Earlier this month, the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) jointly announced efforts to ready the physician community for the transition to ICD-10.  Part of this effort includes CMS’ claim processing flexibility and guidance that will prevent Medicare part B claims from being denied due to lack of specificity as well as eliminating potential penalties associated with its various quality reporting initiatives.  Though not the most desirable of arrangements, this agreement should clear an unabated path to October 1,2015 and the implementation of the new ICD-10 code set.  As part of the ICD-10 project, we here at NYP should be reminded as to what this announcement means.

• This announcement is only applicable to claims being submitted by physicians and other providers for professional services.
• Hospital based encounters and their associated (technical) claims are not affected by this announcement.  Clinical documentation activities performed by our physicians and other providers will continue to require the most specific representation of care provided to our patients.  This has been the case prior to ICD-10 and will continue to be the case after the implementation of ICD-10 on October 1.
• There is no indication that commercial insurance carriers to which physicians and other providers may be submitting professional claims will follow CMS’ lead in relaxing its own and respective medical policies and coverage guidelines.

The NYP ICD-10 Project PMO, in conjunction with its various workgroups and in cooperation with the Cornell and Columbia Faculty Practice Organizations will continue to work to ensure consistent understanding of this announcement as well as all other impacts to affected parties.  Questions can be directed to ICD-10Help@nyp.org.

 

80 days to go –  We have all at one point become familiar with the value of compromise. In both our professional and personal endeavors, the art of giving a little to get a little (or a little more) has become an endemic commodity in a complex society governed by postulations and opinions and where the short term currency of stagnation is sometimes seen as more profitable that the long term currency of transformation. Such compromise was center stage earlier this month when the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) agreed to collaborate on ICD-10 implementation. This collaboration includes CMS’ concession that claims for Part B services (i.e. – physician and other provider claims for professional services) will not be denied for lack of specificity for a period of one year. While this concession has its drawbacks, it is certainly hopeful that any future adversarial rhetoric from the AMA has finally been quelled, clearing an unabated path to October 1, 2015 and a new code set to define the healthcare we provide to our patients. The NYP ICD-10 project, in continued cooperation with our respective Faculty Practice partners, will work to ensure there is clear understanding as to what this latest news means for all affected parties communicating a singular message to aid the ongoing transition.

The NYP ICD-10 project comes into July at approximately 74% complete. A list of NYP’s most recent and cumulative accomplishments continues to move the organization closer to realizing the benefits of ICD-10 and much more.

• Operationalize dual coding.More than 90% of all Health Information Management (HIM) coding professionals are now coding in ICD-10 for inpatient, ambulatory surgery, and Emergency Department cases. Dual coding interfaces from Epic to our ICD-10 environment are complete and implemented.
• Enabling physician support of ICD-10 documentation requirements. Faculty Practice Organizations (FPO) at both the Cornell and Columbia Campus continue to work cooperatively with the NYP as approximately 60% of all physicians have completed ICD-10 related documentation training. ICDx, the Allscripts SCM customized documentation assistance tool is complete and being embedded into its first wave of high volume document template in the next 7 days.
• Apply applicable financial reserves. Our Revenue Cycle, Finance & Reimbursement workgroup has moved its primary initiatives of dual coding and claim testing into monitoring states and will transition to defining and developing the appropriate operational readiness protocols and associated post-implementation support models.
• Supporting Hospital operations with an ICD-10 ready technology and data infrastructure. Tremendous work by the IT workgroup continues to pay dividends as the number of system-to-system interfaces successfully tested increases to nearly 70%. Leadership has lent assistance by assigning specific delegates to inventory a spectrum of reports requiring conversion to ICD-10 prior to October 1.
• Create an ICD-10 informed and insulated organization. Our first draft of an organization-wide training module has been developed and is expected to be available in the next 30 days. A broader communication plan to cover the more than 13,000 NYP employees who are affected by ICD-10, large and small; has been defined with collaboration from internal communications.

Other activities will continue to progress and expand under the assumption that no further delays shall occur. For a complete overview of the project status, click here to view the Project Scorecard.

Should you have questions about what you can be doing to get your department ready for ICD-10 or would like to request an in person presentation from the ICD-10 project team, please e-mail ICD10Help@nyp.org.