the ins and outs of icd10 in centricity™ group management may, 2015
TRANSCRIPT
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The Ins and Outs of ICD10 in Centricity™ Group ManagementMay, 2015
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©2015 General Electric Company – All rights reserved.
The results expressed in this document may not be applicable to a particular site or installation and individual results may vary. This document and its contents are provided to you for informational purposes only and do not constitute a representation, warranty or performance guarantee. GE disclaims liability for any loss, which may arise from reliance on or use of information, contained in this document. All illustrations are provided as fictional examples only. Your product features and configuration may be different than those shown. Information contained herein is proprietary to GE. No part of this publication may be reproduced for any purpose without written permission of GE.
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Agenda
Constants Review
Obtaining and Loading ICD-10 Codes
Mapping
Charge Posting and Claims Submission
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The Constants
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Insurance Codes
‘Hidden’ Default Date is 10/01/2015
Workers Comp claims will not require ICD-10s
Update the ICD10 Date to 6/30/2029
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Diagnosis Code Constant
Alpha-numeric field (7 characters)
ICD-10 Y/N flag
Mapping fields
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How to get the ICD-10 codes (without mapping)Create your own Spreadsheet – Use CONSTANTS
Purchase the ICD10 codes from GE Healthcare – Use XCPT4
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Create a SpreadsheetAccess the CMS Websitehttp://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-and-GEMs.html
Download to PC as .txt files
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Create a Spreadsheet
Open CMS Code Description file in Microsoft® Excel® using Text Import Wizard• Change all fields to TEXT
• Import only columns you need
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Create a SpreadsheetTransfer Diag_Template.txt from /gpms
Open in Excel using Text Import Wizard
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Create a Spreadsheet
You have 2 Spreadsheets open
Copy/Paste into Diagnosis Template for Code and Description
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Create a SpreadsheetFile – Save As
Text (Tab Delimited) (*.txt) – Selected from Drop Down
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Create a Spreadsheet
Save Spreadsheet as .txt (icd10codes)
Transfer to Server
Upload using CONSTANTS
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Upload the Codes
Using CONSTANTS program • Access Optional Programs (8, 5)
• Type constants <enter>
Enter option 13
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Upload the Codes
Run in TEST MODE
Review reports in Printer Management
Run in LIVE MODE
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Option 2 – Purchase codes from GE HealthcareContact Support Services – 1-888-436-8491, Opt. 3
Approve quote via eService ($500)
GE Healthcare transfers to system
Use XCPT4 to upload (instructions provided)
No Mapping included
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Using XCPT4Access Optional Programs (8, 5)
Type xcpt4 <enter>
NOTE: No TEST mode
and no Reports
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ICD-9 Mapping
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CMS’ GEMs Reimbursement Mapping Guide
95% of codes one to one translation
5% of codes map to a cluster code
Handful of Duplicates
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Mapping ICD-9 codes
Layout based on CMS Reimbursement Mapping File
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Create a Spreadsheet
Open CMS Reimbursement Mapping file in Excel using Text Import Wizard• Change all fields to TEXT
• Import only columns you need
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Create a New Spreadsheet
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Create a Spreadsheet
Save Spreadsheet as .txt (icdmap)
Transfer to Server
Upload using CONSTANTS
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Upload the Codes
Using CONSTANTS program
Access Optional Programs (8, 5)
Type constants <ente
Enter option 13
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Upload the Codes
Run in TEST MODE
Review reports in Printer Management
Run in LIVE MODE
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Posting Charges
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Posting ChargesWhen date of service is equal to or greater than compliance date
User enters ICD-10 codes for services
Mapped ICD-9 codes will default on charge when defined within constants
No mappings defined, user can manually enter ICD-9 code(s) on the charge
ICD-9 code(s) will be required if payer is not ready
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Posting ChargesPrimary Insurance is ICD-10 Ready
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Posting ChargesPrimary Insurance is ICD-10 Ready, Secondary is not
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Posting ChargesPrimary Insurance is ICD-10 Ready, Secondary is not
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What is stored on the Charge?
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What is stored on the charge?
Both ICD-10 and ICD-9 codes
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What about the Claim?
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What about the Claim?
Who is being billed
Is the payer ready for ICD-10 codes?
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What about the Claim?
TestingContact GE Healthcare
Set up Test Practice
Create Test Charges
Work with Centricity™ EDI Services to send Test Claims
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Final Thoughts
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Final Thoughts – Get started now
Download the ICD-10 code set
Map the ICD-9 codes
Upload spreadsheet into your class/test practice
Get out there and Play!
Contact GE Healthcare for Payer Testing
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Thank you!
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