Countdown to ICD-10: 97 Days to Go – Will You Be Ready?

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, June 25, 2015 Editor's Note: The October 1, 2015, compliance date for ICD-10 will be here in less than 100 days. Starting this week, your eNews has a new “Countdown to ICD-10” section, which groups all related information in one place to help you prepare. Can't view the image? Read the eNews! View this edition as a PDF In This Edition: Countdown to ICD-10 ICD-10 Deadline: October 1, 2015 ICD-10 Training Series for Small and Rural Practices Claims that Span the ICD-10 Implementation Date ICD-10 FAQs: CMNs, Prescriptions, and Orders Coding for ICD-10-CM: Continue to Report CPT/HCPCS Modifiers for Laterality Transition to ICD-10 for Home Health MLN Connects® National Provider Calls ESRD QIP System Training — Registration Now Open ESRD QIP: Reviewing Your Facility's PY 2016 Performance Data — Register Now 2016 PFS Proposed Rule: Medicare Quality Reporting Programs — Register Now ESRD QIP: Proposed Rule for Payment Year 2019 — Register Now MLN Connects® Events IQCP for CLIA Laboratory Nonwaived Testing: Workbook Tool — Webcast Announcements Are You Providing an Annual Wellness Visit to Your Medicare Patients? Affordable Care Act Payment Model Saves More than $25 Million in First Performance Year National Medicare Fraud Takedown Results in Charges against 243 Individuals for Approximately $712 Million in False Billing Changes to the Medicare Opt-Out Law for Physicians and Practitioners Corrections to eCQM Measures for 2016 Reporting Claims, Pricers, and Codes July 2015 Outpatient Prospective Payment System Pricer File Update CY 2015 Home Health PPS Mainframe Pricer Software Available Medicare Learning Network® Educational Products Medicare Learning Network® Products Available In Electronic Publication Format New Medicare Learning Network® Educational Web Guides Fast Fact Like the eNews? Have suggestions? Please let us know!

ICD-10 News: Quick Start Step 4 – Talk to Your Vendors and Health Plans

News Updates | June 25, 2015
ICD-10 Deadline October 1, 2015: Talk to Your Vendors and Health Plans Get Ready Now with the New CMS Quick Start Guide! While ICD-10 is almost here, you still have time to get ready. But you must get ready now. Each day this week we are highlighting 1 of the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. Today our focus is: Step: 4 Talk to Your Vendors and Health Plans Call your vendors to confirm the ICD-10 readiness of your practice’s systems Confirm that the health plans, clearinghouses, and third-party billing services you work with are ICD-10 ready Ask vendors, health plans, clearinghouses, and third-party billers about testing opportunities Tips You can use forms available in the Road to 10’s Template Library to guide discussions with vendors, health plans, clearinghouses, and billing services Double check that you’ve identified all systems that use ICD codes—e.g., practice management systems, electronic health record (EHR) products—when contacting vendors Update contracts with vendors and health plans as needed Transition costs for small medical practices could be substantially lower than projected earlier: Many EHR vendors are including ICD-10 in their systems or upgrades—at little or no cost to their customers Software and systems costs for ICD-10 could be minimal for many providers To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals. Keep Up to Date on ICD-10Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
		Questions?  Contact Us Stay Connected:

ICD-10 News: Quick Start Step 3 – Update Your Processes

News Updates | June 24, 2015
ICD-10 Deadline October 1, 2015: Update Your Processes Get Ready Now with the New CMS Quick Start Guide! While ICD-10 is almost here, you still have time to get ready. But you must get ready now. Each day this week we are highlighting 1 of the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. Today our focus is: Step: 3 Update Your Processes It is crucial to update hard-copy and electronic forms (e.g., superbills, CMS 1500 forms ) Resolve any documentation gaps identified while coding top diagnoses in ICD-10 Make sure clinical documentation captures key new coding concepts: Laterality—or left versus right Initial or subsequent encounter for injuries Trimester of pregnancy Details about diabetes and related complications Types of fractures Tips Create a documentation checklist for any new concepts that need to be captured for ICD-10 coding Remember that ICD-10 does not change the requirements for good documentation, which is always about capturing the complete clinical picture in order to provide high-quality patient care Review NCDs and LCDs with ICD-10 codes to ensure consistency with internal policies (e.g., coding, billing, and documentation processes) Outpatient and office procedure codes aren’t changing—ICD-10 does not affect the use of CPT and HCPCS coding for outpatient and office procedures To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals. Keep Up to Date on ICD-10Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
		Questions?  Contact Us Stay Connected:

ICD-10 News: Quick Start Step 2 - Train Your Staff

News Updates | June 23, 2015
ICD-10 Deadline October 1, 2015: Train Your Staff Get Ready Now with the New CMS Quick Start Guide! While ICD-10 is almost here, you still have time to get ready. But you must get ready now. Each day this week we are highlighting 1 of the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. Today our focus is: Step: 2 Train Your Staff Train staff on ICD-10 fundamentals using the wealth of free resources from CMS, which include the ICD-10 website, Road to 10, Email Updates, National Provider Calls, and webinars. Free resources are also available from: Medical societies, health care professional associations Hospitals, health systems, health plans, vendors Identify top codes. What ICD-9 diagnosis codes does your practice see most often? Target the top 25 to start. You might want to look at common diagnosis codes available from: Road to 10 (see Specialty References) Medical specialty societies Using the documentation available, code current cases in ICD-10. Flag any cases where more documentation is needed. Tips Training for clinical staff—e.g., physicians, nurse practitioners, physician assistants, registered nurses—should focus on documentation, new coding concepts captured in ICD-10 Training for coding and administrative staff—e.g., coders, billers, practice managers—should focus on ICD-10 fundamentals You can review your superbills, encounter forms, and practice management system reports to identify your most commonly used ICD-10 codes If time permits, expand your ICD-10 coding of current cases to include 50 or more of your top codes, until 80% of your claims are covered You don’t have to use 68,000 codes—as you do now, your practice will likely use a very small subset of ICD-10 codes You will use a similar process to look up ICD-10 codes that you use with ICD-9 While crosswalks from ICD-9 to ICD-10 can be useful references, ICD-10 codes should be based on the clinical documentation rather than selected from a crosswalk Practices that do not prepare for ICD-10 will not be able to submit claims for services performed on or after October 1, 2015 To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals. Keep Up to Date on ICD-10Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
		Questions?  Contact Us Stay Connected:

ICD-10 News: 100 Days Away

News Updates | June 22, 2015
100 DAYS AWAY: ICD-10 Deadline October 1, 2015 Get Ready Now with the New CMS Quick Start Guide! While ICD-10 is almost here, you still have time to get ready. But you must get ready now. Each day this week we are highlighting 1 of the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. Today our focus is: Step: 1 Make a Plan Assign target dates for completing steps outlined here Most important, obtain access to ICD-10 codes. The codes are available from many sources and in many formats: Code books CD/DVD and other digital media Online (e.g., go to cms.gov/ICD10 and select “2016 ICD-10-CM and GEMS” to download 2016 Code Tables and Index) Practice management systems Electronic health record (EHR) products Smartphone apps Decide role(s) your clearinghouse(s) will play in your transition. Some providers who are not ready could benefit from contracting with a clearinghouse to submit claims: Clearinghouses can help by: Identifying problems that lead to claims being rejected Providing guidance about how to fix rejected claims (e.g., more or different data need to be included) Clearinghouses cannot help you code in ICD-10 codes unless they offer third-party billing/coding services Tips You must use: ICD-10 codes for all services provided on or after October 1 ICD-9 codes for all services provided before October 1 Identify everywhere in your practice that you use ICD-9 codes to make sure you know what processes and systems need to be updated for ICD-10; for example: Patient registration and scheduling Clinical documentation/health records Referrals and authorizations Order entry Coding Billing Reporting and analysis Even clearinghouses that offer coding and billing services cannot translate ICD-9 codes to ICD-10 codes unless they have the detailed clinical documentation required to select the right code Practices that do not prepare for ICD-10 risk disruptions in cash flow For a more in-depth approach to planning, see the Action Plan section of the Road to 10 To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals. Keep Up to Date on ICD-10Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
		Questions?  Contact Us Stay Connected: