SUMMARY OF EVENTS

The previous ten days of activity continue to demonstrate the organization’s commitment to and the overall success of the ICD-10 implementation. Since our last update, NYP has received more than 1300 commercial third party payments for inpatient claims coded and billed with ICD-10 codes including the early signs of payment from some of our larger commercial payers such as Blue Cross, Aetna, Cigna, and United Healthcare. Some lingering billing issues, specifically related to what are referred to as “cross-over period” encounters (From dates prior and Through dates after October 1) are being researched and remedies are being tested and implemented. The impact of these issues is nominal in the context of NYP’s overall revenue base. As a reminder, the ICD-10 Support Center’s last day of operations will be Friday, October 30. Providers and staff with inquiries can continue to e-mail ICD-10Help@nyp.org and a member of the project team will respond. An ongoing summary of the project is listed below and the full presentation can be found here.

 

OVERALL IMPACT

Financial and operating metrics are trending slightly unfavorable in what appears to be largely due to typical productivity ebbs and flows of the operation and not ICD-10 related issues. Providers continue to interact with the new Allscripts documentation assistance tool, ICDx, though actually leveraging it to document in the patient’s record is still somewhat low. As such, Documentation Improvement specialists in HIM continue to generate increased volumes of provider inquiries in an effort to take advantage of the specificity available in ICD-10. Coding production is slightly down due to requests to dual code select populations of inpatient encounters but should return to normal and expected production by month end. Payments for current month discharges are trending similar to previous months suggesting that some insurance carriers are demonstrating an ability to pay under ICD-10.

 

ITEMS BEING RESOLVED

The Eagle IT team is applying vendor remedies to correct some billing issues related to cross-over period claims and should be resolved before month end. Health Information Management professionals are dual coding select populations of inpatient encounters in order to comply with payer specific billing requirements. An updated implementation issues log can be found here.

 

SUPPORT CENTER ACTIVITY

The ICD-10 Support Center received 3 phone calls and 3 e-mail inquiries in the last 10 days while preparing for the “Transition back to Operations” webinar on Thursday, October 29. In total, the Support Center has logged 103 issues and 17 remain open. Reference materials and other educational aids continue to be produced and disseminated to the organization. The ICD-10 AnTENna website recorded an additional 540 hits.

 

REMEMBER

• ICD-10 Diagnosis Codes are 3 – 7 characters, alpha-numeric, and ALWAYS begin with a letter
• ICD-10 is date of service/date of discharge sensitive
• DO NOT insert decimal points when entering ICD-10 diagnosis codes in Eagle
• Use ICDx to assist with documentation efforts in Sunrise Clinical Manager (SCM)
• Correct old health issues by clicking the health issue, selecting ‘update preferred mapping, select the ICD-10 code, and clicking ‘Accept”
• Ambulatory encounters scheduled prior to October 1, 2015 that included ICD-9 diagnosis codes will have to be manually corrected by converting the code to ICD-10 upon arrival.

 

HELP

For continued assistance and inquiry, please e-mail ICD-10Help@nyp.org, or visit the ICD-10 AnTENna website.

SUMMARY OF EVENTS

As we continue to move our patient encounters through the revenue cycle at rates commensurate with historical claims processing benchmarks, we continue to celebrate the receipt of payment on our earliest discharges of the “new era”. These payments are exclusively being remitted by Medicare, an expedient, if not the most lucrative of our payers. While we anxiously await the first commercial third party payment, the ICD-10 project moves into its next phase, that being to monitor the efficacy of those payment outcomes as well as the continuing to evolve our clinical documentation into an asset for the organization. As calls and inquiries to the ICD-10 Support Center begin to wane, its operating hours have been dialed back and updates will move to a weekly and/or bi-weekly basis. An ongoing summary of the project is listed below and the full presentation can be found here.

 

OVERALL IMPACT

Financial and operating metrics continue to remain stable as Support Center efforts prevent ICD-10 related issues from funneling back to the operation.  Providers are demonstrating an uptick in their interaction with the new Allscripts documentation assistance tool, ICDx.  Documentation Improvement specialists in HIM continue to generate increased volumes of provider inquiries in an effort to take advantage of the specificity available in ICD-10.  Coding production has remained solid despite the transition to the new code set.  Unbilled receivables are trending up due primarily to reporting format issues as opposed to actual data deficiencies. Payments continue to funnel in on our earliest discharges, exclusively from Medicare.

 

ITEMS BEING RESOLVED

A reporting issue in the billing system has artificially increased the unbilled receivable for the past two days. A remedy has been provided and should clear the majority of the increase by Monday, October 19. A separate issue related to inpatient admissions being converted back to ED is being researched. The Allscripts team continues to research an outstanding item related to ICDx and the entry of psychiatry diagnoses. An updated implementation issues log can be found here.

 

SUPPORT CENTER ACTIVITY

The ICD-10 Support Center received 1 phone call and 1 e-mail inquiry and largely completing the re-coding of outstanding and erroneously coded outpatient encounters. Inflow is predominantly related to previously scheduled visits in which patients were pre-registered with ICD-9 codes prior to October 1, 2015. In total, the Support Center has logged 99 issues and 18 remain open. Support Center staff will be preparing materials to present on Thursday, October 29 to finalize transition of these activities back to the operation. Reference materials and other educational aids continue to be produced and disseminated to the organization. The ICD-10 AnTENna website recorded an additional 106 hits.

 

REMEMBER

• ICD-10 Diagnosis Codes are 3 – 7 characters, alpha-numeric, and ALWAYS begin with a letter
• ICD-10 is date of service/date of discharge sensitive
• DO NOT insert decimal points when entering ICD-10 diagnosis codes in Eagle
• Use ICDx to assist with documentation efforts in Sunrise Clinical Manager (SCM)
• Correct old health issues by clicking the health issue, selecting ‘update preferred mapping, select the ICD-10 code, and clicking ‘Accept”
• Ambulatory encounters scheduled prior to October 1, 2015 that included ICD-9 diagnosis codes will have to be manually corrected by converting the code to ICD-10 upon arrival.

 

HELP

For continued assistance and inquiry, please call the ICD-10 Support Center at 646-NYP-9-2-10 (646-697-9210), e-mail ICD-10Help@nyp.org, or visit the ICD-10 AnTENna website.

SUMMARY OF EVENTS

As New York Met fans rejoice in the spoils of one of the more signature moments in its 53 year history, NewYork-Presbyterian fans can also “pile on the pitcher’s mound” as we celebrate the first paid claim coded and billed using the new ICD-10 code set. In fact, NYP received payment on several dozen inpatient claims across its six campuses. An accomplishment not to be understated, this milestone is a testament to the presence, contributions, and resolve of a Support Team, a project, and an organization that refuses to accept anything less than superior performance, superior quality, and amazing outcomes. Much work shall continue as we learn to leverage the increased specificity of an improved classification system that describes our patients’ conditions. But today, like the Mets, NYP celebrates success that has been years in the making. Congratulations! An ongoing summary of the project is listed below and the full presentation can be found here.

 

OVERALL IMPACT

Financial and operating metrics continue to remain stable as Support Center efforts prevent ICD-10 related issues from funneling back to the operation.  Providers are demonstrating an uptick in their interaction with the new Allscripts documentation assistance tool, ICDx.  Documentation Improvement specialists in HIM continue to generate increased volumes of provider inquiries in an effort to take advantage of the specificity available in ICD-10.  Coding production has remained solid despite the transition to the new code set.  Billing and claims submission production continues to be in line with historical volumes and time frames.

ITEMS TO BE RESOLVED

The Allscripts team has supplied a solution to the iCharge interface program that largely affects the Columbia Doctors professional billing and is monitoring its results. The Eagle team is research I minor reporting issue related to the continued presence of billing errors despite the fact that the claims have actually billed. A specific code truncation issue with one of our EDI vendors is also being research by the vendor though its impact is expected to be minimal. An updated implementation issues log can be found here.

SUPPORT CENTER ACTIVITY

An indication of the ongoing stability of the operation, the Support Center received no phone calls or e-mail inquiries for the day, though it continues to prepare for transition back to the operation by correcting additional erroneously coded outpatient encounters. There are less than 300 cases left to correct. In total, the Support Center has logged 96 issues and 19 remain open. The ICD-10 AnTENna website recorded an additional 99 hits.

 

REMEMBER

• ICD-10 Diagnosis Codes are 3 – 7 characters, alpha-numeric, and ALWAYS begin with a letter
• ICD-10 is date of service/date of discharge sensitive
• DO NOT insert decimal points when entering ICD-10 diagnosis codes in Eagle
• Use ICDx to assist with documentation efforts in Sunrise Clinical Manager (SCM)
• Correct old health issues by clicking the health issue, selecting ‘update preferred mapping, select the ICD-10 code, and clicking ‘Accept”

 

HELP

For continued assistance and inquiry, please call the ICD-10 Support Center at 646-NYP-9-2-10 (646-697-9210), e-mail ICD-10Help@nyp.org, or visit the ICD-10 AnTENna website.

SUMMARY OF EVENTS

Day 13 of the transition did not reveal any bad luck in the form of new issues or challenges and both inpatient and outpatient billing continue to produce expected volumes of claims to third party insurance carriers. Reviews of current unbilled inventories similarly indicate that any billing errors that are occurring are in line with standard operational deficiencies and not ICD-10 related. Call and inquiries to the ICD-10 support center have decreased and systemic issues affecting subsets of encounters have largely been resolved. As such, Support Center troubleshooting operations will begin to subside with remaining efforts concentrated on the monitoring of payment and denial in conjunction with Patient Financial Services (PFS). An ongoing summary of the project is listed below and the full presentation can be found here.

 

OVERALL IMPACT

At this stage of the transition, the impact of the ICD-10 transition on patient care/patient experience activities is essentially anon-factor. Financial and operating metrics continue to remain stable as Support Center efforts prevent ICD-10 related issues from funneling back to the operation. Coding production has remained solid despite the transition to the new code set. Documentation Improvement specialists in HIM continue to generate increased volumes of provider inquiries in an effort to take advantage of the specificity available in ICD-10. Providers are demonstrating and uptick in their interaction with new Allscripts documentation assistance tool, ICDx.

ITEMS TO BE RESOLVED

The interface issue between R4 and Eagle has been fixed and 90% of affected cases have been corrected. Similarly, the code dictionary issue in the billing system has been corrected and all affected cases are now scheduled to or have already generated accurate bills. Remaining open items are largely of the “one-off” variety with specific expertise from the Support Center reaching out to providers and staff to resolve. OR Manager team continues to work with its vendor to identify solutions to eliminate invalid code options from its data dictionaries. An updated implementation issues log can be found here.

 

 

SUPPORT CENTER ACTIVITY

Staff received 2 phone calls and 0 e-mail inquiries while correcting approximately 200 additional outpatient encounters erroneously assigned ICD-9 codes. In total, the Support Center has logged 96 issues and 19 remain open. The ICD-10 AnTENna website recorded an additional 142 hits.

 

REMEMBER

• ICD-10 Diagnosis Codes are 3 – 7 characters, alpha-numeric, and ALWAYS begin with a letter
• ICD-10 is date of service/date of discharge sensitive
• DO NOT insert decimal points when entering ICD-10 diagnosis codes in Eagle
• Use ICDx to assist with documentation efforts in Sunrise Clinical Manager (SCM)
• Correct old health issues by clicking the health issue, selecting ‘update preferred mapping, select the ICD-10 code, and clicking ‘Accept”

 

HELP

For continued assistance and inquiry, please call the ICD-10 Support Center at 646-NYP-9-2-10 (646-697-9210), e-mail ICD-10Help@nyp.org, or visit the ICD-10 AnTENna website.