ICD-10 A Refresher for ICD-10 Implementation NEXT STEPS AND KEY CONSIDERATIONS By Valerie Fernandez, MBA, CPC, CPC-H, AHIMA ICD-10 Trainer July 31, 2014, the Department of Health and Human Services confirmed that the new implementation date for ICD-10 would be October 1, 2015. In light of this, it is important to invigorate planning for ICD-10 implementation right away. There are a number of key items to complete and consider. The following is a refresher of those ICD-10 to dos. staff training should be included in any ICD-10 preparations. There are a number of tools available to help you. The american association of Professional Coders (aaPC) is offering modules online that will provide staff with the necessary information to implement ICD- 10 coding. The american Health Information management association (aHIma) also has online modules with associated boot camps that will enable certification in ICD-10. local chapters of these organizations are also providing training at reduced costs. Documentation improvement has always been a focus to ensure medical necessity for services rendered. ICD-10 codes require more granularity and specificity related to laterality and the status of the disease process. Conducting reviews of documentation to determine whether it will support an ICD-10 code is essential in preparation for the new implementation date. The Center for medicare & medicaid services (Cms) is offering acknowledgement testing in November 2014, march 2015, and june 2015. Cms will also be offering end-to-end testing in january, april, and july of next year. ensure that your staff are registered on the Cms listserv so that these important dates are not missed and other training opportunities can be identified. staff who had been focused on ICD-10 planning may have been redeployed or given other responsibilities. It is now time to reconvene the workgroups responsible for implementation so that strategic planning for the new implementation date is undertaken. reconfirm with software vendors that they will be ready to support ICD-10. Contact carriers to determine opportunities for testing using the new code set. evaluate carrier contracts to ensure they contain language related to budget neutrality so that reimbursement is not adversely impacted with the implementation of ICD-10. review the preparation timeline to make sure the practice is on track. Take advantage of free webinars offered by agencies such as Navicure. Cms has a wealth of information for small, medium, and large practices, and medicare university offers beneficial webinars at no additional cost for the practice. If the practice is still using a paper encounter form, it is important to revise that document to prepare for using the ICD-10 codes. There is not a one-to-one correspondence from ICD-9 to ICD-10, so the ICD-10 codes will not be able to be listed on paper encounter forms. a decision tree may be a better option on the revised encounter form. One example would be to include base code information with options to check off laterality: __ 01 right __ 02 left Or for fractures: __ Open __ Closed __ malunion __ Nonunion __ Comminuted __ spiral __ routine Healing __ Delayed Healing review the coding guidelines that are located at the front of the ICD-10 code book to ensure a clear understanding of which codes are presented as primary codes and which as secondary codes based on various services rendered. Focus on specialty-specific coding guidelines to ensure comprehensive preparation. V codes in ICD-9 translate to Z codes in ICD-10. Become familiar with those codes, as they will be used to report history and status, such as smoking history, Z87.891, and presence of prosthesis, such as a pacemaker or stent. THe jOurNal OF THe HealTHCare BIllINg aND maNagemeNT assOCIaTION 33 On
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