaving the third party system to determine which code to accept Customers should work with their third party vendors to understand how they will process the codes Do interface assessment and modifications require an additional cost? Modifications to your existing interfaces should not be required; any interface work can be quoted by GE For a quote, please contact inside.sales@med.ge.com 42

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44 GE Healthcare is committed to helping you manage the transition to ICD-10 codes, and optimize progressive technology to achieve compliance Education Resources Consulting Drive understanding and increase adoption through our ICD-10 training. Access resources to help you understand how to utilize ICD-10 features for CPS v12 and EMR 9.8. Gain insights to Centricity Practice Solution features to help navigate ICD-10 requirements and prepare for regulatory compliance. We can help you navigate ICD-10 and prepare for regulatory compliance 44

45 Education Computer-based Training Courses Problem Search Watch - Instruction on how to search for ICD-10 codes within the EMR Chart. Diagnosis Search Watch - Instruction on how to search for ICD-10 codes within the PM Billing module. Revenue Cycle Upgrade Training For upgrades to CPSv11 and v12, the training includes content on ICD-10 Can be purchased separately, for customers that are self-upgrading. 45

46 Resources ICD-10 FAQ Documents Provides answers to commonly asked ICD-10 questions and features and capabilities for CPS and CEMR (forthcoming) ICD-10: A Dose of Reality, A Plan for Success Whitepaper describing the importance of advance planning for ICD-10 implementation and outlines a plan for success Virtual Demo: ICD-10 & One-Click Problem Entry See how CPS helps ease the transition to ICD-10 with a predictive search engine and one-click problem entry. External websites CMS ICD-10 ICD-10 Code Definitions d10/browse/2010/en#/a

47 Consulting Tailored specifically for Centricity Practice Solution and Centricity EMR Understand all necessary ICD-10 regulatory measures and tools, reporting and implications for revenue cycle management. Review system and workflow for required coding, data exchange, setup and claims management. Implement new workflow mapping for ICD-10 coding and revenue cycle management. 47

48 Consulting Choice of three ICD-10 consulting offers designed to meet your specific needs Accelerator 360 Customized An interactive, web-based education and optimization program Education of regulation and operational requirements Review of ICD-10 reports, including any needed configuration, and results interpretation A combination of virtual sessions and 2 day on-site planning Education of regulation and operational requirements Workflow mapping review of required coding, data exchange, setup and claims management Training plan Pre and post go-live planning A comprehensive full service program that provides a complement of services based on customer needs Accounts for customized workflows, and can include review and testing of interfaces. Aimed at organizations with 30 or more providers and/or multi-specialty practices 48

49 Weekly Readiness Webinar Program Date Name On Demand Now MU 2014 requirements overview On Demand Now CPS12 & CEMR 9.8 Overview On Demand Now CPS12 & CEMR 9.8: Draft HW & SW requirements On Demand Now ICD-10 Prep and new problem search: CPS customers On Demand Now ICD-10 Prep and new problem search: CEMR customers On Demand Now MU 2014 Prep: Core - Part #1 On Demand Now MU 2014 Prep: Core - Part #2 On Demand Now MU 2014 Prep: Core - Part #3 On Demand Now MU 2014 Prep: Menu & Interfaces On Demand Now MU 2014 Prep: Clinical Content On Demand Now Upgrade and Install Planning* February 6 ICD-10 Prep: ICD-10 services* February 13 MU 2014 Prep: MU Services* February 20 Operating New Features in CPS12 February 27 Operating New Features in CEMR 9.8 March 6 Leveraging New Meaningful Use Reporting Platform for 2014 Learn more about our Meaningful Use Services next week *VAR customers: please contact your VAR representative for relevant information on these topics. All webinars are on Thursdays from 1pm-2pm EST Recording and slides available at Lorem ipsum dolor sicut amet adipiscing elit. Ibid

50 Save $160 with Early Bird Registration (Expires 3/7/14) May 4-7, 2014 Denver, CO Register now at: gehealthcare.com/centricitylive2014 Captain Chesley (Sully) Sullerberger Miracle on the Hudson airplane captain Michael Leavitt Former Secretary of US Dept. of Health, Threeterm Governor of Utah Allison Massari International Speaker & Visual Artist, featured on ABC, NBC and FOX John Dineen President and CEO, GE Healthcare 50

51 Thank you for joining us For additional information about ICD-10 services, please visit the Healthcare IT Service Portal: We will also be sending you an after this session with a link to the Healthcare IT Service Portal, where you can download the slides and watch the recording. 51