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Can ICD-9 and ICD-10 coexist? Erik Newlin, director of national

standards consulting in Xerox’s Govern- ment Healthcare Solutions group, urges organizations to have a system in place that allows ICD-9 to co-exist with ICD- 10 in order to ensure business continuity from October 1, 2014, forward. “With an implementation of this magnitude, it is important to be prepared for all possibilities,” says Newlin. Keeping ICD-9 running while ramping up ICD-10 can help ensure a smooth transition because: • T ere is a need for both code sets depending on dates of service or discharge dates.

• T ere may be a need to adjust claims after the compli- ance date.

• T e code sets are used by entities that are not covered under HIPAA, such as Worker’s Comp and other acci- dent insurance. It is conceivable that a few of these may continue to use ICD-9 codes after the compliance date.

• Some providers may choose to submit paper claims with ICD-9 codes after the compliance date.

• Organizations can plan for how they will handle imple- mentation issues if one or more of their trading partners is not ready, or if after the compliance date production issues are detected.

Solutions

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Treat ICD-10 holistically

SSI has got you covered before and after October 1, 2014. T e company’s

10Smart Solution provides smooth ICD-10 conversion and helps protect your fi nancial picture during the transition to ICD-10. 10Smart includes: ClaimSmart Suite, a fourth-generation RCM solution; A/Rchitect, a breakthrough platform that features an Analytics Suite and ICD-10 Assessment Tool; and ClickON ClearView ICD-10, a claim-validation test harness. SSI www.rsleads.com/401ht-152

Managing external risks associated with the ICD-10 transition

Matthew R. Dutton, a management consultant with Freed Associates, says that in looking at previous CMS regulatory ini- tiatives (e.g., v5010/D.O.), there has never been 100 percent compliance. After October 1, 2014, there will be coding errors, reimbursement errors, and even providers and payers that are not at all ready for the ICD-10 cutover, he says. Whether you are a payer or a provider, Dutton says your organization should consider the following three steps: • Create an inventory of your external trading partners, sorting by annual dollar volume (high to low).

• Reach out to your trading partners and schedule a test of healthcare transactions (e.g., 837 claims and 835 remittances) using claims with ICD-10 codes.

• Take appropriate steps to insulate your organization by prepar- ing for dual processing and dual coding contingency strategies. When engaging external trading partners, focus on answering the

following, says Dutton: “What will you code?” and “What will you pay?” By using these two questions for your book of business, you will be taking appropriate steps toward managing external risks associated with the ICD-10 transition.

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Rx decision support code set updated An ICD-10-CM and ICD-10-PCS revi- sion is available for FDB MedKnowl- edge, a proprietary clinical drug knowl- edge program also used for clinical decision support. Clinicians use the

codes to record patient problems and when performing drug- disease decision support for drug-disease contraindication screen- ing, screening for drug side eff ects, drug indications and indica- tion-specifi c drug dose checking. Since patient profi les will continue to contain ICD-9-CM codes for several years to come, FDB will continue to support ICD-9-CM codes. First Databank (FDB)

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Complete, customizable training Optum ICD-10 Core Educa- tion is a customizable, three- level, complete

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learning needs of physicians, nurses, coders, clinical documenta- tion improvement specialists and other hospital workers. Levels include: overview training, knowledge-based/skill-transfer and on-the-job training. Supplemental ICD-10 training options are also available, including on-site train-the-trainer sessions, dual coding and post-transition. Optum www.rsleads.com/401ht-154

HEALTH MANAGEMENT TECHNOLOGY

January 2014

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