Remain profitable and compliant under the ICD-10 coding system, as you begin preparation for the upcoming transition. Beacon Health provides you with a three-step plan that takes you from understanding the differences between ICD-9 and ICD-10 to full-scale ICD-10 readiness at your agency with ICD-10 Essentials for Homecare: Your Guide to Preparation and Implementation. You will learn the fundamentals of ICD-10 coding, what you can do today to manage the transition to ICD-10, and how to prepare for the impact on your daily operations. Complete with a chronological, step-by-step ICD-10 implementation action plan for your entire agency, this book is the perfect primer to get you where you need to be in order to survive and thrive under ICD-10.

This book will help you:

• Implement simple coding changes immediately to ease the burden of the transition in future months
• Familiarize your coders with the ICD-10 format to ensure a smooth transition and avoid interruption of payments during implementation
• Develop timelines to train clinicians in new documentation requirements and ensure readiness by the implementation date
• Achieve leadership buy-in for the necessary budget, policy changes, and infrastructure upgrade to accommodate ICD-10 requirements
• Prevent payment denials under ICD-10 by determining primary diagnosis and sequencing in the new coding system
• Compare what documentation is necessary now to what will be required under ICD-10 with an ICD-9/ICD-10 crosswalk tool
• Ensure system readiness with a list of questions to ask your vendor
• Execute a step-by-step action plan throughout your agency to ensure timely ICD-10 readiness

Table of Contents

• Acronym Guide
• PART I: Understanding the Fundamentals of ICD-10-CM Coding
  • Introduction
  • The Origins of ICD Coding
  • Getting to Know the ICD-10-CM Manual
  • Understanding the Coding Manual: Format and Setup
    • Alphabetical index
    • Tabular listing (essential under ICD-10)
  • Conventions and Terms
  • Format and structure (categories, subcategories, code)
  • The 3-7 characters expansion
  • New dummy place holders
  • The complex general coding guidelines
  • Five Easy Steps to Accurate Coding
• PART II: Home Health Specifics: What You Need to Know
  • Primary and Other Diagnoses
    • Selection of the primary and other diagnoses
    • Case mix diagnosis
    • Home health plan of care
  • Effective Management of the Coding Process
    • Referral and clinical documentation impact on coding
    • The query process
    • Coding functions and productivity
    • Coding manager required skills
  • Coverage Criteria
    • Eligibility for coverage
    • The new face-to-face encounter
    • Home health care CAHPS survey
    • Conditions of coverage
  • OASIS
    • CoPs and OASIS requirements
    • OBQI and OBQM pre-survey reports
    • Home health compare
  • Receiving Appropriate Reimbursement
    • Home health PPS
    • Medical supplies, non-routine supplies, and DME under PPS
    • HHRG and case mix adjustments
  • Case Mix and Coding
    • Diagnostic categories
    • Grouper logic
  • Ethical Coding Practice
    • HIPAA and coding practices
    • Health care fraud and abuse
    • Corporate Compliance
    • AHIMA Standards of Ethical Coding
• PART III: ICD-10-CM Preparation and Implementation
  • ICD-10 Implementation Planning
    • Step-by-step plan
    • Education tool
  • Administration Leadership and Support
  • Managing the Coding Function
    • Intake, liaisons, clinician
    • Query
    • Query forms and questions
    • Understanding GEM
  • Fiscal and Billing Necessities
  • Information Systems Readiness
    • Checklist for vendor readiness
  • Performance Improvement Data
  • Compliance Oversight

Valuable tools and forms include:

• ICD-9/ICD-10 crosswalk
• Step-by-step action plan for implementation
• Vendor readiness questions
• Query form for clinicians
• Query form for intake

About the author
Joan L. Usher, BS, RHIA, COS-C, ACE, is president of JLU Health Record Systems in Pembroke, MA. Usher has more than 25 years’ experience as a consultant and is a nationally recognized expert in the field of ICD-9-CM coding and health information management (HIM). She has taught ICD-9 coding in home health for 13 years and has educated more than 7,500 people nationwide. Usher is a past president of the Massachusetts Health Information Management Association.