Immigrate to I-10: AAPC Prepares for the New Land

When you open the October 2013 Coding Edge, we’ll be using ICD-10-CM.

After more than a decade of false starts and revisions, we are all finally packing for destination ICD-10, which features a new language of an enormous but elegant “smart code” set. For a profession whose members weather weekly reimbursement rules and quarterly code changes, implementation seems both reassuringly far away and uncomfortably close. And frankly, after experiences like the Correct Coding Initiative (CCI) Black Box Edits and various audit programs, it’s hard to get excited about embarking on a boat for yet another federal initiative.

Certified Professional Coder-Payer CPC-P

That’s why when AAPC leaders looked at the journey ahead, they searched for “the right approach, the right curriculum, the right timing, and the right cost,” said Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, COBGC, CEMC, CDERC, CCS-P. As AAPC vice president of strategic development and former National Advisory Board (NAB) president, she’ll guide us through the transition. Grider is a long-time Coding Edge ICD-10 contributor and author of such coding standards as AMA Press’ Coding with Modifiers, with a new book, Preparing for ICD-10-CM: Make the Transition Manageable being released by the AMA this month.

With the help of colleagues, she has developed an action plan for AAPC members and others who worry about what ICD-10-CM will be like after disembarking.

The Right Approach, Timing, and Curriculum

Coders won’t be abandoned on the shore. “Expert trainers have been recruited and will be educated in general and specific topics for training throughout the country,” Grider said. “To make it easier, we’re taking advantage of new technologies to reach every member.” Training via the Internet and “smart phone” will supplement, and in many cases, replace traditional workshops. New technologies make training more convenient for members, she said, but traditional workshops and other techniques will also be used.

Webinars for both providers and payers are already available. These audiovisual presentations are available via the Internet for free, and offer an overview of ICD-10 implementation to help set the scope for the transition. They can be viewed at your leisure from home or the office. Continuing education units (CEUs) can be earned for these for an additional $29.95 by taking post presentation tests.

Proper planning now forestalls panic later, Grider said.

“Most of the overall training through 2010 is aimed at large organizations,” she said. “They need to start earlier because they have more to do to coordinate than smaller practices. We don’t want people to panic and feel they have to learn everything now or fail. We have four years to do this so that we can make the transition smooth and effective.”

Right now, the emphasis is on what needs to be done to get ready. Beginning next year, training is on proper code structure, information technology (IT) requirements, crosswalking, and how implementation alters the reimbursement cycle. Training will include a three-to-five day session for large facilities and physicians’ offices, presented by a cadre of elite, well-prepared coding instructors.

For individuals—besides Webinars and what pops up on your Blackberry—there will be presentations at national conferences, Internet-based distance learning modules, and more Coding Edge articles to allow education outside of the office. Onsite and distance learning will continue well into 2013.

And in 2013, as we get closer to implementation, there will be eight regional conferences—all on ICD-10—to help members and others before things change. Here is what curriculum is tentatively planned:

Implementation Distance Learning Modules.  A series of around a dozen Webinars focusing on implementation begins this month. Cost for the Webinars is still being determined.

2010 – Onsite Provider Training Begins

February, 15-Minute Webinars for Physicians & Admin. – A series of 15 Webinars specifically geared for the physician or nonphysician practitioner (NPP). These modules will be approximately 15 minutes long and cover issues applicable to practitioners (for example, how to make sure your documentation will support ICD-10, how to set your budgets, etc.) These brief Webinars are for doctors and practice administrators who are not deeply involved in coding, but need to be prepared because they may have some involvement in implementation. ($299.95 for all 15 or $29.95 each).

Beginning in April, Onsite Three-Day Implementation Training Available – Particularly geared toward larger practices, small payers and physician clinics, this onsite program will cover implementation training and guidance, featuring intensive instruction on ICD-10-CM, structure and guidelines, and crosswalking and mapping, along with hands-on exercises using the ICD-10-CM code set. The curriculum will also include an introduction into ICD-10-PCS, which will be beneficial for the facility coder. This will enable any provider location to systematically and cleanly make the switch to ICD-10. Onsite training is for large providers.

National Conference: Five Education Sessions – Don’t miss these sessions, which will help you adopt ICD-10-CM, while you’re attending the annual AAPC conference in Long Beach, Calif.

2011 – Onsite Provider Training Continues

One Half-Day Workshop Throughout the Country – This workshop will be held in 65 locations across the country and will help you progress through implementation benchmarks and to become knowledgeable about the new ICD-10-CM codes and structure. The half-day workshops will cover guidelines, structure of ICD-10-CM, crosswalks and mapping, as well as hands-on exercises, and an introduction to ICD-10-PCS. This workshop is for all coders.

March, Specialty-specific Distance Learning Webinars, and Audio Conference Courses Become Available – These courses will cover new specialty-specific ICD-10 codes (for example, obstetrics/gynecology (OB/GYN), cardiology, orthopaedics, family practice, internal medicine, and general surgery ICD-10-CM codes), addressing the common procedure codes each specialty will use. How the current coding method might be impacted—such as the superbill versus the electronic medical record (EMR)—along with crosswalking and mapping from ICD-9-CM to ICD-10-CM will be addressed. These courses will contain three modules:

  • ICD-10-CM guidelines (based on the specialty)
  • Commonly used codes (based on the specialty)
  • Crosswalking and mapping

There will be a quiz at the end of each module and a final exam at the end of the course. The Webinars and audio conference series will occur in one-hour segments.

National Conference: 10 Education – On the Long Beach in 2011, you can learn how to implement and use ICD-10-CM without gambling your reimbursement[r1] .

2012 – Proficiency Validation Begins

Two Half-day Workshops Throughout the Country – An update on the 2011 workshop, these workshops will be held in 65 locations across the country and help you progress through implementation benchmarks and become knowledgeable about the new ICD-10-CM codes and structure. The half-day workshops will cover ICD-10-CM guidelines, structure, and crosswalks and mapping, as well as provide hands-on exercises and an introduction to ICD-10-PCS. This workshop is for all coders.

Specialty-specific Distance Learning (E-learning), Webinars, and Audio Conference Courses Continue.

National Conference: 20 Education Sessions – All eyes will be on ICD-10 implementation at the AAPC national conference when half of the presentations address the new coding system[r2] .

Proficiency Validation Available – Proficiency validation begins Oct. 1, 2012 and can be taken online within the AAPC Member Area at www.aapc.com. The validation will be composed of 75 questions—timed, and open book. All certified coders are required to pass the validation by Sept. 30, 2014 to maintain certification. The proficiency validation may be taken twice for $60.

2013 – Regional Conferences

Eight Regional Conferences (January – May) – Conferences will be held in locations across the country. General, payer, and specialty ICD-10 tracks will be available to further help implementation.

National Conference: 20 Education Sessions – General, payer and specialty ICD-10 sessions will help you as we near the end of the journey and implementation begins.

Specialty-specific Distance Learning (E-learning), Webinars, and Audio Conference Course Continue.

Set the Proper Pace

For years, coders have been told it is important to learn ICD-10-CM and ICD-10-PCS details as soon as possible, but Grider disagrees. Planning is the first step to successful implementation, she maintains, and the details are best left until later in the process after each practice and payer determines how to manage reimbursement under ICD-10. She doesn’t advise immersing yourself in ICD-10 just yet, either. You’ll forget a lot of it; you probably already have. And, the Centers for Medicare & Medicaid Services (CMS) and payer policy and procedures still to be written may change the details of using ICD-10-CM and ICD-10-PCS. Grider recommends a timeline and course preparation for both provider and payer.

Recommended Provider Preparation Timeline

September 2009

Organize the Implementation Effort

October 2009

Develop a Communication Plan

May 2010

Conducting an Impact Analysis

August 2010

Organize Cross Functional Efforts (for medium to large practices)

August 2010

Estimate Budget

August 2010

Begin Internal System Design and Development (for medium to large practices)

September 2010

Development of Education and Training Plan

December 2010

Contact System Vendors

September 2011

Implementation Planning

August 2012

Business Process Analysis

September 2012

Phase I Education and Training

October 2012

Begin Education and Training, Phase II

May 2013

Deployment of Code by Vendors to Customers

July 2013

Policy Change Development

September 2013

Outcomes Measurement

Oct. 1, 2013

Implementation Compliance


Recommended Payer-specific Preparation Timeline

July 2009

ICD-10 Awareness

October 2009

Organizing the Implementation Effort

April 2010

Impact Assessment

July 2010

Budget for the Change

November 2010

Development of Education Plan

November 2010

Business Area Strategy Formulation

December 2010

Application Systems Strategies

December 2010

Vendor Strategies

December 2011

System Design and Development

October 2012

Begin Phase II ICD-10-CM and ICD-10-PCS Training

October 2012

Internal Testing

May 2013

Deployment of Code

Oct. 1, 2013

Begin Monitoring and Support

You can track your progress in the Members Area on the AAPC Web site.

Empowering Credentials at the Right Cost

Going to a new system can be expensive, but Grider said the plan is to keep prices low, so coders can learn what is necessary to make the transition. For example, the Overview Webinars available now are free of cost.

Naturally, said Grider, with the AAPC CPC® and other credentials being the accepted standard for coders among employers, it will be necessary to update current credentials to reflect the new code set. Coders will have two years to take an online, open book, 75-question Proficiency Evaluation on ICD-10 beginning Oct. 1, 2012. There will only be a $60 administration fee and the exam can be taken twice in the comfort of your home or office.

Coders need not re-take their CPC®, CPC-H®, CPC-P®, or CIRCC® exams when ICD-10-CM and ICD-10-PCS arrive.

Nothing Ventured, Nothing Gained

Fear and anxiety about venturing to the new land of ICD-10 is natural. You may experience some bumps in the road; however, Grider thinks you will love the detailed coding the new land brings. Like the immigrants stepping off at Ellis Island a century ago, we face huge possibilities. The reward for accuracy and ease are tremendous if we’re all prepared.

Brad Ericson, MPC, CPC, COSC, is director of publications at AAPC.

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