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.