ICD-10 Arrives in 37 Days
The transition from ICD-9 to ICD-10 for reporting diagnoses and procedures on October 1, 2015, is quickly approaching.
The key to success transitioning to ICD-10 is providers documenting completely and with greater specificity. By being aware of what needs to be in the documentation, providers can ensure proper codes are applied and avoid any financial and regulatory non-compliance repercussions.
In preparation for this change, Kaleida Health has compiled several resources to assist providers through the transition.
Provider Workflow
The most significant change with ICD-10 for providers is the need to provide more specific and complete documentation that supports the new and expanded set of codes.
Providers should use the Problems and Diagnoses section of a patient’s record to document the most specific and detailed diagnosis for the patient’s condition. Diagnoses should be documented using the Diagnosis search components in the electronic medical record (EMR). By using these tools, the diagnoses will populate the histories and physicals and progress notes documentation, and will also be available to link to orders and order sets.
Physician Transition Early
Physician Transition Early (PTE) is an electronic tool that supports providers with documenting diagnoses and the transition ICD-10.
PTE allows providers to:
- Become familiar with ICD-10 specificity
- View ICD-9 and ICD-10 codes together
- Increases adoption and readiness for ICD-10
- Utilize Diagnosis Assistant, an electronic tool that aids the physician in the selection of a specified ICD-10 diagnosis code, in advance of October 1, 2015
PTE will be implemented into the EMR on Monday, August 31, 2015.
With Diagnoses Assistant, a “Specificity” icon will display next to the diagnoses in the patient record indicating which diagnoses needs to be reviewed for additional specificity.
A web-based training module, “Introduction to Physician Transition Early and ICD-10,” is available on Talent Management.
Talent Management Training
In addition to the “Introduction to Physician Transition Early and ICD-10,” a series of educational training modules were assigned to providers based on specialty.
These educational modules provide background information on ICD-10, the reason for the conversion, and documentation expectations, among other items. Each module also includes a post-test of the learning, and CME credits will be provided.
All credentialed providers have access to Talent Management. Assignment notifications are sent to providers kaleidahealth.org email account. To access your Talent Management account:
- Go to www.kaleidatms.com
- Enter your Kaleida Health network user ID and password, and select sign in
- See the To-Do List for assigned trainings
Provider Resources
Numerous useful tools and educational resources are available through the ICD-10 countdown button on KaleidaScope and InfoClique. In addition to the web-based trainings assigned through Talent Management, other resources include:
Quick Reference Cards (QRCs) – Guidance on how the new EMR tools can impact workflow and help complete documentation specificity requirements including diagnosis and specialty- specific tips
Code Look-up – Applications and websites that can be used to identify the ICD-10 code based on key word or ICD-9 code search. Hard-copy ICD-9 to ICD-10 code mapper translation cards will be distributed to ambulatory clinics and other designated departments
Industry links – Centers for Medicare and Medicaid Services (CMS) offers providers and other members of the healthcare team resources on documentation and codes
On-Site Training
Staff will be available at various locations as of September 1, 2015. These documentation and workflow specialists will support providers with Cerner functionality to drive the documentation needed to gain the level of specificity required for ICD-10. This team will support the use of Physician Transition Early, Diagnosis Assistant and advise providers on how to manage their Problems and Diagnoses list.
Coding Orders and Scripts Reminder
Kaleida Health requests that any orders or scripts being written for testing after October 1, 2015 include an ICD-10 code. Those tests that include regulatory requirements related to medical necessity must include the ICD-10 coding for those diagnoses.
When appropriate coding is missing, Kaleida Health will contact your office for the additional coding. Providing sufficient coding at the time the order is written will decrease many of the time-consuming calls to your office staff, and will assist Kaleida Health in providing better and timelier services for your patients.
Additional Questions
Please contact Vickie Trautman, director of health information, at vtrautman@kaleidahealth.org for any general questions or concerns, or Kathy Tomasulo, information technology project manager, at ktomasulo@kaleidahealth.org for any information technology questions.