Transcription
2014 AAO-HNSF ICD-10 MiniseminarRichard Waguespack, MD, FACSAAO-HNS President and Physician Payment Policy(3P) Workgroup MemberAcademy Resources: http://bit.ly/entICD10-Bulletin, May 2013Member Benefit: Ear, Nose and ThroatSuperbill TemplateWhat do you need from the Academy?EMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENT CAREwww.entnet.org/annual meeting
2014 AAO-HNS ICD-10 Miniseminar“ICD-10 Implementation Delayed but NotEliminated: AAO-HNS Urges ContinuedPreparation.”Panelists Robert Lorenz, MD, MBA Annie Boynton, BS, RHIT, CPC, CCS, CPC-H,CCS-P, CPC-P, CPC-I, CPhTEMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENT CAREwww.entnet.org/annual meeting
ICD-10 Delayed but Not Eliminated:AAO-HNS Urges ContinuedPreparationRobert Lorenz, MD, MBA, FACS Medical Director of Payment Reform, Risk & Contracting for theCleveland Clinic Health System. Serves as the physician lead on the transition of 41,000employees to ICD-10 in 2015 for the Cleveland Clinic. Co-Chair elect of the AAO-HNS Physician Payment Policy (3P)workgroup and member of the Ad Hoc Payment Model workgroup. Former (2008-2011) Chief Medical Officer of Cleveland Clinic AbuDhabi (CCAD). Represents Cleveland Clinic on Ohio Governor Kasich’s AdvisoryCouncil on Health Care Payment Innovation Received his MBA from the London School of Economics withdistinctionEMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENTCAREEMPOWERINGPHYSICIANSTO DELIVER THE BESTW WW.ENTNET.ORG/ANNUAL MEETPATIENT CAREING
ICD-10 in OtolaryngologyRobert Lorenz, MD, MBAMedical Director Payment Reform, Risk &ContractingCleveland ClinicEMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENT CAREwww.entnet.org/annual meeting
DisclosuresNo conflicts of interest to discloseCo-Chair AAO-HNS 3P WorkgroupCoordinator Practice AffairsEMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENT CAREwww.entnet.org/annual meeting
Brief ICD-10 background EMR vs. Paper Professional Revenue vs. TechnicalEMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENTCAREEMPOWERINGPHYSICIANSTO DELIVER THE BESTW WW.ENTNET.ORG/ANNUAL MEETPATIENT CAREING
ICD-93-5 characters1st is numeric or E/V2nd, 3rd, 4th, 5th numericAt least 3 charactersDecimal after 1st 3 ICD-103-7 charactersFirst is alphaAll letters except U2nd & 3rd numeric4th, 5th, 6th, 7th can bealpha or numericDecimal after 1st 3EMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENTCAREEMPOWERINGPHYSICIANSTO DELIVER THE BESTW WW.ENTNET.ORG/ANNUAL MEETPATIENT CAREING
Changes in Brief .1. Disease Acuity2. Site3. Laterality4. Infectious Agent5. Connect disease process withcommon manifestations6. Circumstances surrounding injuryEMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENTCAREEMPOWERINGPHYSICIANSTO DELIVER THE BESTW WW.ENTNET.ORG/ANNUAL MEETPATIENT CAREING
EMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENTCAREEMPOWERINGPHYSICIANSTO DELIVER THE BESTW WW.ENTNET.ORG/ANNUAL MEETPATIENT CAREING
Proposed Benefits .EMPOWERING PHYSICIANS TO DELIVER THE BESTPATIENTCAREEMPOWERINGPHYSICIANSTO DELIVER THE BESTW WW.ENTNET.ORG/ANNUAL MEETPATIENT CAREING
ICD-9/10 Mapping RiskMappingCategoryLowRiskMapping Risk1:1ExactDescriptionSampleExact match indicates matchingdefinitionsICD-9ICD-10786.50R07.9Chest pain, ySingle1:ManyCombinationMatching clinical meanings withdiffering meaningsChest pain, unspecifiedICD-9ICD-10002.0A01.00Typhoid feverTyphoid fever, unspecifiedICD-9ICD-10S02.400ASeveral options for clinicalmeaning with increasedspecificity802.4S02.401A MaxillaryClosed facture of malar & maxillary bonesAn ICD-9 code maps to 2 or moreICD-10 codes in combination inorder to maintain clinical parityMany: 1Combination2 or more ICD-9 codes maps to asingle ICD-10 codeS02.402ANo Mapping toICD-10I
2 or more ICD-9 codes maps to a single ICD-10 code unstable angina No Mapping to ICD-10 With each new iteration of the GEMS there are fewer and fewer codes in this category 786.50 R07.9 ICD-9 ICD-10 Chest pain, unspecified Chest pain, unspecified 002.0 A01.00 ICD-9 ICD-10 Typhoid fever Typhoid fever, unspecified 802.4 ICD-9
