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.

SUMMARY OF EVENTS

Day 12 of the implementation welcomes yet another accomplishment in the transition, that is, the billing of outpatient encounters. All totaled, the six campuses of NYP submitted more than 4,500 ambulatory surgery, emergency department, hospital-based clinic, and other outpatient encounters to third party insurance carriers, all using ICD-10 codes. Inpatient billing has been fully resolved of remaining technical items and the outstanding batch of October 1 discharges have similarly been submitted. Coding production remains stable and erroneous use of ICD-10 codes continues to dwindle. The implementation has been largely devoid of any issues of significance and smaller items crossing the spectrum of IT, operations, and education and awareness continue to be resolved through collaboration of the ICD-10 Support Center, Information technology Services, staff and providers. An ongoing summary of the project is listed below and the full presentation can be found here.

 

OVERALL IMPACT

The impact of the ICD-10 transition on patient care/patient experience activities continues to remain minimal. Financial and operating metrics remain largely stable indicating that the transition to ICD-9 has not necessarily impacted our or the insurance industry’s ability to continue processing in ICD-9. The temporary increase in the unbilled receivable has subsided though not completely and Support Center Staff are evaluating any relation to ICD-10 specific anomalies.  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.

 

ITEMS TO BE RESOLVED

The previously reported interface/file extract issue with R4, an OB-GYN application at Lower Manhattan has been confirmed in which codes were being truncated due to insufficient field length. IT is collaborating with the Support Center to resolve this batch of encounters. An erroneous code file issue with ICD-10 code dictionaries resulted in some incorrect mappings of certain diagnoses as external cause of injury codes, resulting in claim submission errors. Impact was less than 100 claims and has similarly been resolved. An updated implementation issues log can be found here.

 

SUPPORT CENTER ACTIVITY

Staff received 3 phone calls and 2 e-mail inquiries while correcting approximately 300 additional outpatient encounters erroneously assigned ICD-9 codes. In total, the Support Center has logged 95 issues and 18 remain open. Implementation alerts and ICD-10 transition aids have been developed and deployed for closing outpatient encounters and correction of unmapped health issues.  The monitoring and auditing effort has resulted in verifying more than 99% data integrity for Inpatient, Ambulatory Surgery, and ED encounters. The ICD-10 AnTENna website recorded an additional 181 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 webiste.

SUMMARY OF EVENTS

As the week closes, word from our Patient Financial Services (PFS) divisions at Cornell and Columbia indicate the previously submitted claims are beginning to generate acknowledgements from insurance carriers and are being prepared for claims processing and payment. Yet another significant milestone in the ongoing transition. Coding production remains stable and the impact of ICD-10 to HIM productivity appears to be minimal at this stage. Ambulatory care operations and corrections to enabling technologies and interfaces are aiding in the reduction of erroneous registrations and continued use of ICD-9 codes. Support Center staff are diligently working to troubleshoot and resolve any remaining and flawed encounters in advance of October 12, the first day that October 1 outpatient encounters are eligible for billing. An ongoing summary of the project is listed below and the full presentation can be found here.

 

OVERALL IMPACT

The impact of the ICD-10 transition on patient care/patient experience activities continues to remain minimal. Financial and operating metrics remain largely stable indicating that the transition to ICD-9 has not necessarily impacted our or the insurance industry’s ability to continue processing in ICD-9. A temporary increase in the unbilled receivable due to a billing system issue for inpatient cases has been resolved and is expected to return to normal levels on Monday, October 12. 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.

 

ITEMS BEING RESOLVED

Continued diligence by the Eagle IT team appears to have resolved the inpatient billing issue that affected a subset of October 1, 2015 discharges and these cases are prepared to bill on Monday, October 12. An interface issue between Allscripts SCM and the billing system was identified and fixed that should aid in the receipt of OCD-10 codes on ambulatory encounters using electronic Superbill. Research is being conducted on a potential interface or file extract issue between the R4 system used at Lower Manhattan Hospital and the billing system. An updated implementation issues log can be found here.

SUPPORT CENTER ACTIVITY

Staff received 3 phone calls and 1 e-mail inquiry while correcting approximately 425 additional outpatient encounters erroneously assigned ICD-9 codes. In total, the Support Center has logged 91 issues and 20 remain open. Implementation alerts and ICD-10 transition aids have been developed and deployed for closing outpatient encounters and correction of unmapped health issues. The monitoring and auditing effort has resulted in verifying more than 99% data integrity for Inpatient, Ambulatory Surgery, and ED encounters. The ICD-10 AnTENna website recorded an additional 176 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”
• Code conversions with multiple options presented in the NYP Code converter should prioritize the choices with bidirectional arrows
• Close open outpatient encounters as quickly as possible to ensure timely billing

 

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 webiste.

SUMMARY OF EVENTS

As NYP moves into it second full week of ICD-10, the successes of week one have carried over. Inpatient coding, billing, and claim submission continues to funnel out and onto the insurance carriers’ own ICD-10 ready (we hope) technologies. More than 500 inpatient claims in total have cleared NYP’s multiple tiers of editing increasing the likelihood of clean submissions and timely payment from third parties. Outpatient monitoring and triage continues as an additional 450 ambulatory visits incorrectly coded with ICD-9 codes are corrected by Support Center staff. Ongoing fixes in Allscripts SCM and use of the code conversion tools made available to the operation should eventually minimize the recurrence. An ongoing summary of the project is listed below and the full presentation can be found here.

 

OVERALL IMPACT

The impact of the ICD-10 transition on patient care/patient experience activities continues to remain minimal. Financial and operating metrics remain largely stable indicating that the transition to ICD-9 has not necessarily impacted our or the insurance industry’s ability to continue processing in ICD-9. 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.

 

ITEMS BEING RESOLVED

Information Technology Services continues to monitor two minor issues affecting approximately 80 inpatient claims, awaiting solutions from application vendors. Similarly, the Allscripts SCM team is researching one template related issue that may have resulted in some health issues lists that were not updated from ICD-9 to ICD-10. Ongoing “ICD-10 Rounds” highlighted some education and training needs for providers to correct old health issues that require updated mapping from ICD-9 to ICD-10. An updated implementation issues log can be found here.

 

SUPPORT CENTER ACTIVITY

Staff received 4 phone call and 4 e-mail inquiries while correcting approximately 450 additional outpatient encounters erroneously assigned ICD-9 codes. In total, the Support Center has logged 87 issues and 19 remain open. The monitoring and auditing effort has resulted in verifying more than 99% data integrity for Inpatient, Ambulatory Surgery, and ED encounters. The ICD-10 AnTENna website recorded an additional 171 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”
• Code conversions with multiple options presented in the NYP Code converter should prioritize the choices with bidirectional arrows
• Close open outpatient encounters as quickly as possible to ensure timely billing.

 

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 webiste.

SUMMARY OF EVENTS

Day 7 of ICD-10 yielded our first submission of inpatient billing to third party insurance carriers, a major if not most significant milestone in the implementation and an unequivocal success for the project, Support Center staff and the Organization. These cases are now being meticulously monitored for payer acceptance and eventual payment by our Patient Financial Services Staff. Our coding professionals in HIM continue to settle into an “ICD-10 production mode”, coding more than 200 additional October discharges, and continued “ICD-10 rounds” across the campuses is providing needed visibility and attention to the transition for unreached providers and staff. Outpatient encounter monitoring is mitigating risk against unintended spikes in the unbilled receivable as we prepare for our first outpatient billing and submission on October 12. An ongoing summary of the project is listed below and the full presentation can be found here.

 

OVERALL IMPACT

The impact of the ICD-10 transition on patient care/patient experience activities continues to remain minimal. Financial and operating metrics remain largely stable indicating that the transition to ICD-9 has not necessarily impacted our or the insurance industry’s ability to continue processing in ICD-9. Documentation Improvement specialists in HIM have expectedly increased the volume of provider inquiries in an effort to take advantage of the specificity available in ICD-10.

 

ITEMS BEING RESOLVED

Collaboration across the ICD-10 Support Center, Information Technology Services, and Patient Financial Services helped identify and correct a minor inpatient billing issue that prevented a subset of our eligible inpatient discharges from being successfully billed and submitted. Similarly, The Support Center and the OR Manager team continue to engage the vendor on improving the data integrity of its ICD-10 code dictionary to prevent invalid codes from being selected for surgical bookings. Implementation Alerts and reminders regarding transition specific idiosyncrasies in Allscripts SCM have aided in getting providers to clean up legacy health issues that are no longer valid in ICD-10. An updated implementation issues log can be found here.

 

SUPPORT CENTER ACTIVITY

Staff received 2 phone call and no additional e-mail inquiries while correcting approximately 400 additional outpatient encounters erroneously assigned ICD-9 codes. In total, the Support Center has logged 7 issues and 17 remain open. The monitoring and auditing effort has resulted in verifying more than 99% data integrity for inpatient, Ambulatory Surgery, and ED encounters. The ICD-10 AnTENna website recorded an additional 164 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) Code conversions with multiple options presented in the NYP Code converter should prioritize the choices with bidirectional arrows
• Close open outpatient encounters as quickly as possible to ensure timely billing.

 

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 webiste.

SUMMARY OF EVENTS

The transition to ICD-10 continues to stabilize and its first submission of ICD-10 coded claims to insurance carriers is imminent. Daily ICD-10 rounding across the campuses has highlighted a generally informed and engaged group of staff and providers asking necessary questions, leveraging the tools and resources available, and demonstrating flexibility for the handful of operational and technical items that have popped up. Support Center staff continues to remedy batches of outpatient encounters that have been incorrectly registered and coded in an effort to effectuate smooth and seamless billing on October 12. Coding professionals in HIM continue to settle into a “business as usual” operating model. Inpatient documentation review activities are yielding increased levels of provider inquiry to ensure NYP leverages the specificity of the ICD-10 code set. An ongoing summary of the project is listed below and the full presentation can be found here.

 

OVERALL IMPACT

The impact of the ICD-10 transition on patient care/patient experience activities continues to remain minimal.  Financial and operating metrics remain largely stable indicating that the transition to ICD-9 has not necessarily impacted our or the insurance industry’s ability to continue processing in ICD-9. Documentation Improvement specialists in HIM have expectedly increased the volume of provider inquiries in an effort to take advantage of the specificity available in ICD-10.

 

ITEMS RESOLVED

There are currently no material issues of significance outstanding or that require escalated resolution across the campuses. Support Center staff continues to resolve minor end-user inquiries including proper code assignment and entry, interpretation of coding guidelines, and clarifications around recently released fixes to OR Manager and Allscripts that will now prevent selection of ICD-9 codes for dates of service on or after October 1.  An updated issues log can be found here.

 

SUPPORT CENTER ACTIVITY

Staff received 2 phone call and 3 additional e-mail inquiries while correcting approximately 1000 outpatient encounters erroneously assigned ICD-9 codes.  In total, the Support Center has logged 74 issues and 19 remain open. The monitoring and auditing effort has resulted in verifying more than 99% data integrity for inpatient, Ambulatory Surgery, and ED encounters. The ICD-10 AnTENna website recorded close to an additional 150 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)
• Code conversions with multiple options presented in the NYP Code converter should prioritize the choices with bidirectional arrows
• Close open outpatient encounters as quickly as possible to ensure timely billing.

 

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 webiste.

As the transition heads into the week 2, Day 5 the rewards of preparation, teamwork, dedicated effort, and responsiveness continue to pay off. Many small but nonetheless, nagging items have been remedied and a combination of fixes and workarounds for our most significant item to be resolved have been placed into production and communicated. The Support Center’s monitoring and reconciliation activities appear to have adequately prepared NYP for successful ICD-10 inpatient and outpatient billing runs on October 6 and October 12 respectively. A summary of yesterday’s events is listed below and the full presentation from yesterday’s Daily Transition Update can be found here.

 

OVERALL IMPACT

Though early in the implementation, the ICD-10 transition has generated minimal to no disruption in patient care/patient experience activities.  Financial and operating metrics remain largely stable indicating that the transition to ICD-9 has not necessarily impacted our or the insurance industry’s ability to continue processing in ICD-9.

 

ITEMS RESOLVED

Items of significance to be resolved include the application of error messaging and removal of Allscripts Health issues for which there is no applicable ICD-10 code. This will minimize if not eliminate patient encounters from NYP clinics from being coded with only ICD-9 codes. The OR Manager team has also expedited a fix to ensure our colleagues in the Cornell and Columbia Faculty Practice Organizations book surgical cases with ICD-10 codes. A minor issue with an Admitting Diagnosis field in our Eagle registration system similarly was identfieid and resolved within 30 minutes. An updated issues log can be found here.

 

SUPPORT CENTER ACTIVITY

The Support Center revised its operating hours for the week of October 5. Revised hours are now from 7:00 AM – 7:00 PM. It received 1 phone call and 4 additional e-mail inquiries while it continues a massive monitoring, auditing, and reconciliation effort at the encounter, transaction, and even data element level. In total the Support Center has logged 62 issues and 7 remain open. The ICD-10 AnTENna website recorded close to an additional 200 hits. Though, it appears as individuals stabilize in their understanding of ICD-10 and the practical idiosyncrasies of the transition, there is less need for material support. The Support Center continues to work with HIM experts to convert ICD-9 codes to ICD-10 on select population of patient encounters in advance of outpatient billing on October 12.

 

NEW & UPDATED RESOURCES

The Support Center has added an Allscripts reminder aid on adding Health Issues.

 

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)
• Code conversions with multiple options presented in the NYP Code converter should prioritize the choices with bidirectional arrows
• Close open outpatient encounters as quickly as possible to ensure timely billing.

 

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 webiste.