ICD-10 Essentials for Homecare: Your Guide to Preparation and Implementation
Remain profitable and compliant under the ICD-10 coding system, as you begin preparation for the upcoming transition. Beacon Health provides you with a three-step plan that takes you from understanding the differences between ICD-9 and ICD-10 to full-scale ICD-10 readiness at your agency with "ICD-10 Essentials for Homecare: Your Guide to Preparation and Implementation." You will learn the fundamentals of ICD-10 coding, what you can do today to manage the transition to ICD-10, and how to prepare for the impact on your daily operations. Complete with a chronological, step-by-step ICD-10 implementation action plan for your entire agency, this book is the perfect primer to get you where you need to be in order to survive and thrive under ICD-10.
This book will help you:
- Implement simple coding changes "immediately" to ease the burden of the transition in future months
- Familiarize your coders with the ICD-10 format to ensure a smooth transition and avoid interruption of payments during implementation
- Develop timelines to train clinicians in new documentation requirements and ensure readiness by the implementation date
- Achieve leadership buy-in for the necessary budget, policy changes, and infrastructure upgrade to accommodate ICD-10 requirements
- Prevent payment denials under ICD-10 by determining primary diagnosis and sequencing in the new coding system
- Compare what documentation is necessary now to what will be required under ICD-10 with an ICD-9/ICD-10 crosswalk tool
- Ensure system readiness with a list of questions to ask your vendor
- Execute a step-by-step action plan throughout your agency to ensure timely ICD-10 readiness
Table of ContentsAcronym Guide
PART I: Understanding the Fundamentals of ICD-10-CM Coding
- Introduction
- The Origins of ICD Coding
- Getting to Know the ICD-10-CM Manual
- Understanding the Coding Manual: Format and Setup
- Alphabetical index
- Tabular listing (essential under ICD-10)
Conventions and Terms- Format and structure (categories, subcategories, code)
- The 3-7 characters expansion
- New dummy place holders
- The complex general coding guidelines
Five Easy Steps to Accurate CodingPART II: Home Health Specifics: What You Need to Know
- Primary and Other Diagnoses
- Selection of the primary and other diagnoses
- Case mix diagnosis
- Home health plan of care
Effective Management of the Coding Process- Referral and clinical documentation impact on coding
- The query process
- Coding functions and productivity
- Coding manager required skills
Coverage Criteria- Eligibility for coverage
- The new face-to-face encounter
- Home health care CAHPS survey
- Conditions of coverage
OASIS- CoPs and OASIS requirements
- OBQI and OBQM pre-survey reports
- Home health compare
Receiving Appropriate Reimbursement- Home health PPS
- Medical supplies, non-routine supplies, and DME under PPS
- HHRG and case mix adjustments
Case Mix and Coding- Diagnostic categories
- Grouper logic
Ethical Coding Practice- HIPAA and coding practices
- Health care fraud and abuse
- Corporate Compliance
- AHIMA Standards of Ethical Coding
PART III: ICD-10-CM Preparation and Implementation
Joan L. Usher, BS, RHIA, COS-C, ACE, is president of JLU Health Record Systems in Pembroke, MA. Usher has more than 25 years' experience as a consultant and is a nationally recognized expert in the field of ICD-9-CM coding and health information management (HIM). She has taught ICD-9 coding in home health for 13 years and has educated more than 7,500 people nationwide. Usher is a past president of the Massachusetts Health Information Management Association.