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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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