ICD-10 Staff Awareness
WHAT IS THIS COURSE?
This course is designed to provide a
basic awareness and understanding of
ICD-10 and why it is so critical to our
organization
WHAT IS ICD-10?
We have all been hearing the whispers … and screams …
about the transition to ICD-10.
For many of you, you may know all too well what it means
and how it affects you in your job. For others, you may not
know much about ICD-10 and what the fuss is all about.
International Classification
of Diseases (ICD)
ICD-9 is currently the official system of assigning codes to
diagnoses and procedures associated with hospital, outpatient,
clinical and physician utilization in the United States
We will be transitioning to the next version
of ICD codes – ICD-10
• The DIAGNOSTIC CODE is like
the rebar in the cement of a
building
 You may not know it’s there, but it
provides the structure and it is
everywhere!
• Defines Patient Illness
(diagnosis, signs, symptoms,
diseases, disorders, treatment,
and medication)
 Provides for Billing and
Reimbursement
 Measure Quality of Care
 Facilitates Clinical Research
 Determines Medical Necessity
 Captures Data for Reporting
World Health Organization (WHO) took over responsibility for ICD at
its creation in 1948 in its Sixth Revision (ICD-6) to provide a
consistent way to monitor and trend diagnoses and diseases
The United States has been using ICD-9 for over 30 years
Payers cannot pay claims fairly using ICD-9, since the classification
does not accurately reflect current technology
It is difficult to evaluate the outcome of new procedures and
emerging healthcare conditions when codes are not precise
 The healthcare industry cannot accurately measure
Quality of Care, particularly causes of mortality
 Clinical Research will be improved
 Impacts Billing and Reimbursement
ICD-9 Outdated
The U.S. is one of the few developed nations that has
not transitioned to the ICD-10 system
WHEN DOES THE CHANGE
FROM ICD-9 TO ICD-10 HAPPEN?
The deadline for organizations
to convert from ICD-9 codes to
ICD-10 codes is October 1, 2015
BENEFITS OF ICD-10
We will be able to capture more detailed data to
support clinical research, quality outcomes, and
patient care
For an academic organization, ICD-10 will
accommodate data capture of new technologies
and procedures and allow us to better define the
complexity of care provided
ICD-10 data will be more easily retrieved in
electronic format, resulting in less manual work in
reporting, quality reviews, and auditing
BENEFITS OF ICD-10 (CONT’D)
ICD-10 was designed with the idea that healthcare
delivery and technology are not static, but
constantly changing. It has far greater granularity,
specificity, and more current healthcare
information
An important benefit and result: The widespread
efforts within our organization to prepare for ICD10 will yield improved workflows, improved
efficiency, and greater organizational integration
and teamwork
HOW DO WE MAKE THIS
CHANGE HAPPEN?
There are seven BUMD-T/S ICD-10 teams who will be
leading the implementation effort:
 Clinical Documentation Team – responsible for facilitating effective
clinical documentation
 Coding Team – responsible for transition to new ICD-10 codes
 Education Team – responsible for staff training
 Revenue Cycle Team – responsible for redesign of revenue cycle
processes
 Reimbursement/Finance Team – responsible for ensuring payer and
contract readiness, reimbursement and financial reporting
 Technology Team – responsible for remediation and integration of
IT systems for ICD-10 implementation
The Health Plan – responsible for implementation as a payer
INTEGRATION WITH EPIC
• ICD-10 teams and Epic teams are
integrated
 Enables both projects to be in sync
with one another
ICD-10 IMPLEMENTATION PROCESS
Education needs are based on the staff member’s
position within the organization
Several different forms of training will be used:
learning modules via HealthStream, posters,
group forums, etc.
Coordination with Epic team
Epic includes both ICD-9 and -10 for dual coding
options
ICD-10 tools are embedded in Epic to facilitate the
transition
WHAT CHANGES CAN WE EXPECT?
The number of diagnostic codes will increase from
approximately 17,000 today to 140,000 after ICD-10
is implemented
Clinical documentation will require greater
specificity
All providers and staff involved in documentation
and coding must have a thorough understanding of
ICD-10
UAHN systems and workflows will need to be
modified to include ICD-10
NEXT STEPS
The ICD-10 Teams will coordinate with the
departments impacted by the change
Additional implementation training for
providers and staff directly affected by ICD10, will be rolled out through September,
2015
Regular communications will keep
everyone informed of project progress