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Open Line Friday: ICD-10 Edition
ICD-10 Readiness: Another
Practice Testimonial
Lori Ann Martell, LPN, CMPE
Practice Administrator
Advance Medical of Naples, LLC
July 18, 2014
9:30 a.m. – 10:30 a.m. EST
Dial Toll-Free: (800) 882-3610 or (412) 380-2000
Conference Passcode: 6829655#
900-4559-0714
Open Line Friday: ICD-10
Panelists
Deborah Stewart, MD
Medical Director
Florida Blue
Gale Scott
EDI Regulatory Compliance
Administrator
Tampa General Hospital
Laurie Darst
Revenue Cycle Regulatory Advisor
Mayo Clinic (MN)
Matthew Ketterman
Director, Business Solutions
Availity®1
Joseph Gonzalez
VP of Business Development
Secure EDI
Lee Ratliff
Clinical Business Technology Consultant
Baptist Health South Florida
Mary Rita Hyland
VP of the Cooperative Exchange
Diana Brijbag
CMM, CPC, CCP, CMSCS, HITCM-PP
Office Manager
The Springs Family Medical Center
George Vancore
Senior Manager, Delivery Systems
Mandates and Compliance
Florida Blue
1 Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit www.availity.com
2
Open Line Friday: ICD-10
July 18, 2014
Special Guest
3
Lori Ann Martell, LPN, CMPE
Practice Administrator
Advance Medical of Naples, LLC
Note: Practitioner guests are subject to unforeseen clinical or other emergencies. Should guest(s) become unavailable at the time
of our program, Florida Blue will attempt to reschedule guest(s) for a future session.
Open Line Friday: ICD-10
ICD-10 Readiness: Another Practice Testimonial
4
Agenda
July 18, 2014
1. Objectives
2. Healthcare Industry Updates
3. Florida Blue Updates
4. Advance Medical of Naples
5. Next Steps
Objectives
1. Promote collaboration, communication and coordination between providers, payers
and electronic trading partners.
2. Expand your understanding of the current state of ICD-10, recent regulatory
decisions and industry perspectives.
3. Raise your awareness and understanding of the unique opportunities and challenges
that ICD-10 brings to the entire health care industry including providers, payers and
electronic trading partners.
4. Provide you with tools, techniques, best practices and helpful hints from your peers
that can be used as you continue (or begin) your ICD-10 journey.
**** Please remember that during the call all attendees will be placed on “mute”
except for any guest speakers and all panelists. If you have a question, please
email it to FloridaBlueOpenLineFriday@FloridaBlue.com.
5
Open Line Friday: ICD-10
Open Line Friday: ICD-10
Health Care Industry & Regulatory Update
• On June 17, 2014, HHS sent the ICD-10 interim final rule to the Office of Management and
Budget (OMB) for review and approval; according to health care industry sources, a new
compliance date requiring the use of ICD-10 will be October 1, 2015; in addition, the rule
also requires covered entities to continue to use ICD-9-CM through September 30, 2015.
• CMS/Medicare has postponed their ICD-10 end-to-end systems testing until 2015:
"CMS planned to conduct ICD-10 testing during the week of July 21 through 25,
2014, to give a sample group of providers the opportunity to participate in end-to-
end testing with Medicare Administrative Contractors (MACs) and the Common
Electronic Data Interchange (CEDI) contractor. The July testing has been canceled
due to the ICD-10 implementation delay. Additional opportunities for end-to-end
testing will be available in 2015.“
• On June 4, 2014, a letter was sent to Marilyn Tavenner (CMS Administrator) from the
chairs and ranking members of the Senate Finance, House Ways and Means, and House
Energy and Commerce committees (see next slide).
6
7
Open Line Friday: ICD-10
Health Care Industry & Regulatory Update (continued)
• NUCC changes to the CMS 1500 professional paper claim form to accommodate ICD-10
(www.nucc.org); the following recommended transition timeline has applied:
• January 6, 2014: Payers begin receiving and processing paper claims submitted on the
revised 1500 Claim Form (version 02/12).
• January 6 through March 31, 2014: Dual use period during which payers continue to receive
and process paper claims submitted on the old 1500 Claim Form (version 08/05).
• April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500
Claim Form (version 02/12).
• Partial code freeze continues until one year after the implementation of ICD-10:
• Only codes for new diagnosis and new technologies will be considered for exception inclusion.
• Last regular updates to ICD-9-CM and ICD-10 occurred on October 1, 2011.
• Regular ICD-10 updates will begin on October 1, 2016 pending the approval of the October 1,
2015 ICD-10 implementation date.
8
Florida Blue Update:
• Florida Blue is deploying a full remediation strategy to implement ICD-10.
• Florida Blue’s ICD-10 initiative is proceeding on plan. We are in the process of
completing our internal Compliance Level 1 testing and are fully engaged in
Compliance Level 2 testing with physicians, providers and external entities.
• Open Line Friday ICD-10 Edition teleconferences will continue every 3rd Friday
of each month. Audio podcast recordings are available through the Podcast link
located at www.floridablue.com/icd-10.
• ICD-10 Testing with Providers: we are continuing to engage providers in Phase I
and Phase II Testing. Phase III is in beta-test mode and will be generally available
in the late July timeframe; details of our provider testing, including a self-service
option, are available at www.floridablue.com/icd-10.
• Florida Blue’s ICD-10 Provider Toolkit will be maintained going forward and is
accessible from www.floridablue.com/icd-10.
• Attention Small to Medium sized providers: “Build your action plan and start
your transition to ICD-10 now with the CMS “Road to 10” tool. It’s simple. Visit the
www.roadto10.org”
Open Line Friday: ICD-10
9
10
Open Line Friday: ICD-10
ICD-10 Readiness: Another Practice Testimonial
Please refer to our guest speaker’s program material if available which can be accessed at
www.floridablue.com/ICD-10 under Open-Line Friday located in right margin.
Lori Ann Martell, LPN, CMPE
Practice Administrator
Advance Medical of Naples, LLC
11
ICD-10 Outreach
2-sided Flyer:
.
Send ICD-10 questions, comments or feedback to
floridablueopenlinefriday@floridablue.com.
12
Open Line Friday: ICD-10
ICD-10 Readiness: Another Practice Testimonial
12
ICD-10
The most effective
way to do it,
is to do it!
– Amelia Earhart
Next Steps
Next Steps
Build your ICD-10 action plan now with the CMS “Road to 10” tool. Visit www.roadto10.org
Access our Open Line Friday podcasts at www.floridablue.com/icd-10
ICD-10 Open Line Friday email list: send us your email by contacting us at
floridablueopenlinefriday@floridablue.com
Test ICD-10 with us. Visit www.floridablue.com/icd-10 and select our “Test ICD-10 icon”
for details. Testing questions? Email us at ICD-10Testing@floridablue.com
Access Florida Blue’s ICD-10 Provider Toolkit and more at www.floridablue.com/ICD-10
Visit the Availity Learning Center (www.availity.com/learningcenter) to access live and webinars
including information about Ready10 - a popular ICD-10 project management tool (see “There’s
Ready and There’s Ready10”).
Add, update or delete your email and contact information at any time using Availity's secure website. Log
on to Availity at www.availity.com, select Payer Resources, Florida Blue and Update My Email
Information with Florida Blue then follow the prompts.
Open Line Friday: ICD-10
Follow us on Twitter @FLBlue
14
Addendum
ICD-10 Helpful Resources and Reference Material
• www.cms.gov/ICD10
• www.wedi.org
• www.ama-assn.org
• www.ahima.org/icd10
• www.availity.com
• www.fha.org
• www.hbma.com
• www.mgma.com
• www.floridablue.com/ICD-10
• www.fmaonline.org/HomePage.aspx
• www.cdc.gov/nchs/icd/icd10.htm
 For regular CMS ICD-10 email updates, subscribe at:
 https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_608
 WEDI's Survey on Industry ICD-10 progress:
 http://www.wedi.org/docs/comment-letters/2013-wedi-icd-10-survey-results-letter.pdf?sfvrsn=0
 FREE CMS and WEDI ICD-10 End-to-End Testing Webinars available for download:
 http://www.wedi.org/forms/meeting/MeetingFormPublic/view?id=220AC00000156
 HIMSS/WEDI National ICD-10 Pilot Program Update:
 http://www.himss.org/library/icd-10/national-pilot-program?navItemNumber=13477
Though not inclusive, the following list includes several public websites that can help increase general awareness
and understanding of the ICD-10 mandate and its impact to the health care industry:
The links below were referenced during this presentation. The actual URLs below are provided for your convenience:
15
Open Line Friday: ICD-10

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ICD-10 Readiness: Another Practice Testimonial

  • 1. 900-3571-0213 Open Line Friday: ICD-10 Edition ICD-10 Readiness: Another Practice Testimonial Lori Ann Martell, LPN, CMPE Practice Administrator Advance Medical of Naples, LLC July 18, 2014 9:30 a.m. – 10:30 a.m. EST Dial Toll-Free: (800) 882-3610 or (412) 380-2000 Conference Passcode: 6829655# 900-4559-0714
  • 2. Open Line Friday: ICD-10 Panelists Deborah Stewart, MD Medical Director Florida Blue Gale Scott EDI Regulatory Compliance Administrator Tampa General Hospital Laurie Darst Revenue Cycle Regulatory Advisor Mayo Clinic (MN) Matthew Ketterman Director, Business Solutions Availity®1 Joseph Gonzalez VP of Business Development Secure EDI Lee Ratliff Clinical Business Technology Consultant Baptist Health South Florida Mary Rita Hyland VP of the Cooperative Exchange Diana Brijbag CMM, CPC, CCP, CMSCS, HITCM-PP Office Manager The Springs Family Medical Center George Vancore Senior Manager, Delivery Systems Mandates and Compliance Florida Blue 1 Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit www.availity.com 2
  • 3. Open Line Friday: ICD-10 July 18, 2014 Special Guest 3 Lori Ann Martell, LPN, CMPE Practice Administrator Advance Medical of Naples, LLC Note: Practitioner guests are subject to unforeseen clinical or other emergencies. Should guest(s) become unavailable at the time of our program, Florida Blue will attempt to reschedule guest(s) for a future session.
  • 4. Open Line Friday: ICD-10 ICD-10 Readiness: Another Practice Testimonial 4 Agenda July 18, 2014 1. Objectives 2. Healthcare Industry Updates 3. Florida Blue Updates 4. Advance Medical of Naples 5. Next Steps
  • 5. Objectives 1. Promote collaboration, communication and coordination between providers, payers and electronic trading partners. 2. Expand your understanding of the current state of ICD-10, recent regulatory decisions and industry perspectives. 3. Raise your awareness and understanding of the unique opportunities and challenges that ICD-10 brings to the entire health care industry including providers, payers and electronic trading partners. 4. Provide you with tools, techniques, best practices and helpful hints from your peers that can be used as you continue (or begin) your ICD-10 journey. **** Please remember that during the call all attendees will be placed on “mute” except for any guest speakers and all panelists. If you have a question, please email it to FloridaBlueOpenLineFriday@FloridaBlue.com. 5 Open Line Friday: ICD-10
  • 6. Open Line Friday: ICD-10 Health Care Industry & Regulatory Update • On June 17, 2014, HHS sent the ICD-10 interim final rule to the Office of Management and Budget (OMB) for review and approval; according to health care industry sources, a new compliance date requiring the use of ICD-10 will be October 1, 2015; in addition, the rule also requires covered entities to continue to use ICD-9-CM through September 30, 2015. • CMS/Medicare has postponed their ICD-10 end-to-end systems testing until 2015: "CMS planned to conduct ICD-10 testing during the week of July 21 through 25, 2014, to give a sample group of providers the opportunity to participate in end-to- end testing with Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor. The July testing has been canceled due to the ICD-10 implementation delay. Additional opportunities for end-to-end testing will be available in 2015.“ • On June 4, 2014, a letter was sent to Marilyn Tavenner (CMS Administrator) from the chairs and ranking members of the Senate Finance, House Ways and Means, and House Energy and Commerce committees (see next slide). 6
  • 7. 7
  • 8. Open Line Friday: ICD-10 Health Care Industry & Regulatory Update (continued) • NUCC changes to the CMS 1500 professional paper claim form to accommodate ICD-10 (www.nucc.org); the following recommended transition timeline has applied: • January 6, 2014: Payers begin receiving and processing paper claims submitted on the revised 1500 Claim Form (version 02/12). • January 6 through March 31, 2014: Dual use period during which payers continue to receive and process paper claims submitted on the old 1500 Claim Form (version 08/05). • April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500 Claim Form (version 02/12). • Partial code freeze continues until one year after the implementation of ICD-10: • Only codes for new diagnosis and new technologies will be considered for exception inclusion. • Last regular updates to ICD-9-CM and ICD-10 occurred on October 1, 2011. • Regular ICD-10 updates will begin on October 1, 2016 pending the approval of the October 1, 2015 ICD-10 implementation date. 8
  • 9. Florida Blue Update: • Florida Blue is deploying a full remediation strategy to implement ICD-10. • Florida Blue’s ICD-10 initiative is proceeding on plan. We are in the process of completing our internal Compliance Level 1 testing and are fully engaged in Compliance Level 2 testing with physicians, providers and external entities. • Open Line Friday ICD-10 Edition teleconferences will continue every 3rd Friday of each month. Audio podcast recordings are available through the Podcast link located at www.floridablue.com/icd-10. • ICD-10 Testing with Providers: we are continuing to engage providers in Phase I and Phase II Testing. Phase III is in beta-test mode and will be generally available in the late July timeframe; details of our provider testing, including a self-service option, are available at www.floridablue.com/icd-10. • Florida Blue’s ICD-10 Provider Toolkit will be maintained going forward and is accessible from www.floridablue.com/icd-10. • Attention Small to Medium sized providers: “Build your action plan and start your transition to ICD-10 now with the CMS “Road to 10” tool. It’s simple. Visit the www.roadto10.org” Open Line Friday: ICD-10 9
  • 10. 10 Open Line Friday: ICD-10 ICD-10 Readiness: Another Practice Testimonial Please refer to our guest speaker’s program material if available which can be accessed at www.floridablue.com/ICD-10 under Open-Line Friday located in right margin. Lori Ann Martell, LPN, CMPE Practice Administrator Advance Medical of Naples, LLC
  • 12. . Send ICD-10 questions, comments or feedback to floridablueopenlinefriday@floridablue.com. 12 Open Line Friday: ICD-10 ICD-10 Readiness: Another Practice Testimonial
  • 13. 12 ICD-10 The most effective way to do it, is to do it! – Amelia Earhart
  • 14. Next Steps Next Steps Build your ICD-10 action plan now with the CMS “Road to 10” tool. Visit www.roadto10.org Access our Open Line Friday podcasts at www.floridablue.com/icd-10 ICD-10 Open Line Friday email list: send us your email by contacting us at floridablueopenlinefriday@floridablue.com Test ICD-10 with us. Visit www.floridablue.com/icd-10 and select our “Test ICD-10 icon” for details. Testing questions? Email us at ICD-10Testing@floridablue.com Access Florida Blue’s ICD-10 Provider Toolkit and more at www.floridablue.com/ICD-10 Visit the Availity Learning Center (www.availity.com/learningcenter) to access live and webinars including information about Ready10 - a popular ICD-10 project management tool (see “There’s Ready and There’s Ready10”). Add, update or delete your email and contact information at any time using Availity's secure website. Log on to Availity at www.availity.com, select Payer Resources, Florida Blue and Update My Email Information with Florida Blue then follow the prompts. Open Line Friday: ICD-10 Follow us on Twitter @FLBlue 14
  • 15. Addendum ICD-10 Helpful Resources and Reference Material • www.cms.gov/ICD10 • www.wedi.org • www.ama-assn.org • www.ahima.org/icd10 • www.availity.com • www.fha.org • www.hbma.com • www.mgma.com • www.floridablue.com/ICD-10 • www.fmaonline.org/HomePage.aspx • www.cdc.gov/nchs/icd/icd10.htm  For regular CMS ICD-10 email updates, subscribe at:  https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_608  WEDI's Survey on Industry ICD-10 progress:  http://www.wedi.org/docs/comment-letters/2013-wedi-icd-10-survey-results-letter.pdf?sfvrsn=0  FREE CMS and WEDI ICD-10 End-to-End Testing Webinars available for download:  http://www.wedi.org/forms/meeting/MeetingFormPublic/view?id=220AC00000156  HIMSS/WEDI National ICD-10 Pilot Program Update:  http://www.himss.org/library/icd-10/national-pilot-program?navItemNumber=13477 Though not inclusive, the following list includes several public websites that can help increase general awareness and understanding of the ICD-10 mandate and its impact to the health care industry: The links below were referenced during this presentation. The actual URLs below are provided for your convenience: 15 Open Line Friday: ICD-10