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Meaningful Use Stage 2
and ICD-10:
What Lies Ahead
Rebecca Wiedmeyer
CEO of Vela Consulting Group, LLC
Sponsored by:
CMS says:
●  Measures focused on more rigorous
health information exchange (HIEs)
●  Additional requirements for e-prescribing
and incorporating lab results
Meaningful Use Stage 2
CMS says:
●  Electronic transmissions of patient care
summaries across multiple settings
●  Increased patient and family engagement
Meaningful Use Stage 2
17 Core objectives (opposed to 13 in MU
Stage 1)
3 of 6 Menu objectives (opposed to 5 of 10
in MU Stage 1)
=20 Total + CQM
MU Stage 2 Requirements
●  CPOE
●  e-Prescribing
●  Demographics
●  Vital signs
●  Smoking Status
●  Clinical Decision Support
Core Measures
●  Ability for patients to see certain aspects
of their health record (portal or PHR)
●  Protected EHR/Secure technology
●  Integrated lab results
●  Patient lists by conditions
Core Measures
●  Analytics for preventative and follow-up
care
●  Patient Education materials
●  Medication Reconciliation
●  Summary of care per transfer or referral
●  Immunization registries
●  Bilateral communication tool for MDs/
patients
Core Measures
Example: CPOE
●  60% of Medications
●  30% of Labs
●  30% of Imaging Studies
Attestation - MDs Must Make the
Numbers for 90 days
Begins in 2014
Runs until 2016
Must use a certified EHR
Must complete attestation form and submit
(e.g. simply running reports will not
suffice)
Attestation
●  International Classification of Diseases
(ICD) has been used since 1979
●  Current code set is ICD-9, consisting of
diagnosis codes (ICD-9 CM)
●  In 1994, the World Health Organization
approved ICD-10.
ICD-10: History
ICD-10 consists of two code sets:
●  ICD-10 CM codes - Diagnosis
●  ICD-10 PCS codes - Procedures
In 2008, the Department of Health and
Human Services determined that the US
was ready to adopt ICD-10
ICD-10: History
●  Recent legislation has delayed
compliance until the end of 2015, no
firm date has been announced.
●  ICD-10 compliance is a requirement for
Meaningful Use Stage 2.
ICD-10: Current State
ICD-9 =13,000 CM codes
ICD-10 = 68,000 CM codes
ICD-10 = 72,000 PCS codes
ICD-9 Versus ICD-10
ICD-9 codes are 3-5 characters in length
ICD-10 codes are 5-7 characters in length
*ICD-10 CM codes will be used in the
Inpatient and Outpatient spaces, but PCS
codes will only be used in the IP space.
ICD-9 Versus ICD-10
●  More specificity
●  Less gratuitous procedures ordered
●  Tracking and reporting for grants and
public health initiatives
●  Globalization: other countries are
already using ICD-10
ICD-10: Pros
●  Loss of productivity
Coders, MDs, Billing, IT
●  Revenue impact
Some healthcare facilities are
predicting up to a 70% revenue loss
ICD-10: Cons
●  Electronic system readiness - work with
vendors
●  Update paper processes and content
●  Communicate across organization or
clinic
Risk Mitigation
●  Test, test, test!
●  Train and retrain staff and clinicians
●  Confirm coders are certified in ICD-10
●  Create and leverage a strong project plan
Risk Mitigation
●  Create/run reports both before and after
ICD-10 to monitor areas of weakness
●  Plan for and utilize a strong support model
for the time of ICD-10 “go-live”
●  Engage Legal and Compliance
●  Select project “champions”
Risk Mitigation
For further information, go to
www.cms.gov
Questions?
www.compliancy-­‐group.com	
  
	
  
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•  Intelligent web based solution designed by auditors.
•  Used by over 1,000 Covered Entities and Business Associates
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Just the Facts- Meaningful Use Stage 2 & ICD 10

  • 1. 855.85HIPAA   www.compliancygroup.com   Industry leading Education Certified Partner Program Please ask questions For todays & past webinars go to: http://compliancy-group.com/ webinar/ Get Involved. #cgwebinar
  • 2. Meaningful Use Stage 2 and ICD-10: What Lies Ahead Rebecca Wiedmeyer CEO of Vela Consulting Group, LLC Sponsored by:
  • 3. CMS says: ●  Measures focused on more rigorous health information exchange (HIEs) ●  Additional requirements for e-prescribing and incorporating lab results Meaningful Use Stage 2
  • 4. CMS says: ●  Electronic transmissions of patient care summaries across multiple settings ●  Increased patient and family engagement Meaningful Use Stage 2
  • 5. 17 Core objectives (opposed to 13 in MU Stage 1) 3 of 6 Menu objectives (opposed to 5 of 10 in MU Stage 1) =20 Total + CQM MU Stage 2 Requirements
  • 6. ●  CPOE ●  e-Prescribing ●  Demographics ●  Vital signs ●  Smoking Status ●  Clinical Decision Support Core Measures
  • 7. ●  Ability for patients to see certain aspects of their health record (portal or PHR) ●  Protected EHR/Secure technology ●  Integrated lab results ●  Patient lists by conditions Core Measures
  • 8. ●  Analytics for preventative and follow-up care ●  Patient Education materials ●  Medication Reconciliation ●  Summary of care per transfer or referral ●  Immunization registries ●  Bilateral communication tool for MDs/ patients Core Measures
  • 9. Example: CPOE ●  60% of Medications ●  30% of Labs ●  30% of Imaging Studies Attestation - MDs Must Make the Numbers for 90 days
  • 10. Begins in 2014 Runs until 2016 Must use a certified EHR Must complete attestation form and submit (e.g. simply running reports will not suffice) Attestation
  • 11. ●  International Classification of Diseases (ICD) has been used since 1979 ●  Current code set is ICD-9, consisting of diagnosis codes (ICD-9 CM) ●  In 1994, the World Health Organization approved ICD-10. ICD-10: History
  • 12. ICD-10 consists of two code sets: ●  ICD-10 CM codes - Diagnosis ●  ICD-10 PCS codes - Procedures In 2008, the Department of Health and Human Services determined that the US was ready to adopt ICD-10 ICD-10: History
  • 13. ●  Recent legislation has delayed compliance until the end of 2015, no firm date has been announced. ●  ICD-10 compliance is a requirement for Meaningful Use Stage 2. ICD-10: Current State
  • 14. ICD-9 =13,000 CM codes ICD-10 = 68,000 CM codes ICD-10 = 72,000 PCS codes ICD-9 Versus ICD-10
  • 15. ICD-9 codes are 3-5 characters in length ICD-10 codes are 5-7 characters in length *ICD-10 CM codes will be used in the Inpatient and Outpatient spaces, but PCS codes will only be used in the IP space. ICD-9 Versus ICD-10
  • 16. ●  More specificity ●  Less gratuitous procedures ordered ●  Tracking and reporting for grants and public health initiatives ●  Globalization: other countries are already using ICD-10 ICD-10: Pros
  • 17. ●  Loss of productivity Coders, MDs, Billing, IT ●  Revenue impact Some healthcare facilities are predicting up to a 70% revenue loss ICD-10: Cons
  • 18. ●  Electronic system readiness - work with vendors ●  Update paper processes and content ●  Communicate across organization or clinic Risk Mitigation
  • 19. ●  Test, test, test! ●  Train and retrain staff and clinicians ●  Confirm coders are certified in ICD-10 ●  Create and leverage a strong project plan Risk Mitigation
  • 20. ●  Create/run reports both before and after ICD-10 to monitor areas of weakness ●  Plan for and utilize a strong support model for the time of ICD-10 “go-live” ●  Engage Legal and Compliance ●  Select project “champions” Risk Mitigation
  • 21. For further information, go to www.cms.gov Questions?
  • 22. www.compliancy-­‐group.com     855.85  HIPAA     (855.854.4722)   The Guard: •  Intelligent web based solution designed by auditors. •  Used by over 1,000 Covered Entities and Business Associates •  Quickly and cost-effectively Achieve, Illustrate and Maintain HIPAA, HITECH, and Omnibus Compliance. •  HIPAA Audit Guarantee   Features •  Policy & Procedure Templates Included •  Business Associate Management •  Document & Version Control •  Training & Attestations Tracking •  HIPAA Coaches to Assist every step of the way HIPAA Education Series sponsored by: