march 2015 icd10: preparation for physicians and small practices
TRANSCRIPT
900-3571-0213
Open Line Friday: ICD-10 Edition
ICD-10 Preparation for Individual
Physicians & Small Practices
March 20, 2015 9:30 a.m. – 10:30 a.m. EST
Dial Toll-Free: (800) 882-3610 or (412) 380-2000
Conference Passcode: 6829655#
900-893-0315
Open Line Friday
Panelists*
Deborah Stewart, MD Medical Director
Florida Blue
Gale Scott EDI Regulatory Compliance Administrator
Tampa General Hospital
Laurie Darst Revenue Cycle Regulatory Advisor
Mayo Clinic (MN)
Matthew Ketterman Director, Business Solutions
Availity®1 LLC
Stanley Nachimson Principal
Nachimson Advisors, LLC
Deborah Enfield ICD10 Project Manager
Baptist Health South Florida
Diana Brijbag CMM, CPC, CCP, CMSCS, HITCM-PP
Office Manager The Springs Family Medical Center
George Vancore Senior Manager, Delivery Systems
Mandates and Compliance Florida Blue
*Panelists are subject to availability. 1 Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit www.availity.com
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Joseph Nichols, MD Principal
Health Data Consulting
Follow us on Twitter @FLBlue
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Special Guests Speakers
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Follow us on Twitter @FLBlue
Karen Blanchette Association Director,
Professional Association of
Health Care Office Management
(PAHCOM)
Brandy Ziesemer RHIA, CCS, ICD-10 Trainer
Florida Health Information
Management Association
(FHIMA)
Carl Costa RHIT, CDIP, CHTS-TR, CPC
Senior Coordinator for Coding &Training
Florida Health Information
Management Association
(FHIMA) Mr. Jim Daley
Immediate Past Chair of WEDI
Director of IT, Risk and Compliance
BlueCross BlueShield of South Carolina
Open Line Friday
Agenda
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1. Objectives
2. Healthcare Industry Regulatory Update
3. ICD-10 Preparation for Individual Physicians and Small Practices
4. Next Steps
Follow us on Twitter @FLBlue
Objectives
1. Promote collaboration, communication and coordination between providers, payers
and electronic trading partners.
2. Expand your understanding of the current state of ICD-10, recent regulatory
decisions and industry perspectives.
3. Raise your awareness and understanding of the unique opportunities and challenges
that ICD-10 brings to the entire health care industry including providers, payers and
electronic trading partners.
4. Provide you with tools, techniques, best practices and helpful hints from your peers
that can be used as you continue (or begin) your ICD-10 journey.
**** Please remember that during the call all attendees will be placed on “mute”
except for any guest speakers and all panelists. If you have a question, please
email it to [email protected].
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Health Care Industry & Regulatory Update
• Medicare announced two rounds of ICD-10 testing with physicians/provider:
• Functional Acknowledgement Testing: this is where you test the “chain of trust” partners from the
provider to the payer (Medicare) using an ICD-10 coded claim; Medicare will edit and compliance check the
claim and return a response to the sender; there is no claim adjudication or ERA is being generated during this
round of testing; test claims can be sent to Medicare anytime up to the October 1, 2015 implementation date;
• Special Functional Acknowledgement Testing Weeks: Medicare submitters will have access to
real-time help desk support during the weeks of November 17th through the 21st, 2014; March 2nd through the
6th, 2015 and June 1st through the 5th, 2015.
• End-to-end testing: this is where ICD-10 coded claims are sent to the Medicare (the payer), adjudicated
and an ERA is generated back to the provide; participation in Medicare’s end-to-end testing requires enrollment
and selection by your MAC; on a national basis, Medicare is limiting the number of testing providers to 2550.
• For additional details, please see the following:
• http://medicare.fcso.com/ICD-10/267332.pdf
• www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
MLN/MLNMattersArticles/Downloads/SE1409.pdf
• http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
MLN/MLNMattersArticles/Downloads/MM8858.pdf
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Health Care Industry & Regulatory Update (cont’d)
• NUCC changed the CMS 1500 professional paper claim form to accommodate ICD-10
(see www.nucc.org); the transition to this new form began in January 2014 and continues
across the health care industry.
• Partial code freeze continues until one year after the implementation of ICD-10: • Only codes for new diagnosis or new technologies will be considered for exception inclusion.
• Last regular updates to ICD-9-CM and ICD-10 occurred on October 1, 2011.
• Regular ICD-10 updates will begin on October 1, 2016.
• Miscellaneous health care industry and regulatory updates will be provided from our
panelists when applicable and when time permits.
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A Florida Blue Update
“As we approach the October 1, 2015 ICD-10 compliance
deadline, the Florida Blue ICD-10 testing window of
opportunity is closing.
Florida Blue encourages providers to contact us either
via e-mail @ [email protected] or
simply visit www.FloridaBlue.com/ICD-10 to
jump start your ICD-10 testing.
While capacities still exist,
now is the time to test ICD-10 with Florida Blue.
DON’T WAIT”.
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Visit www.floridablue.com/icd-10 and select the Test ICD-10 Icon:
ICD-10 Provider Testing
Testing ICD-10 is one of the more critical success factors in achieving ICD-10 compliance and managing your revenue interruption risk. Florida Blue is recommending ICD-10 provider testing in the three phases below. Links to testing instructions and other important details are available below for initiating testing with us. Questions? Email us at [email protected].
Testing Results may be accessed following Phase III Instructions below.
ICD-10 Testing Phase
Start Date(s)
Instructions for Test Phase
Phase I
“Code Validation”
Now
Phase I testing (click here for overview) involves coding a selection of clinical diagnosis scenarios developed by Florida Blue Nurse Coders. You can print out the scenarios for your staff to code in both ICD-9 and ICD-10 for you to compare. This is a manual process and is
available for you on a self-service basis. Clinical Scenarios are
available in the instructions below.
Phase I Instructions: (click here)
ICD-10 Testing Phase
Start Date(s)
Instructions for Test Phase
Phase II
“Internal End-to-End”
Now
Phase II testing (click here for overview) consists of electronic receipt and internal processing of ICD-10 coded claims transactions that were previously processed by Florida Blue with ICD-9 codes. The instructions contain contact information for a Florida Blue ICD-10 testing coordinator in order to initiate Phase II testing
Phase II Instructions: Providers (click here)
Vendors (click here)
ICD-10 Testing Phase
Start Date(s)
Instructions for Test Phase
Phase III
“Round-Trip”
Now
Phase III testing (click here for overview) pertains to the “Round-trip” processing of ICD-10 coded electronic claim and remittance advice transactions. Phase II testing is a prerequisite.
(click here)
Phase III Instructions:
Providers (click here)
Vendors (click here)
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A Florida Blue Update
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Join our tweet chat! The dialogue will include some of the more pressing ICD-10
topics. A tweet chat is a pre-arranged chat that happens on Twitter through the
use of Twitter updates (called tweets) that include a predefined hashtag (keyword
preceded by the # symbol). The hashtag is used to link those tweets together in a
virtual conversation. Shadow along or join in on the conversation. Follow us on
Twitter @FLBlue and tag your posts #FLBlueChat!
Open Line Friday
A Florida Blue Update
Open Line Friday
Special Guests Speakers
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Follow us on Twitter @FLBlue
Karen Blanchette Association Director,
Professional Association of
Health Care Office Management
(PAHCOM)
Open Line Friday
Special Guests Speakers
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Follow us on Twitter @FLBlue
Carl Costa RHIT, CDIP, CHTS-TR, CPC
Senior Coordinator for Coding &Training
Florida Health Information
Management Association
(FHIMA)
Brandy Ziesemer RHIA, CCS, ICD-10 Trainer
Florida Health Information
Management Association
(FHIMA)
.
Send ICD-10 questions, comments, or your request
to be added to our email distribution to
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Next Steps
Next Steps
Test with us and your trading partners!!!
• Florida Blue testing details available at www.floridablue.com/icd-10
• Testing questions? Email us [email protected]
Visit the CMS “Road to 10” tool (www.roadto10.org) and get busy if
you’re not already preparing for Oct. 1, 2015!
Visit the Availity Learning Center (www.availity.com/learningcenter) for
ICD-10 education. (To add, change or remove your email and contact data visit
www.availity.com, select Payer Resources, Florida Blue and Update My Email Information with
Florida Blue, then follow the prompts).
REMEMBER to visit www.floridablue.com/icd-10
for ICD-10 testing, Open Line Friday and podcast information,
FAQs, our toolkit and more.
Follow us on Twitter @FLBlue
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City Day and Date Local Time Enroll
Hialeah Fri, March 13 1:00-3:00 PM Register
Lakeland Tues., March 10 2:00-4:00 PM Register
Naples Fri., March 13 8:00-10:00 AM Register
Orlando Mon., March 9 2:00-4:00 PM Register
Sarasota Wed., March 11 1:00-3:00 PM Register To register click HERE
OR visit: http://www.roadto10.org and refer to the
“Events” tab location on the left hand navigation bar.
CMS ICD-10 Education
CMS is offering free, ICD-10 two-hour training
sessions throughout Florida during the month
of March 2015*.
The first session is March 6, 9 AM – 11 AM at the
Tallahassee Memorial Hospital Auditorium.
Five other sessions are offered as indicated
below:
* Hospitals or facilities interested in hosting a
March event in Florida locations including The
Villages, Tampa, Port Charlotte, Fort Myers, or
Pensacola, please email Keith Gilliam at
Next Steps
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Addendum
ICD-10 Helpful Resources and Reference Material
• www.cms.gov/ICD10
• www.wedi.org
• www.ama-assn.org
• www.ahima.org/icd10
• www.availity.com
• www.fha.org
• www.hbma.com
• www.mgma.com
• www.floridablue.com/ICD-10
• www.fmaonline.org/HomePage.aspx
• www.cdc.gov/nchs/icd/icd10.htm
• www.AAPC.com
For regular CMS ICD-10 email updates, subscribe at:
https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_608
WEDI's 2014 Survey on Industry ICD-10 Readiness:
http://www.wedi.org/news/press-releases/2014/08/04/WEDI-Releases-ICD10-Readiness-Survey
Though not inclusive, the following list includes several public websites that can help increase general awareness
and understanding of the ICD-10 mandate and its impact to the health care industry:
The links below were referenced during this presentation. The actual URLs below are provided for your convenience:
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ICD-10
The most effective
way to do it,
is to do it! – Amelia Earhart