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Open Line Friday: ICD-10
Seven Months to ICD-10: Useful
Guidance for the Countdown
Ken Bradley of Navicure &
Stanley Nachimson of Nachimson Advisors
Feb. 21, 2014
9:30 a.m. – 10:30 a.m. EST

Dial Toll-Free: (800) 882-3610
Conference Passcode: 6829655#

900-4299-0214
900-3571-0213
Open Line Friday: ICD-10
We are here for you.
Do we have your correct email address?

Register and regularly update your email address with us.
•

You can add, update or delete your email address and contact
information at any time using Availity's secure website.


•

1Availity,

Log on to Availity®1 at www.availity.com, select Payer Resources, Florida Blue
and Update My Email Information with Florida Blue, then follow the prompts.

ICD-10 Open Line Friday email list: Send us your email by contacting us
at floridablueopenlinefriday@floridablue.com

LLC is a multi-payer joint venture company. For more information or to register, visit Availity’s website at www.availity.com.

2
Open Line Friday: ICD-10
Lee Ratliff
Clinical Business Technology Consultant
Baptist Health South Florida

Panelists

Laurie Darst

Medical Director
Florida Blue

Mary Rita Hyland

Matthew Ketterman

CPO and VP Regulatory Affairs
The SSI Group, Inc.

Director, Business Solutions
Availity®1

Joseph Gonzalez

Diana Brijbag, CMM, CPC, CCP, CMSCS
George Vancore
Senior Manager, Delivery Systems
Mandates
Florida Blue

1

EDI Regulatory Compliance
Administrator
Tampa General Hospital

Deborah Stewart, MD

Revenue Cycle Regulatory Advisor
Mayo Clinic (MN)

VP of Business Development
Secure EDI

Gale Scott

Office Manager
The Springs Family Medical Center

Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit Availity’s website at www.availity.com

4
Open Line Friday: ICD-10
Feb. 21, 2014
Special Guests
Ken Bradley
VP, Strategic Planning
& Regulatory Compliance

Stanley Nachimson
Principal

Nachimson Advisors, LLC
Making Health Care Information Technology
Work for YOU!

Note: Practitioner guests are subject to unforeseen clinical or other emergencies. Should our guest(s) lack availability at the time of our
program, Florida Blue will attempt to reschedule guest(s) for a future session.

5
Open Line Friday: ICD-10

Agenda
Feb. 21, 2014
1. Objectives

2. Healthcare Industry Updates
3. Florida Blue Updates
4. Useful Guidance for the Countdown to ICD-10
5. Next Steps

6
Open Line Friday: ICD-10
Open Line Friday Objectives
1. Increase collaboration, communication and coordination between providers,
payers and electronic trading partners.
2. Expand your understanding of the current state of ICD-10, recent regulatory
decisions and industry perspectives.
3. Raise your awareness and understanding of the unique challenges that ICD-10
brings to the entire health care industry including providers, payers and
electronic trading partners.
4. Provide you with tools, techniques, best practices and helpful hints from your
peers that can be used as you begin and continue your ICD-10 journey.
**** Please remember that during the call all attendees must be on “mute”
except for any guest speakers and all panelists. If you have a question, please
email it to FloridaBlueOpenLineFriday@FloridaBlue.com.

7
Open Line Friday: ICD-10
Health Care Industry & Regulatory Update
•

The ICD-10 regulatory compliance date of October 1, 2014 remains in effect.

•

CMS has re-launched their ICD-10 teleconferences and industry-wide communications
across physicians, providers and electronic trading partner channels (www.cms.gov/ICD10).

•

State and regional ICD-10 collaboratives have formed with a focus on shared learning's,
outreach and engagement with physicians, providers and electronic trading partners

•

NUCC recently announced changes to the CMS 1500 professional paper claim form to
accommodate ICD-10 (www.nucc.org); the following is the recommended transition timeline:
•

January 6, 2014: Payers begin receiving and processing paper claims submitted
on the revised 1500 Claim Form (version 02/12).

•

January 6 through March 31, 2014: Dual use period during which payers
continue to receive and process paper claims submitted on the old 1500 Claim
Form (version 08/05).

•

April 1, 2014: Payers receive and process paper claims submitted only on the
revised 1500 Claim Form (version 02/12).
8
Open Line Friday: ICD-10
Health Care Industry & Regulatory Update (continued)
•

Industry workgroups (I.e. WEDI) and health care industry trade associations (I.e. HBMA;
AHA; PAHCOM; HFMA; MGMA, etc.) are accelerating their ICD-10 outreach efforts to
their constituents.

•

CMS announced an ICD-9 and ICD-10 code set freeze which has been in effect since
October 1, 2013.

•

Testing ICD-10 continues to be a significant industry challenge.

•

ICD-10 readiness survey’s are accelerating across all health care industry segments; key
findings indicate various levels of preparedness with the “small to mid-sized physician
practices showing slow adoption and action toward ICD-10 engagement”.

9
Open Line Friday: ICD-10
Florida Blue Update:
•

NEW! Open Line Friday teleconferences are now available as podcasts! Need to
miss Open Line Friday? No problem. Now you can listen to our teleconference on
your schedule. Beginning with our Dec. 2013 program, recorded sessions are
available as podcasts in Dr. Stewarts blog. To access podcasts, visit
http://blog.floridablue.com/. Podcasts will be availble soon on our ICD-10 web
page (www.floridablue.com/icd-10)

•

Our overall ICD-10 initiative is proceeding on plan. We are currently in our initial
phase of internal (Level 1) testing. Florida Blue is deploying a full remediation
strategy to implement ICD-10.

•

ICD-10 Testing with Providers – Currently, engaging providers in Phase I and
Phase II Testing. Phase III is anticipated to begin in our first quarter of 2014.
Details of our provider testing, including a self-service option, are now available at
www.floridablue.com/icd-10 . Click on the “Test ICD” icon to get started:

•

Florida Blue’s ICD-10 Provider Toolkit (In one convenient location, access reliable
ICD-10 facts, tips, guides, timelines, education and more) is accessible from
www.floridablue.com/icd-10. This tool is for you!
10
Open Line Friday: ICD-10

Seven Months to ICD-10: Useful Guidance
for the Countdown*
Stanley Nachimson, Nachimson Adviosrs LLC.
&

Ken Bradley, Navicure
(refer to supplemental program presentation *)
* If applicable, supplemental (guest speaker) program material can be accessed at www.floridablue.com/ICD-10
under Open Line Friday located in right margin within 48 hours prior to teleconference.

11
Open Line Friday: ICD-10
Next Steps Next Contact Information
and Steps
Join us in our next session, Friday Mar. 21, 2014 where we anticipate a special guest from CMS.

Access our Open Line Friday podcasts. See Florida Blue Update page for details.
ICD-10 Open Line Friday email list: send us your email by contacting us at
floridablueopenlinefriday@floridablue.com
Test ICD-10 with us. Visit www.floridablue.com/icd-10 and select our “Test ICD-10 icon”
for details. Testing questions? Email us at ICD-10Testing@floridablue.com
Access Florida Blue’s ICD-10 Provider Toolkit and more at www.floridablue.com/ICD-10

Visit the Availity®1 Learning Center (www.availity.com/learningcenter) to access live and recorded ICD10 webinars including information about Ready10 - a popular ICD-10 project management tool (see
“There’s Ready and There’s Ready10”).

Add/update your email address so we can keep you informed via email (Bluemail)
• Add, update or delete your email and contact information at any time using Availity's secure website.
Log on to Availity at www.availity.com, select Payer Resources, Florida Blue and Update My Email
Information with Florida Blue then follow the prompts.
Send general ICD-10 questions and comments to floridablueopenlinefriday@floridablue.com.

Follow us on Twitter @FLBlue
12
Open Next Friday: ICD-10
Line Steps

Twelve months ago, it may have been too early to engage
individual physicians and small medical practices
in ICD-10 preparations!
However, six months from today, it may be too late!
Get engaged NOW!

13
Open Line Friday: ICD-10
Next Steps

V97.33xD
Sucked into
jet engine,
subsequent
encounter

14
Addendum
ICD-10 Helpful Resources and Reference Material
Though not inclusive, the following list includes several public websites that can help increase general awareness
and understanding of the ICD-10 mandate and its impact to the health care industry:
•
•
•
•
•
•

www.cms.gov/ICD10
www.wedi.org
www.ama-assn.org
www.ahima.org/icd10
www.availity.com
www.fha.org

•
•
•
•
•

www.hbma.com
www.mgma.com
www.floridablue.com/ICD-10
www.fmaonline.org/HomePage.aspx
www.cdc.gov/nchs/icd/icd10.htm

The links below were referenced during this presentation. The actual URLs below are provided for your convenience:


For regular CMS ICD-10 email updates, subscribe at:
 https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_608



WEDI's Survey on Industry ICD-10 progress:
 http://www.wedi.org/docs/comment-letters/2013-wedi-icd-10-survey-results-letter.pdf?sfvrsn=0



FREE CMS and WEDI ICD-10 End-to-End Testing Webinars available for download:
 http://www.wedi.org/forms/meeting/MeetingFormPublic/view?id=220AC00000156



HIMSS/WEDI National ICD-10 Pilot Program Update:
 http://www.himss.org/library/icd-10/national-pilot-program?navItemNumber=13477

15
Addendum
Next Steps
Stanley Nachimson
Principal
Nachimson Advisors, LLC
Making Health Care Information Technology
Work for YOU!

Nachimson Advisors is a health IT consulting firm dedicated to finding innovative uses for health information
technology and encouraging its adoption. The firm serves a number of clients, including, the Cooperative
Exchange, EHNAC, No World Borders, and the American Osteopathic Association. Stanley advises health
care providers, vendors, and plans with their ICD-10 and other regulatory implementations. He is the director
of the NCHICA-WEDI Timeline Initiative and serves on the Board of Advisors for the Lott QA Group, an
innovative health care IT testing company. Stanley is the author of the authoritative paper on the cost of ICD10 for physician practices, and also co-chairs the HIMSS ICD-10 Task Force and the WEDI ICD-10 Testing
Workgroup.
Stanley served for over 30 years in the US Department of Health and Human Services in a variety of
statistical, management, and health technology positions. His last ten years prior to his 2007 retirement were
spent developing HIPAA policy, regulations, and implementation planning and monitoring, beginning CMS’s
work on Personal Health Records, and serving as the CMS liaison with several industry organizations,
including WEDI and HITSP. He brings a wealth of experience and information regarding the use of standards and
technology to the health care industry.

16
Addendum
Addendum
Next Steps
Ken Bradley
Vice President, Strategic Planning and Regulatory Compliance

Qqqqqqqqqqqqqqqqqq

Ken Bradley, vice president of strategic planning and regulatory compliance and one of
Navicure's founding members, is responsible for assessing markets, monitoring
government regulatory requirements and providing competitive analyses to develop
strategies and solutions that ensure Navicure and its clients continued success in an increasingly complicated business
environment.
Mr. Bradley is responsible for all Navicure industry transitions, including ICD-10 and 5010. He is also the primary
contributor to the ICD-10 Hub Blog (www.ICD10hub.com) and was recognized as one of the most influential individuals
tweeting about ICD-10 (@Ken_Bradley). He has given educational presentations and written several articles on 5010
and ICD-10.
Prior to his current role at Navicure, Mr. Bradley directed the development and management of healthcare transaction
data and associated interfaces between Navicure, healthcare providers and payer organizations. Mr. Bradley has more
than 18 years of experience in the healthcare industry, specializing in the development of practice management software
(PMS), and the design and development of systems and applications utilized to process healthcare data. Prior to joining
Navicure, he served as the Manager for Development with NDCHealth’s Provider Healthcare Transaction Group.
Mr. Bradley joined NDC from Physicians Practice Management, where he spent several years in various positions
supporting the development and operations of the company’s Practice Management System and integrated claims
processing clearinghouse. Mr. Bradley graduated from Purdue University with a bachelor’s degree in Systems Analysis
and a minor in Business.

17

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Seven Months to ICD-10: Useful Guidance for the Countdown

  • 1. Open Line Friday: ICD-10 Seven Months to ICD-10: Useful Guidance for the Countdown Ken Bradley of Navicure & Stanley Nachimson of Nachimson Advisors Feb. 21, 2014 9:30 a.m. – 10:30 a.m. EST Dial Toll-Free: (800) 882-3610 Conference Passcode: 6829655# 900-4299-0214 900-3571-0213
  • 2. Open Line Friday: ICD-10 We are here for you. Do we have your correct email address? Register and regularly update your email address with us. • You can add, update or delete your email address and contact information at any time using Availity's secure website.  • 1Availity, Log on to Availity®1 at www.availity.com, select Payer Resources, Florida Blue and Update My Email Information with Florida Blue, then follow the prompts. ICD-10 Open Line Friday email list: Send us your email by contacting us at floridablueopenlinefriday@floridablue.com LLC is a multi-payer joint venture company. For more information or to register, visit Availity’s website at www.availity.com. 2
  • 3.
  • 4. Open Line Friday: ICD-10 Lee Ratliff Clinical Business Technology Consultant Baptist Health South Florida Panelists Laurie Darst Medical Director Florida Blue Mary Rita Hyland Matthew Ketterman CPO and VP Regulatory Affairs The SSI Group, Inc. Director, Business Solutions Availity®1 Joseph Gonzalez Diana Brijbag, CMM, CPC, CCP, CMSCS George Vancore Senior Manager, Delivery Systems Mandates Florida Blue 1 EDI Regulatory Compliance Administrator Tampa General Hospital Deborah Stewart, MD Revenue Cycle Regulatory Advisor Mayo Clinic (MN) VP of Business Development Secure EDI Gale Scott Office Manager The Springs Family Medical Center Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit Availity’s website at www.availity.com 4
  • 5. Open Line Friday: ICD-10 Feb. 21, 2014 Special Guests Ken Bradley VP, Strategic Planning & Regulatory Compliance Stanley Nachimson Principal Nachimson Advisors, LLC Making Health Care Information Technology Work for YOU! Note: Practitioner guests are subject to unforeseen clinical or other emergencies. Should our guest(s) lack availability at the time of our program, Florida Blue will attempt to reschedule guest(s) for a future session. 5
  • 6. Open Line Friday: ICD-10 Agenda Feb. 21, 2014 1. Objectives 2. Healthcare Industry Updates 3. Florida Blue Updates 4. Useful Guidance for the Countdown to ICD-10 5. Next Steps 6
  • 7. Open Line Friday: ICD-10 Open Line Friday Objectives 1. Increase collaboration, communication and coordination between providers, payers and electronic trading partners. 2. Expand your understanding of the current state of ICD-10, recent regulatory decisions and industry perspectives. 3. Raise your awareness and understanding of the unique challenges that ICD-10 brings to the entire health care industry including providers, payers and electronic trading partners. 4. Provide you with tools, techniques, best practices and helpful hints from your peers that can be used as you begin and continue your ICD-10 journey. **** Please remember that during the call all attendees must be on “mute” except for any guest speakers and all panelists. If you have a question, please email it to FloridaBlueOpenLineFriday@FloridaBlue.com. 7
  • 8. Open Line Friday: ICD-10 Health Care Industry & Regulatory Update • The ICD-10 regulatory compliance date of October 1, 2014 remains in effect. • CMS has re-launched their ICD-10 teleconferences and industry-wide communications across physicians, providers and electronic trading partner channels (www.cms.gov/ICD10). • State and regional ICD-10 collaboratives have formed with a focus on shared learning's, outreach and engagement with physicians, providers and electronic trading partners • NUCC recently announced changes to the CMS 1500 professional paper claim form to accommodate ICD-10 (www.nucc.org); the following is the recommended transition timeline: • January 6, 2014: Payers begin receiving and processing paper claims submitted on the revised 1500 Claim Form (version 02/12). • January 6 through March 31, 2014: Dual use period during which payers continue to receive and process paper claims submitted on the old 1500 Claim Form (version 08/05). • April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500 Claim Form (version 02/12). 8
  • 9. Open Line Friday: ICD-10 Health Care Industry & Regulatory Update (continued) • Industry workgroups (I.e. WEDI) and health care industry trade associations (I.e. HBMA; AHA; PAHCOM; HFMA; MGMA, etc.) are accelerating their ICD-10 outreach efforts to their constituents. • CMS announced an ICD-9 and ICD-10 code set freeze which has been in effect since October 1, 2013. • Testing ICD-10 continues to be a significant industry challenge. • ICD-10 readiness survey’s are accelerating across all health care industry segments; key findings indicate various levels of preparedness with the “small to mid-sized physician practices showing slow adoption and action toward ICD-10 engagement”. 9
  • 10. Open Line Friday: ICD-10 Florida Blue Update: • NEW! Open Line Friday teleconferences are now available as podcasts! Need to miss Open Line Friday? No problem. Now you can listen to our teleconference on your schedule. Beginning with our Dec. 2013 program, recorded sessions are available as podcasts in Dr. Stewarts blog. To access podcasts, visit http://blog.floridablue.com/. Podcasts will be availble soon on our ICD-10 web page (www.floridablue.com/icd-10) • Our overall ICD-10 initiative is proceeding on plan. We are currently in our initial phase of internal (Level 1) testing. Florida Blue is deploying a full remediation strategy to implement ICD-10. • ICD-10 Testing with Providers – Currently, engaging providers in Phase I and Phase II Testing. Phase III is anticipated to begin in our first quarter of 2014. Details of our provider testing, including a self-service option, are now available at www.floridablue.com/icd-10 . Click on the “Test ICD” icon to get started: • Florida Blue’s ICD-10 Provider Toolkit (In one convenient location, access reliable ICD-10 facts, tips, guides, timelines, education and more) is accessible from www.floridablue.com/icd-10. This tool is for you! 10
  • 11. Open Line Friday: ICD-10 Seven Months to ICD-10: Useful Guidance for the Countdown* Stanley Nachimson, Nachimson Adviosrs LLC. & Ken Bradley, Navicure (refer to supplemental program presentation *) * If applicable, supplemental (guest speaker) program material can be accessed at www.floridablue.com/ICD-10 under Open Line Friday located in right margin within 48 hours prior to teleconference. 11
  • 12. Open Line Friday: ICD-10 Next Steps Next Contact Information and Steps Join us in our next session, Friday Mar. 21, 2014 where we anticipate a special guest from CMS. Access our Open Line Friday podcasts. See Florida Blue Update page for details. ICD-10 Open Line Friday email list: send us your email by contacting us at floridablueopenlinefriday@floridablue.com Test ICD-10 with us. Visit www.floridablue.com/icd-10 and select our “Test ICD-10 icon” for details. Testing questions? Email us at ICD-10Testing@floridablue.com Access Florida Blue’s ICD-10 Provider Toolkit and more at www.floridablue.com/ICD-10 Visit the Availity®1 Learning Center (www.availity.com/learningcenter) to access live and recorded ICD10 webinars including information about Ready10 - a popular ICD-10 project management tool (see “There’s Ready and There’s Ready10”). Add/update your email address so we can keep you informed via email (Bluemail) • Add, update or delete your email and contact information at any time using Availity's secure website. Log on to Availity at www.availity.com, select Payer Resources, Florida Blue and Update My Email Information with Florida Blue then follow the prompts. Send general ICD-10 questions and comments to floridablueopenlinefriday@floridablue.com. Follow us on Twitter @FLBlue 12
  • 13. Open Next Friday: ICD-10 Line Steps Twelve months ago, it may have been too early to engage individual physicians and small medical practices in ICD-10 preparations! However, six months from today, it may be too late! Get engaged NOW! 13
  • 14. Open Line Friday: ICD-10 Next Steps V97.33xD Sucked into jet engine, subsequent encounter 14
  • 15. Addendum ICD-10 Helpful Resources and Reference Material Though not inclusive, the following list includes several public websites that can help increase general awareness and understanding of the ICD-10 mandate and its impact to the health care industry: • • • • • • www.cms.gov/ICD10 www.wedi.org www.ama-assn.org www.ahima.org/icd10 www.availity.com www.fha.org • • • • • www.hbma.com www.mgma.com www.floridablue.com/ICD-10 www.fmaonline.org/HomePage.aspx www.cdc.gov/nchs/icd/icd10.htm The links below were referenced during this presentation. The actual URLs below are provided for your convenience:  For regular CMS ICD-10 email updates, subscribe at:  https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_608  WEDI's Survey on Industry ICD-10 progress:  http://www.wedi.org/docs/comment-letters/2013-wedi-icd-10-survey-results-letter.pdf?sfvrsn=0  FREE CMS and WEDI ICD-10 End-to-End Testing Webinars available for download:  http://www.wedi.org/forms/meeting/MeetingFormPublic/view?id=220AC00000156  HIMSS/WEDI National ICD-10 Pilot Program Update:  http://www.himss.org/library/icd-10/national-pilot-program?navItemNumber=13477 15
  • 16. Addendum Next Steps Stanley Nachimson Principal Nachimson Advisors, LLC Making Health Care Information Technology Work for YOU! Nachimson Advisors is a health IT consulting firm dedicated to finding innovative uses for health information technology and encouraging its adoption. The firm serves a number of clients, including, the Cooperative Exchange, EHNAC, No World Borders, and the American Osteopathic Association. Stanley advises health care providers, vendors, and plans with their ICD-10 and other regulatory implementations. He is the director of the NCHICA-WEDI Timeline Initiative and serves on the Board of Advisors for the Lott QA Group, an innovative health care IT testing company. Stanley is the author of the authoritative paper on the cost of ICD10 for physician practices, and also co-chairs the HIMSS ICD-10 Task Force and the WEDI ICD-10 Testing Workgroup. Stanley served for over 30 years in the US Department of Health and Human Services in a variety of statistical, management, and health technology positions. His last ten years prior to his 2007 retirement were spent developing HIPAA policy, regulations, and implementation planning and monitoring, beginning CMS’s work on Personal Health Records, and serving as the CMS liaison with several industry organizations, including WEDI and HITSP. He brings a wealth of experience and information regarding the use of standards and technology to the health care industry. 16
  • 17. Addendum Addendum Next Steps Ken Bradley Vice President, Strategic Planning and Regulatory Compliance Qqqqqqqqqqqqqqqqqq Ken Bradley, vice president of strategic planning and regulatory compliance and one of Navicure's founding members, is responsible for assessing markets, monitoring government regulatory requirements and providing competitive analyses to develop strategies and solutions that ensure Navicure and its clients continued success in an increasingly complicated business environment. Mr. Bradley is responsible for all Navicure industry transitions, including ICD-10 and 5010. He is also the primary contributor to the ICD-10 Hub Blog (www.ICD10hub.com) and was recognized as one of the most influential individuals tweeting about ICD-10 (@Ken_Bradley). He has given educational presentations and written several articles on 5010 and ICD-10. Prior to his current role at Navicure, Mr. Bradley directed the development and management of healthcare transaction data and associated interfaces between Navicure, healthcare providers and payer organizations. Mr. Bradley has more than 18 years of experience in the healthcare industry, specializing in the development of practice management software (PMS), and the design and development of systems and applications utilized to process healthcare data. Prior to joining Navicure, he served as the Manager for Development with NDCHealth’s Provider Healthcare Transaction Group. Mr. Bradley joined NDC from Physicians Practice Management, where he spent several years in various positions supporting the development and operations of the company’s Practice Management System and integrated claims processing clearinghouse. Mr. Bradley graduated from Purdue University with a bachelor’s degree in Systems Analysis and a minor in Business. 17