How to Plan a Smooth Transition to ICD-10

Transcription

1 How to Plan a Smooth Transition to ICD-10

2 Today s Host Jana Macon, Vice President of Strategic Services

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4 Avoid Cash Flow Crunch! 4

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6 Agenda ICD-10 Basics Brightree Product Plans Brightree Services Planning Guide Suggested Resources Future Brightree Communications Q & A 6

7 Today s Speakers Steve Rogers VP, Product Management Diana Dipierro VP, Customer Support HME

8 ICD-10 Basics

9 ICD-10 Basics International Classification of Disease (ICD), 10 th Rev Effective Date: October 1, 2015 A new standard for diagnosis codes More Laterality, Specificity and Severity details Required for claims with date-of-service (DOS), or From Date, on or after 10/1/2015 Recurring orders Documentation requirements Not all covered entities required to move to ICD

10 ICD-10 Basics Clinical Modification (CM) Codes 10 Source: CMS

11 ICD-10 Basics 11

12 ICD-10 Basics ICD-9-CM ICD-10-CM Field Length 3 5 characters 3 7 characters Code Composition [A = Alpha N = Numeric] _ N N N N N A _ A N A A A A A N N N N N HME Home Health Hospice Obstructive sleep apnea Chronic Airway Obstruction not elsewhere classified Malignant neoplasm of upper lobe, bronchus, or lung G47.33 Obstructive sleep apnea (adult) (pediatric) J44.9 Chronic Obstructive Pulmonary Disease, unspecified C34.10 Malignant neoplasm of upper lobe, unspecified bronchus or lung C34.11 Malignant neoplasm of upper lobe, right bronchus or lung C34.12 Malignant neoplasm of upper lobe, left bronchus or lung

13 Brightree Product Plans

14 Product Updates Planning and Development well underway Support new CMS 1500 (02-12) form No additional charge for upgrade Included as part of the release Cloud platform advantages Support for both ICD-9 & ICD-10 Support OASIS-C1 changes System and Payer level Effective Dates Home Health & Hospice Start and Stop dates for Diagnosis codes 14

15 Testing & Release Dates Payer Testing Brightree is participating in all CMS testing Working with Clearinghouses for non-cms Brightree HME / DME / Pharmacy Beta testing in April Generally Available in May Brightree Home Health / Hospice Beta testing in July Generally Available in August 15

16 Brightree HME Tools Report of Patients not updated with ICD-10 codes Start collecting ICD-10 codes on CMNs & PARs Brightree forms Form to assist ICD-10 conversation with Physicians ICD-10 Work List Tool to assist in migrating the whole patient record Patient, Sales Orders, Sales Order Templates CMNs & PARs These tools will be available for core Brightree HME Customers 16

17 Brightree HME Tools 17

18 Brightree Services

19 Brightree Training Training will include: New Brightree application functionality as it relates to ICD-10 Preparedness tasks that can be accomplished using Brightree application Post 10/1 share findings, such as rejections or payer activities ICD-10 series of monthly webinars Additional Training Available Classroom training (2 days) locations to be determined 19

20 Brightree Revenue Cycle Management A/R clean-up - Improve cash reserves 20

21 Brightree Services for HME - Dashboard ICD-10 Readiness Dashboard Summary and detail data on Provider Effort Required Build actionable project plan to complete migration Monthly refresh to manage project Initial expert consultative review 21

22 Brightree Services for HME - Prototype 22

23 Brightree Services for HME Work Effort 5000 total patients that need to be update 2000 have a 1 to 1 exact match 3000 require review 3 minutes for migration tool in Brightree 10 minutes to conduct the research 5000 * 3 = 15,000/60 = 250 hours update codes 3000 * 10 = 30,000/60 = 500 hours research TOTAL 750 hours =1 person - 5 months 23

24 Brightree Services for HME Best Practices Cash Flow Protection Consulting Develop an ICD-10 migration timeline with milestones Monthly or weekly meetings to keep tasks ON TRACK Code-Matching Tool Import Provider Requested ICD-10 codes into patient charts 24

25 Brightree Services for HME - Custom Forms Custom Forms CMNs, PARS s, Delivery Tickets, Quotes, PO s, Facility Bills Will automatically populate with either ICD9 or ICD- 10 codes as per cut-off date in Payer record State Custom forms will do so as well If there is a redesign, then an SOW will be required 25

26 Brightree Services for HME If interested in these tools and services: For continuous information on anything related to ICD-10 for Brightree HME Join the Brightree Community Subscribe to the ICD-10 board 26

27 Planning Guide For Providers

28 Preparing for ICD-10 a common estimate put forth by WEDI (Workgroup for Data Interchange) and others is that about 35 percent of the ICD-10 work will be handled by technology department workers Why Y2K was no ICD-10 October 23, 2013 Tom Sullivan, Editor 28

29 Multiple Areas of Impact 29

30 Planning Guide OCTOBER 1,

31 Planning Guide 31

32 Planning Guide 32

33 Planning Guide correlating ICD-10 codes 33

34 Planning Guide 34

35 Planning Guide 35

36 Planning Guide 36

37 Planning Guide 37

38 Planning Guide OCTOBER 1,

39 Suggested Resources

40 Suggested Resources ICD-10 Website Implementation Guides General Equivalence Mappings (GEMs) GEMs.html Reimbursement Mappings ment_mapping_dx_2015.zip 40

41 Future Communications on ICD-10 Apr 28 HME Product Webinar May 19 Home Health and Hospice Product Webinar

42 Questions? 42

43 Thank you for attending! For more information: call 844.GET.BRTE ( ) 43