CHI Franciscan Health Preparing for ICD-10

The federal government is replacing current ICD-9 diagnosis codes with more specific ICD-10 codes that will help us better understand and prevent disease and injury.

On July 31, 2014, the U.S. Department of Health and Human Services issued a final ruling that set October 1, 2015 as the required ICD-10 compliance date. As of this date, all providers and insurers must be using only the ICD-10 code sets for patient care claims.

Compliance with the federal mandate is not optional. We must successfully transition to ICD-10 by October 1 or claims for payment will be denied or delayed, severely impacting Franciscan revenue.

What are we doing to prepare?

Training for providers

Catholic Health Initiatives has partnered with an ICD-10 expert – Precyse Solutions – to provide training for those directly impacted by the change in codes, including our physicians. Conifer employees also will receive Precyse Solutions ICD-10 training. Because of the broad implications of ICD-10, however, every employee is being encouraged to understand this critical initiative.

Completing training will help providers to more quickly and accurately complete coding and documentation. This will help ensure that they are properly compensated for their time, reduce held claims and rework, and will help physicians make the best decisions for their patients.

Training courses are being assigned in three phases:

Specialty Documentation Improvement Jan – Mar 2015
ICD-10 Documentation Apr – Jun 2015
ICD-10 Awareness Jul – Aug 2015

See the training page for login instructions.

Training for “Role Mappers” and their staff

Directors and managers throughout CHI Franciscan Health are being identified as “role mappers.” Role mappers are leaders who, along with their staff, will benefit from ICD-10 training so that they may better understand the implications of the new coding system.

Role mappers will review the available training courses and then assign specific courses to their staff.

Electronic health record integration and testing

Using ICD-10 codes in both Epic and Meditech requires testing to ensure that the new codes can be accessed, entered and processed correctly. CHI ITS is running end-to-end scenarios in both systems and partnering with insurance carriers to ensure that coding will occur properly.

Clinical Documentation Improvement

ICD-9 and ICD-10 coding is one piece of the patient record that provides a picture of the patient’s condition and plan of care. CHI has implemented a Clinical Documentation Improvement (CDI) program that is comprised of a team of specially-trained nurses partnering with providers to help clarify documentation in the medical record according to CMS standards.

More accurate documentation helps to improve provider and hospital profiles, avoid delayed charges or rework, and ensure proper compensation. In addition, it benefits patients by ensuring that their medical record accurately reflects their diagnosis and plan of care, allowing other providers to better perform their roles in the care plan.

More information available