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Stay the Course
Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced on April 9 a proposed rule that would establish a unique health plan identifier under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The proposed rule would implement several administrative simplification provisions of the Affordable Care Act.
An important part of the new proposed rule includes a proposed delay for ICD-10 implementation in the United States by one year – from Oct. 1, 2013, to Oct. 1, 2014. More information on the proposed rule is available on fact sheets (4/9/12). There is a 30-day comment period on the proposed new date.
In order to match the proposed implementation date change to Oct. 1, 2014, AAPC will be adjusting our ICD-10 timelines. For those members who hold an AAPC certification, the ICD-10-CM proficiency exam will be moved forward and offered from Oct. 1, 2013 through Sept. 30, 2015. AAPC will soon announce new dates for the release of ICD-10-CM code set training and will continue to offer implementation boot camps all across the country.
To help your providers prepare for the documentation challenges that they may face under ICD-10-CM, AAPC will offer Clinical Requirements for Providers in ICD-10-CM. This is a 3-hour online course that is taught by Dr. Joe Nichols. It is an interactive preparation tool that is broken down into 3 major sections: Documentation, Case Studies, and Most Commonly Coded Conditions with Documentation Strategy. The course will be offered by specialty and will help providers with clinical documentation improvement for a smooth transition into ICD-10-CM.
Keep watching for future updates from CMS and AAPC.
IN THE NEWS
Denise Buenning from CMS Speaks about their partnership with AAPC
The Centers for Medicare & Medicaid Services (CMS) have released a video on the ICD-10 transition which was played at the AAPC national conference. The short video addresses the reasons why the transition is necessary, available resources from CMS, and why it is important to "stay the course".
A 50 year-old male presents himself after being referred by his primary care provider for glaucoma. During his preventive medicine visit, he complained of loss of peripheral vision. It came on slowly and is noted in both eyes. He denies eye pain. Patient admits that he does not receive regular eye examinations.
On physical exam, the patient is in no acute distress without eye complaints other than peripheral vision loss. The following tests were performed:
Tonometry, perimetry, gonioscopy, and pachymetry. Ophthalmoscopy indicates increased IOP bilaterally. Test findings are all on attached separate reports.
Assessment: Patient has primary open-angle glaucoma; Mild stage on the right and moderate stage on the left. We discussed different options, including eye drops, oral medications, and laser surgery. The patient wishes to attempt medications first. We have chosen and explained the medication regiment to the patient and he expresses understanding. I will see him again in 2 weeks.
H40.11X2 Primary open-angle glaucoma, moderate stage (for the left eye)
H40.11X1 Primary open-angle glaucoma, mild stage (for the right eye)
Rationale: According to the 2012 ICD-10-CM Official Guidelines/Reporting (C.7.a.3), when a patient has bilateral glaucoma and each eye is documented as having a different type or stage, and the classification does not distinguish laterality, assign one code for each type of glaucoma with the appropriate seventh character for the stage. In the scenario above, the patient has bilateral glaucoma with a different stage in each eye, so two codes must be assigned. Some of the glaucoma code categories in ICD-10-CM contain laterality and some do not.
ICD-10 Implementation Strategies
In this section, we share strategies to help your practice successfully implement ICD-10-CM. Please remember to track your progress in your ICD-10 Implementation Tracker on AAPC's website.
To ensure a smooth transition to ICD-10 all of your systems will have to work together. You will need to complete an in-depth systems review to list the impact that ICD-10 will have and determine compatibility. This will allow you to assess whether upgrades will be necessary. Evaluate all systems, coding applications, and software to ensure compatibility with ICD-10. It will also need to be determined if the systems will be able to hold and extract data from both ICD-9 and ICD-10 code sets for a period of time. Make sure to include coders, billers, IT personnel, and vendors. If any adjustments, upgrades, or new products are necessary, this will allow you the time to plan and integrate them before the deadline.
ICD-9 to ICD-10 Mapping
This handy, one-page reference sheet will help you transition between the ICD-9 code set and ICD-10. It shows how the code sets are organized, with easy color coding to help you find what you're looking for. It also has mnemonic tips (such as "C is for cancer" and "T is for toxicity") to help you remember where the new codes are located.