Overview

The International Classification of Diseases-10 (ICD-10) is a new diagnostic coding system created to improve accuracy, quality, and specificity of healthcare delivery by utilizing a wider range of codes documented in medical diagnosis and inpatient procedures. Although the United States health system currently uses the International Classification of Diseases-9, it has initiated a transition to ICD-10, which is scheduled to take effect October 1, 2015. This webpage provides a review of CPCA training opportunities, announcements, and detailed information about the topic to assist you throughout the transition process.

Click here to review the CMS ICD-10-CM Official Guidelines for Coding and Reporting

 

How Should You Prepare?

Coders, billers, practice managers, physicians, and other health care personnel need to undergo training and be provided with educational materials in order to effectively implement ICD-10. Coders in hospital settings need to learn ICD-10 diagnosis and ICD-10 inpatient procedure coding, while coders in physician practices only need to learn ICD-10 diagnosis coding.

CPCA Training Opportunities

Purchase these recordings on demand by sending an email to CPCA's Training Team at training@cpca.org with the session title.

All/General

Best Practices for ICD-9 to Master the ICD-10 Transition
  • Learn commonality of ICD-9 best practices and application to ICD-10. Understand medical necessity link between ICD and HCPCS (e.g., CPT). Gain knowledge around HER and PM pitfalls pertaining to ICD-10 Transition.
ICD-10 Awareness for Community Clinic and Health Center Staff
  • Ensure every member of your staff is aware of the impending change, understand how they will be affected, and is prepared to do what they can to assist with the transition.
ICD-10 Awareness for Billing Managers and Directors
  • Ensure cash flow is not disrupted by ensuring proper processes are in place, including: staff training; process for discrepancies; software readiness; successful testing; and monitoring claims during go?live.

Coders/Billers/Providers

ICD-10 Champions in Your Clinic
  • Participant will recognize required guidelines for assignment of ICD-10-CM diagnosis codes. Participant will recognize the overall responsibility and value of appropriate diagnosis coding assignments for your patient population. Participant will compose outline of next-steps for ICD-10 readiness.
ICD-10 Transition: Provider-Specific Documentation and Tools
  • Importance of clinical documentation. Policy recommendations for clinical documentation. Essential elements of documenting. Use template. Using copy/forward. Time coding documentation nuances. Special types of encounters.
ICD-10 Clinician Mission: Prepare Your Transition to ICD-10 
  • Participant will recognize required guidelines for assignment of ICD-10-CM diagnosis codes; identify at least three common coding categories, e.g., hypertensive heart disease, diabetes with complications, asthma, et cetera, requiring enhanced special clinician documentation.
ICD-10 Clinician Mission: Coding Primer-Diabetes/Depression
  • This 60-minute session will build on lessons learned during the webinar training on August 6th of this year, Clinician Mission: Prepare Your Transition to ICD-10, with an advanced level of detail regarding clinical diagnosis coding with a focus on diabetes and depression. 
ICD-10 Clinician Mission: Coding Primer-Preventive/Injury
  • This 60-minute session will build on lessons learned during the webinar training on August 6th of this year, Clinician Mission: Prepare Your Transition to ICD-10, with an advanced focus regarding clinical diagnosis coding for preventive services and injuries.

Resources

CMS and AMA ICD-10 Frequently Asked Questions

Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) released a joint statement about their efforts to help the provider community get ready for ICD-10. This statement included guidance from CMS that allows for flexibility in the claims auditing and quality reporting processes.

CMS has released updated “Clarifying Questions and Answers" Related to Joint Announcement and Guidance Regarding ICD-10 Flexibilities, which provides answers to the most commonly asked questions. 

Medi-Cal ICD-10 Stakeholder Council calls
9/10/15 Call: PPT, Agenda, Minutes, CPCA Notes 
10/1/15 Call: PPT, Agenda
11/22/15 Call: PPT, Minutes
12/3/15 Call: PPT, Minutes 

Message from DHCS Regarding ICD-10
September 9, 2015: Message from California's Department of Health Care Services

CMS/AMA released a Joint Announcement and Guidance Regarding ICD-10 Flexibilities
On July 6, 2015, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) released a joint statement about their efforts to help the provider community get ready for ICD-10. This statement included guidance from CMS that allows for flexibility in the claims auditing and quality reporting processes.

ICD - 10 Updates
Anthem will continue to work to help ensure that our systems, supporting business processes, policies and procedures successfully meet the implementation standards and deadlines without interruption to day-to-day business practices. We will be capable of accepting and processing ICD-10 diagnosis and inpatient procedure codes on the mandated compliance date. 

Coding  Behavorial Health Services: CPT, DSM, and ICD
Helpful page with extensive resources on DSM-V and ICD-10. Collectively, these transitions impact clinical diagnoses, billing, contracts, work flow, HIT, compliance protocols, and more. Explore the resources to help you navigate these changes.

DSM-V and ICD-10
The ICD - 10 transition comes on the heels of the release of the DSM-5 in May 2013, which has been adopted by payers and direct service organizations at varying speeds. Providers must start planning now if they have not already begun. 

ICD – 10 Quick Start Guide: Train your Staff
Get ready now with the new CMW Quick Start Guide. This guide outlines 5 steps health care professionals should take to prepare for ICD-10 by the October 1, 2015, compliance date. You can complete parts of different steps at the same time if that works best for your practice.

CMS ICD-10 Infographic
Plan to work on the 5 steps at the same time. Remember that you do not have to necessarily complete one step before working on another step. Visit the Road to 10 tool to build an action plan using the 5 steps. A CMS online ICD-10 resource, Road to 10 was built by physicians for physicians.

ICD-10 Issues and Questions Reporting System 
Explore known issues and answers regarding the ICD-10 transition, or submit your own issues and questions. 

Transition Checklist
CPCA's ICD-10 Transition Workgroup, using a sample Action Plan from the CMS Road to 10 website, has prepared an ICD-10 Transition Checklist.  The checklist spreadsheet has a Master checklist tab, and additional tabs listing the possible duties for different types of health center staff.  CPCA hopes you'll find this checklist useful.

CMS ICD-10 Videos 
The Centers for Medicare & Medicaid Services (CMS) has released two animated shorts that explain key ICD-10 concepts. 

  • Introduction to ICD-10 Coding” gives an overview of ICD-10’s features and explains the benefits of the new code set to patients and to the health care community.
  • ICD-10 Coding and Diabetes” uses diabetes as an example to show how the code set captures important clinical details.

ICD-10: Ready, Set, Go
CPCA and PMG Consulting know how important it is to get your CHC on board and ready for October 2015. In an effort to bring our members the most affordable ICD-10 implementation program, we have been able to secure discounted pricing with PMG Consulting for their comprehensive “Ready, Set, Go!” program.  PMG, CPCA's Revenue Cycle Management partner, is ready to work with you to successfully manage the ICD-10 Transition.  

Coding for ICD-10 CM: More of the Basics
In this MLN Connects™ video, Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) provide a basic introduction to ICD-10-CM coding. The objective of this video is to enhance viewers’ understanding of the characteristics and unique features of ICD-10-CM, as well as similarities and differences between ICD-9-CM and ICD-10-CM.

- How to assign a diagnosis code using ICD-10-CM
- ICD-10-CM code structure
- Coding process and examples: Combination codes, 7th character, placeholder "x,” excludes notes, unspecified codes, external cause codes
- Resources for coders

ICD-10 Consultants
CPCA has compiled a list of ICD-10 consultants, with contact information. Please contact the vendors directly for more information regarding their respective services.

Resources specific to mental and behavioral health
Blue Cross Blue Shield
Hit by a Mac Truck

CPCA Staff Contact

If you have any questions, or need more information, please contact Emily Shipman, Senior Program Coordinator of Health Center Operations, at eshipman@cpca.org or (916) 440-8170.

If you're interested in participating in the ICD-10 Transition Workgroup, please contact Charlotte Reische, Senior Administrative Assistant, at creische@cpca.org or (916) 440-8170.


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