just the facts- meaningful use stage 2 & icd 10

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Meaningful Use Stage 2 and ICD-10:

What Lies Ahead Rebecca Wiedmeyer

CEO of Vela Consulting Group, LLC

Sponsored by:

CMS says: ●  Measures focused on more rigorous

health information exchange (HIEs) ●  Additional requirements for e-prescribing

and incorporating lab results

Meaningful Use Stage 2

CMS says: ●  Electronic transmissions of patient care

summaries across multiple settings ●  Increased patient and family engagement

Meaningful Use Stage 2

17 Core objectives (opposed to 13 in MU Stage 1) 3 of 6 Menu objectives (opposed to 5 of 10 in MU Stage 1) =20 Total + CQM

MU Stage 2 Requirements

●  CPOE ●  e-Prescribing ●  Demographics ●  Vital signs ●  Smoking Status ●  Clinical Decision Support

Core Measures

●  Ability for patients to see certain aspects of their health record (portal or PHR)

●  Protected EHR/Secure technology ●  Integrated lab results ●  Patient lists by conditions

Core Measures

●  Analytics for preventative and follow-up care

●  Patient Education materials ●  Medication Reconciliation ●  Summary of care per transfer or referral ●  Immunization registries ●  Bilateral communication tool for MDs/

patients

Core Measures

Example: CPOE ●  60% of Medications ●  30% of Labs ●  30% of Imaging Studies

Attestation - MDs Must Make the Numbers for 90 days

Begins in 2014 Runs until 2016 Must use a certified EHR Must complete attestation form and submit (e.g. simply running reports will not suffice)

Attestation

●  International Classification of Diseases (ICD) has been used since 1979

●  Current code set is ICD-9, consisting of diagnosis codes (ICD-9 CM)

●  In 1994, the World Health Organization approved ICD-10.

ICD-10: History

ICD-10 consists of two code sets: ●  ICD-10 CM codes - Diagnosis ●  ICD-10 PCS codes - Procedures In 2008, the Department of Health and Human Services determined that the US was ready to adopt ICD-10

ICD-10: History

●  Recent legislation has delayed compliance until the end of 2015, no firm date has been announced.

●  ICD-10 compliance is a requirement for

Meaningful Use Stage 2.

ICD-10: Current State

ICD-9 =13,000 CM codes ICD-10 = 68,000 CM codes ICD-10 = 72,000 PCS codes

ICD-9 Versus ICD-10

ICD-9 codes are 3-5 characters in length ICD-10 codes are 5-7 characters in length *ICD-10 CM codes will be used in the Inpatient and Outpatient spaces, but PCS codes will only be used in the IP space.

ICD-9 Versus ICD-10

●  More specificity ●  Less gratuitous procedures ordered ●  Tracking and reporting for grants and

public health initiatives ●  Globalization: other countries are

already using ICD-10

ICD-10: Pros

●  Loss of productivity Coders, MDs, Billing, IT

●  Revenue impact

Some healthcare facilities are predicting up to a 70% revenue loss

ICD-10: Cons

●  Electronic system readiness - work with vendors

●  Update paper processes and content ●  Communicate across organization or

clinic

Risk Mitigation

●  Test, test, test! ●  Train and retrain staff and clinicians ●  Confirm coders are certified in ICD-10 ●  Create and leverage a strong project plan

Risk Mitigation

●  Create/run reports both before and after ICD-10 to monitor areas of weakness

●  Plan for and utilize a strong support model

for the time of ICD-10 “go-live” ●  Engage Legal and Compliance ●  Select project “champions”

Risk Mitigation

For further information, go to www.cms.gov

Questions?

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