Is your long-term care facility prepared to implement ICD-10 coding? Between the additional specificity required for code selection and the substantial increase in the number of codes, developing efficient processes is imperative to managing the increased workload.
Train your staff now to ensure that effective and compliant processes are in place with ICD-10 Compliance: Process Improvement and Maintenance for Long-Term Care. This book focuses on process improvement before and after the October 1 implementation date. It highlights areas facilities can improve, including collaborating with physicians on documentation accuracy, working with vendors, analyzing revenue risks, claim reviews, and audits. It will help facilities continually monitor their processes to ensure everything is running smoothly.
This resource provides:
- Various examples of effective processes that SNFs can integrate, including specific rationale behind each option
- Explanations on what could potentially prevent payments
- Guidance on how to ensure physician documentation accommodates ICD-10 coding
- Education on how to code new encounters
- Dual-coding examples
- Direction on how to untangle vendor issues to protect SNF Medicare dollars
Table of Contents
Chapter 1: Introduction to ICD
Why ICD-10?
Benefits of Implementing the ICD-10 Coding System
Chapter 2: Planning the Transition to ICD-10
How to Get Started
Critical Tasks
Coding Impact
How Would an Organization Finish the Transition if They Started?
Chapter 3: Determining the Impact on Operations
Determine Implementation Impact Internal vs External
Establishing a Transition Plan
Chapter 4: Budgeting for the ICD-10 Transition
Budgetary Impact Implementation Costs
Predictive Budgeting
Chapter 5: Organizational Implementation/Transition Phase
Training the Facility Coding Staff
Preparing the SNF Physician for the Transition
Value of Adoption of ICD-10-CM
Assigning ICD-10 Codes
Discharge Summary Examples
Testing Phase
Chapter 6: Claims Processing and Auditing
Role of the MAC in Claims Edits and Education
General Claims Submissions and Edit Information for All MACs
Auditing for Valid Appropriate ICD-10 Codes
Free or Low-Cost Resources
Chapter 7: Auditing and Tracking Tools
Auditing Claims for Errors
Triple-Check Policy & Procedure
Chapter 8: How SNF Diagnosis Coding Differs From Other Healthcare Settings
Chapter 9: How to Use the ICD-10 Manual
Episode of Care
Additional Guidance in Coding Fractures
How to Use the GEM Files
Chapter 10: ICD-10-CM Official Guidelines for Coding and Reporting FY 2015
Chapter 11: Diagnosis Code Set General Equivalence Mappings
ICD-10-CM to ICD-9-CM and ICD-9-CM to ICD-10-CM, 2014 Version, Documentation and User's Guide
Section 1 Mapping and the GEMs
Section 2 How to Use GEM Files
Glossary
Diagnosis Code Set, General Equivalence Mappings, 2014 Version
Documentation, Appendix A File and Format Detail
Chapter 12: General Equivalence Mappings
Documentation for Technical Users
General Equivalence Mappings
ICD-10 GEMs FY2015 Version Update
DIAGNOSIS GEMs
Chapter 13: ICD-10 GEMs FY2015 Version Update
References
Who should read this book?
Administrators, DONs, Assistant DONs, Nurses, Staff educators, Clinical managers, Directors, Nurse managers, Coders, Billers, MDS Coordinators