preparing for icd-10

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PREPARING FOR ICD-10 PRESENTED BY: EILEEN SEAGRAVES, COT

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  1. 1. PREPARING FOR ICD-10 PRESENTED BY: EILEEN SEAGRAVES, COT
  2. 2. Introduction Learn what ICD-10 is Learn to search for ICD-10 codes and convert from ICD-9 to ICD-10 Discuss staff implementation plan
  3. 3. What is ICD-10 ICD, International Classification of Diseases created by World Health Organization (WHO) We currently use ICD-9 codes; Sweden began using ICD-10 in 1997! The WHO deemed ICD-9 codes to be too vague and so created ICD-10 codes The implementation deadline is October 1, 2015 We need to take this time to practice and send out test claims
  4. 4. Overview Learn about ICD-10 Practice, Test, and Implement! Learn Practice Test Implement
  5. 5. Vocabulary Glossary of terms Laterality has a left, right, or bilateral side Sequela - a further condition that is different to, but a consequence of, the first condition (time has no bearing) Side note: we now have specificity for upper and lower lids, as well
  6. 6. ICD-9 vs. ICD-10 ICD-9 ICD-10 Code format: 5 numeric characters 7 alpha-numeric Characters: Digits 0-9 Digits 0-9; Letters A-T, V-Z Approx # of codes ICD9 Vol. 1&2; 13,000 ICD9 Vol. 3&4: 4, 000 ICD10-CM: 68,000 ICD10-PCS: 87,000
  7. 7. ICD-9 vs. ICD-10 ICD-9 format: 111.1 or 111.11 ICD-10 format: H11.1, H11.11, or H11.1- Example for Hyperopia H52.0- H52.01 Hypermetropia right eye H52.02 Hypermetropia left eye H52.03 Hypermetropia bilateral Presbyopia is only H52.4! No dash means there is no additional instructional materials so always look up codes thoroughly
  8. 8. ICD-10 Format
  9. 9. Chapters Chapter Topic ICD-10 Codes 1 Certain Infectious and Parasitic Diseases A00-B99 2 Neoplasms C00-D49 3 Diseases of the blood and blood forming organs and certain disorders involving the immune mechanism D50-D89 4 Endocrine, Nutrional, and Metabolic Diseases E00-E89 5 Mental and behavioral disorders F01-F99 6 Diseases of the Nervous System G00-G99 7 Diseases of the Eye and Adnexa H00-H59 8 Diseases of the Ear and Mastoid Process H60-H95 9 Diseases of Circulatory System I00-I99 10 Dieseases of Respiratory System J00-J99 11 Diseases of the Digestive System K00-K94
  10. 10. Chapters Contd Chapter Topic ICD-10 Codes 12 Diseases of Skin and Subcutaneous System L00-L99 13 Diseases of Musculoskeletal System and Connective Tissue M00-M99 14 Diseases of the Genitourinary System N00-N99 15 Pregnancy, Childbirth, and the Puerperium O00-O99 16 Certain conditions originating in the perinatal period P00-P96 17 Congenital malformations, deformations, and chromosomal abnormalities Q00-Q99 18 Symptoms, Signs, and abnormal clinical lab findings, NEC R00-R99 19 Injury, poisoning, and certain other consequences of external causes of mobidity S00-T88 20 External causes of morbidity V00-Y99 21 Factors influencing health status and contact with health services Z00-Z99
  11. 11. Subchapters H00 Hordeolum & Chalazion H31 Other disorders of choroid H01 Other inflammation of eyelid H33 Retinal detachments and breaks H02 Other disorders of eyelid H34 Retinal vascular occlusions H04 Disorders of lacrimal system H35 Other retinal disorders H05 Disorders of orbit H40 Glaucoma H10 Conjunctiva H42 Glaucoma in diseases classified elsewhere H11 Other disorders of conjunctiva H43 - Disorders of vitreous body and globe H15 Disorders of sclera H44 Disorders of globe H16 Keratitis H46 Optic Neuritis H17 Corneal scars and opacitities H47 Other disorders of optic (2nd) nerve and visual pathways H18 Other disorders of the cornea H49 Paralytic strabismus H20 Iridocyclitis H50 Other strabismus H21 Other disorders of iris and ciliary body H51 Other disorders of binocular movement H22 Disorders of iris and ciliary body in diseases classified elsewhere H52 Disorders of refraction and accommodation H25 Age related cataract H53 Visual disturbances H26 Other cataract H54 Blindness and low vision H27 Other disorders of lens H55 Nystagmus and other irregular eye movements H28 Cataract in diseases classified elsewhere H57 Other disorders of eye and adnexa H30 Chorioretinal inflammation H59 Intraoperative and postprocedural complications and disorders of eye and adnexa, NOC
  12. 12. Learn - How to Look Up ICD-10 Codes You may start in the Alphabetic Index or Tabular Index; however, to code appropriately, use the Tabular Index Alphabetic Index Tabular Index
  13. 13. Learn - How To Look Up ICD-10 Codes 1. Look up the main term in the Alphabetic Index (it does not always use common sense) Example: Age related nuclear sclerotic cataract is: Cataract senile Nuclear (sclerosis) H25.1- H25.11 Age-related nuclear cataract, right eye H25.12 Age-related nuclear cataract, left eye H25.13 Age-related nuclear cataract, bilateral
  14. 14. Learn - How To Look Up ICD-10 Codes 2. Observe the punctuation and cross-reference any notation 3. Add the appropriate seventh character, when indicated The seventh character may be one of the following: A initial encounter D subsequent encounter S sequel or sequel (condition resulting from a disease, injury, or other trauma) X is used as a placeholder in the 6th position
  15. 15. ICD-10 Format
  16. 16. Learn - How To Look Up ICD-10 Codes 4. For glaucoma, staging is required. Add the appropriate final seventh character, when indicated 0 stage unspecified 1 mild stage 2 moderate stage 3 severe stage 4 indeterminate stage
  17. 17. Practice Primary Open Angle Glaucoma Alphabetic Index Tabular Index Answer: H40.11X0, H40.11X1, H40.11X2, H40.11X3 or H40.11X4
  18. 18. Practice Multiple chalazia are excised for RUL, LUL, and LLL Alphabetic Index Tabular Index Answer: 1. H00.11 2. H00.14 3. H00.15
  19. 19. Practice Nuclear sclerotic cataract bilateral Alphabetic Index Tabular Index
  20. 20. Team Exercise Look up the diagnosis codes for the following (assume it is not secondary to any other systemic disease and that there is proper documentation): 1. A patient who has chronic iritis OD 2. A patient with a secondary cataract (PCO) OD 3. A patient with moderate POAG 4. A patient who is bilaterally pseudophakic 5. A patient with a corneal abrasion OS
  21. 21. Team Exercise Answers: 1. Chronic iritis OD: H20.11 2. PCO OD: H26.491 3. Moderate POAG : H40.11X2 4. Bilateral pseudophakia: Z96.1 5. Corneal abrasion OS: S05.02XA
  22. 22. Implement Hands on practice Test in Test database Consider use of mobile devices (tablets, phones, etc) Use pocket quick reference guides Utilize EHR lookup code module
  23. 23. Implement Use EHR system
  24. 24. Implement Use tablets
  25. 25. Implement Quick reference Guide
  26. 26. Implement Use the internet
  27. 27. THANK YOU!!!