ICD-10 Essentials for Homecare: Your Guide to Preparation and Implementation
Remain profitable and compliant under the ICD-10 coding system, as you begin preparation for the upcoming transition. Beacon Health provides you with a three-step plan that takes you from understanding the differences between ICD-9 and ICD-10 to full-scale ICD-10 readiness at your agency with
ICD-10 Essentials for Homecare: Your Guide to Preparation and Implementation.
You will learn the fundamentals of ICD-10 coding, what you can do today to manage the transition to ICD-10, and how to prepare for the impact on your daily operations. Complete with a chronological, step-by-step ICD-10 implementation action plan for your entire agency, this book is the perfect primer to get you where you need to be in order to survive and thrive under ICD-10.
This book will help you:
Implement simple coding changes
immediately
to ease the burden of the transition in future months
Familiarize your coders with the ICD-10 format to ensure a smooth transition and avoid interruption of payments during implementation
Develop timelines to train clinicians in new documentation requirements and ensure readiness by the implementation date
Achieve leadership buy-in for the necessary budget, policy changes, and infrastructure upgrade to accommodate ICD-10 requirements
Prevent payment denials under ICD-10 by determining primary diagnosis and sequencing in the new coding system
Compare what documentation is necessary now to what will be required under ICD-10 with an ICD-9/ICD-10 crosswalk tool
Ensure system readiness with a list of questions to ask your vendor
Execute a step-by-step action plan throughout your agency to ensure timely ICD-10 readiness
Table of Contents
Acronym Guide
PART I: Understanding the Fundamentals of ICD-10-CM Coding
Introduction
The Origins of ICD Coding
Getting to Know the ICD-10-CM Manual
Understanding the Coding Manual: Format and Setup
Alphabetical index
Tabular listing (essential under ICD-10)
Conventions and Terms
Format and structure (categories, subcategories, code)
The 3-7 characters expansion
New dummy place holders
The complex general coding guidelines
Five Easy Steps to Accurate Coding
PART II: Home Health Specifics: What You Need to Know
Primary and Other Diagnoses
Selection of the primary and other diagnoses
Case mix diagnosis
Home health plan of care
Effective Management of the Coding Process
Referral and clinical documentation impact on coding
The query process
Coding functions and productivity
Coding manager required skills
Coverage Criteria
Eligibility for coverage
The new face-to-face encounter
Home health care CAHPS survey
Conditions of coverage
OASIS
CoPs and OASIS requirements
OBQI and OBQM pre-survey reports
Home health compare
Receiving Appropriate Reimbursement
Home health PPS
Medical supplies, non-routine supplies, and DME under PPS
HHRG and case mix adjustments
Case Mix and Coding
Diagnostic categories
Grouper logic
Ethical Coding Practice
HIPAA and coding practices
Health care fraud and abuse
Corporate Compliance
AHIMA Standards of Ethical Coding
PART III: ICD-10-CM Preparation and Implementation
ICD-10 Implementation Planning
Step-by-step plan
Education tool
Administration Leadership and Support
Managing the Coding Function
Intake, liaisons, clinician
Query
Query forms and questions
Understanding GEM
Fiscal and Billing Necessities
Information Systems Readiness
Checklist for vendor readiness
Performance Improvement Data
Compliance Oversight
Valuable tools and forms include:
ICD-9/ICD-10 crosswalk
Step-by-step action plan for implementation
Vendor readiness questions
Query form for clinicians
Query form for intake