PYA Consulting Principal Denise Hall, along with co-presenter Julie Chicoine, recently updated health lawyers about ICD-10 transition readiness at the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues, held March 26-27, 2014.

1. Page 0March 26-27, 2014
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American Health Lawyers Association
Institute on Medicare and Medicaid Payment Issues
March 26-27, 2014
ICD-10 Transition Update:
What Health Lawyers Need to Know

2. Page 1March 26-27, 2014
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• What is ICD‐10 and why is it
important to the healthcare
community?
• What is the current regulatory
status of ICD‐10?
• Organizational Impact –
Operational and Finance
• Readiness and Implementation
Strategies
Learning Objectives

3. Page 2March 26-27, 2014
Prepared for AHLA – Institute on Medicare and Medicaid Payment Issues
What is ICD‐10 and why is it
important to the healthcare
community?

4. Page 3March 26-27, 2014
Prepared for AHLA – Institute on Medicare and Medicaid Payment Issues
There’s A Code For That!
Source: http://www.youtube.com/watch?v=GWJQSmqRLRk

5. Page 4March 26-27, 2014
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What Are ICD Codes?
• The International Classification of Disease (ICD) codes
are the international classifications for all diseases and many
other health problems for purposes of health management,
including:
– Analysis of the general health of population groups
– Monitoring of the incidence and prevalence of diseases
– Monitoring other health problems in relation to other variables such
as the characteristics and circumstances of the individuals affected,
reimbursement, resource allocation, and quality
http://www.who.int/classifications/icd/en/
• ICD codes are now recorded on many types of health
records and are key components in reimbursement, quality
and utilization review, and other data management activities.

6. Page 5March 26-27, 2014
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• Replaces ICD-9 – Not a revised version of ICD-9
• ICD-10 represents a complete change from one
coding system to a new one structured in an
entirely new way
• Like all medical coding systems, it provides a way
to condense textual clinical information into “codes”
that can be used for billing and other data-based
applications
What is ICD-10?

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There is no relationship between the two code sets –
they have completely different structures and uses.
ICD-10 Is Really Two Different
Code Sets
ICD-10-CM
• International
Classification of
Diseases, 10th
Revision, Clinical
Modification
ICD-10-PCS
• International
Classification of
Diseases, 10th
Revision, Procedure
Coding System

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What’s ICD-10-CM?
ICD-10-CM
• Diagnosis Coding System – Used to report the patient‟s
condition (i.e., what‟s wrong with the patient)
• Direct replacement for ICD-9-CM Volumes 1 & 2
• Will be used in all settings – hospital inpatient, hospital
outpatient, physician office, etc.
• Like ICD-9-CM, developed and maintained by the World
Health Organization (WHO) and the National Center for Health
Statistics within the Centers for Disease Control

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What’s ICD-10-PCS?
ICD-10-PCS
• Procedure Coding System – Used to report surgical
procedures performed
• Direct replacement for ICD-9-CM Volume 3
• Only used in a hospital inpatient setting (and only for
reporting facility services)
• Like ICD-9-CM Volume 3, ICD-10-PCS was developed
and is maintained by CMS

10. Page 9March 26-27, 2014
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How Big Could It Be?
ICD-9-CM
Diagnosis: 14,000
Procedures: 4,000
ICD-10-CM & ICD-10-PCS
Diagnosis: 68,000
Procedures: 87,000

11. Page 10March 26-27, 2014
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Key ICD-10-CM Changes
• Alphanumeric codes
• Expanded injury codes – grouped by anatomic site not
injury type
• Laterality (right vs. left)
• Obstetric codes include trimester
• Diabetes codes differentiate between I, II, drug, chemical
induced diabetes, or due to an underlying condition
(chemotherapy)
• Intraoperative and postoperative complications
• Visits – initial or subsequent

12. Page 11March 26-27, 2014
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ICD-10 vs. ICD-9
Issue ICD-9-CM ICD-10-CM
Volume of codes Approximately 13,600 Approximately 69,000
Composition of codes Mostly numeric, with E and V codes
alphanumeric.
Valid codes of three, four, or five
digits.
All codes are alphanumeric, beginning
with a letter and with a mix of numbers
and letters thereafter. Valid codes may
have three, four, five, six or seven digits.
Duplication of code sets Currently, only ICD-9-CM codes are
required. No mapping is necessary.
For a period of up to two years, systems
will need to access both ICD-9-CM codes
and ICD-10-CM codes as the country
transitions from ICD-9-CM to ICD-10-CM.
Mapping will be necessary so that
equivalent codes can be found for issues
of disease tracking, medical necessity
edits and outcomes studies.
Source: http://www.aapc.com/icd-10/faq.aspx#why

13. Page 12March 26-27, 2014
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ICD-10 Code Comparison
Tobacco Abuse
ICD-9-CM: 1 Code
ICD-10-CM: 5 Codes
Diabetes Mellitus
ICD-9-CM: 10 Codes
ICD-10-CM: 318 Codes
Fracture of Radius
ICD-9-CM: 33 Codes
ICD-10-CM: 1,818 Codes

14. Page 13March 26-27, 2014
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What are the benefits of ICD-10?
The new, up-to-date classification system will provide much better data needed to:
• Measure the quality, safety, and efficacy of care
• Improve quality reporting and scoring
• Reduce the need for attachments to explain the patient’s condition
• Design payment systems and process claims for reimbursement
• Conduct research, epidemiological studies, and clinical trials
• Set health policy
• Support operational and strategic planning
• Design healthcare delivery systems
• Monitor resource utilization
• Improve clinical, financial, and administrative performance
• Prevent and detect healthcare fraud and abuse
• Track public health and risks

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What can we learn from other
countries’ implementation?
• Planning and preparation are the keys to success
– Start now to allow time to understand the impact and
come up with solutions
• Education and training are all important
– Prepare for productivity loss and longer turn around
times
• Collaborate with others
– Share information and experiences to learn what
works and what to avoid

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There’s A Code For That!
Source: http://www.youtube.com/watch?v=j_mD8yDZD7M

17. Page 16March 26-27, 2014
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What is the current regulatory
status of ICD‐10?

18. Page 17March 26-27, 2014
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When is it official?
January
1, 2010
• Payers and
providers should
begin internal
testing of Version
5010 standards
for electronic
claims
December
31, 2010
• Internal testing of
Version 5010
must be
complete to
achieve Level I
Version 5010
compliance
• Providers should
form ICD-10
sponsorship
team
January
1, 2011
• Payers and
providers should
begin external
testing of Version
5010 for
electronic claims
• CMS begins
accepting
Version 5010
claims
• Version 4010
claims continue
to be accepted
December
31, 2011
• External testing
of Version 5010
for electronic
claims must be
complete to
achieve Level II
Version 5010
compliance
January
1, 2012
• All electronic
claims must use
Version 5010
• Version 4010
claims are no
longer accepted
October 1,
2014
• Claims for
services
provided on or
after this date
must use ICD-
10 codes for
medical
diagnosis and
inpatient
procedures
• CPT codes will
continue to be
used for
outpatient
services
Per the Department of Health and Human Services, the
compliance date for implementation of ICD-10-CM and
ICD-10-PCS is October 1, 2014.

19. Page 18March 26-27, 2014
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National Coverage Determinations
(NCDs)
• CMS is responsible for converting approximately 330
NCDs
• Not all are appropriate for translation
– Edits based on HCPCS
– Older obsolete technology or considered outdated
CMS has determined which NCD should be translated
and is in the process of completing system changes for
those NCDs
http://www.cms.gov/outreach-and-education/medicare-learningnetworkmln/mlnmattersarticles/downloads/MM7818.pdf

20. Page 19March 26-27, 2014
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Local Coverage Determinations
(LCDs)
• According to CMS, LCDs are made by the
individual Medicare Auditing Contractor (MAC
– i.e. CAHABA)
• Contractors shall publish all ICD-10 LCDs
and ICD-10 associated articles on the
Medicare Coverage Database (MCD) no later
than April 10, 2014
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8348.pdf

21. Page 20March 26-27, 2014
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Industry Readiness Survey
• The Workgroup for Electronic Data Interchange (WEDI), the leading authority on the use of
Health IT to improve the exchange of healthcare information, announced submission of the latest
ICD-10 industry readiness survey results to the Centers for Medicare & Medicaid Services (CMS).
• Some key results from the survey include:
– All industry segments appear to have made some progress since February 2013, but have
not gained sufficient ground to remove concern over meeting the October 1, 2014
compliance deadline.
– About three-fifths of health plans have completed their impact assessment- and another one-
fifth are nearly complete. This shows moderate progress since the February 2013 survey
where approximately one-half had completed their assessment.
– The number of providers that responded „unknown‟ to when they would complete their
impact assessment, business changes, and begin external testing is down significantly from
the February 2013 survey; responses indicate the majority will not complete these steps until
2014.
– About three-fifths of vendors indicate they are already doing, or plan to begin customer
review and beta testing by the end of this year. This is down slightly from the two-thirds
indicated in the February 2013 survey.
Sources: http://www.wedi.org/docs/comment-letters/2013-wedi-icd-10-survey-results-letter.pdf?sfvrsn=0
http://www.wedi.org/news/press-releases/2013/04/11/wedi-provides-vital-icd-10-industry-readiness-survey-results-to-cms

22. Page 21March 26-27, 2014
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Fact or Fiction
ICD-10-CM-based super bills will be too long or too complex to be of much use
Fiction (sort of)
• Practices may continue to create super bills that contain the most common
diagnosis codes used in their practice. ICD-10-CM-based super bills will not
necessarily be longer or more complex than ICD-9-CM-based super bills. Neither
currently-used super bills nor ICD-10-CM-based super bills provide all possible
code options for many conditions.
• The super bill conversion process includes:
– Conducting a review that includes removing rarely used codes
– Cross walking common codes from ICD-9-CM to ICD-10-CM, which can be
accomplished by looking up codes in the ICD-10-CM code book or using the General
Equivalence Mappings (GEM)
– Vendors electronic superbill and posting scrubber that assist physicians in the
transition to ICD-10
Source: http://www.whiteplume.com/learn-more/icd-10

23. Page 22March 26-27, 2014
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What do I need to do to get the
claim out the door?
• Medicare will begin accepting a revised 1500 (version
02/12) on January 6, 2014
– Allows for reporting of ICD-10 codes
– Use as many as 12 codes in the diagnosis field (the current
limit is four)
– Qualifiers to identify the following providers role (on item 17)
• Ordering, Referring, Supervising
• Starting April 1, 2014, Medicare will accept only the
revised version of the form
– The revised form will give providers the ability to indicate
whether they are using ICD-9 or ICD-10 diagnosis codes

24. Page 23March 26-27, 2014
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What do I need to know to get the
claim out the door?
• Reporting ICD-10 diagnosis codes
• Claims Submission of diagnosis codes
– ICD-9 codes no longer accepted on claims with date of service after
October 1, 2014
– ICD-10 codes will not be recognized/accepted on claims before
October 1, 2014
– Claims cannot contain both ICD-9 and ICD-10 codes--will be returned
as “Unprocessable”
• Date span requirements
– Outpatient claims-split claim form and use from date
– Inpatient claims-use only through date/discharge date for ICD-10
code submission

25. Page 24March 26-27, 2014
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Once I get this claim out of the door,
am I going to get paid?
• The Department of Health and Humans
Services (HHS) anticipates that the percent of
returned claims following the ICD-10
implementation could be more than double of
what we have seen in the past with ICD-9
updates.

26. Page 25March 26-27, 2014
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DRG Assignment
• CMS did not address the impact of
ICD-10 on DRG assignment in the
ICD-10 Final Rule
• However, CMS and 3M have used
the GEMs to convert the MS-DRG
definitions from ICD-9-CM to ICD-10
• CMS and 3M found that the GEMs
were 95% to >99% effective in
converting the MS-DRGs to ICD-10

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ICD-10 Impact

28. Page 27March 26-27, 2014
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Scope of ICD-10 Impact
• All HIPAA-covered providers and entities
– Includes, payers, health plans, DME,
pharmacy, vendors
• Other Code Sets
– No impact
» Current Procedural Terminology
(CPT) Codes
» Healthcare Common Procedure
Codes (HCPCS)

29. Page 28March 26-27, 2014
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ICD-10 Industry Impact
Hospitals
Pharmacy
Research Vendors
Payers/
Health Plans
Physicians
Home
Health
Laboratory
Business
Associates

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Clinical
Documentation
• Accurate diagnosis
• Improved quality of care
Quality
• Pay-for-performance
• Public Reporting
Financial • Utilization management
• Cost containment
ICD-10 Transitional Impact

31. Page 30March 26-27, 2014
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ICD-10 Organizational Impact
• Physician Documentation
• Physician Integration
• Physician Performance
• Staffing Effectiveness
• Revenue Impact Assessment
• Process Flow & Improvement
• Decision Support Impact
• Documentation Analysis
• ICD-10 Education & Training
• Coding Production Impact
Physician
Office
Post Acute
Services
• Scheduling, ED & Access Areas
• DNFB, Coding, CDI
• Case Management
• Billing, Reimbursement
Health
Information
Management
ICD-10
Revenue
Process
Physician
Operational
Planning
Information
Technology
• IT Systems
• Capability, Communication
• Functionality
• Vendor Preparedness

32. Page 31March 26-27, 2014
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Estimated Financial Impact:
Revenue Cycle
AR (Days
Increase)
Write-Off
(potential $
lost)
Incremental
Staff ($)
AR (Days
Increase)
Write-Off
(potential $
lost)
Incremental
Staff ($)
AR (Days
Increase)
Write-Off
(potential $
lost)
Incremental
Staff ($)
Staffing Impact (incremental) 95,545$ 47,773$ 23,886$
Medical Necessity / Denials 5.2 585,715$ 2.6 292,857$ 1.3 146,429$
Coding 3.2 1.6 1.6
Staffing Impact (incremental) 121,415$ 60,708$ 30,354$
Staffing Prep 60,000$
(creating/testing billing edits)
Billing Rejections / Denials 10.4 1,171,429$ 5.2 585,715$ 2.6 292,857$
Patient Access
Patient Financial Services
Health Information Mgt.
TOTALS 18.9 5.5 439,286$ 54,240$1,757,144$ 276,961$ 9.4 878,572$ 108,480$
FY2016
Revenue Cycle Metrics Revenue Cycle Metrics Revenue Cycle Metrics
FY2014 FY2015
Notes: See Key Assumptions for information on assumptions underlying these estimates. Figures may not add to Totals due to rounding.

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Provider Impact
• Value-based compensation
• Increased documentation time – up to 15%
• May affect patient volume
• Quality Measures/P4P – need to be determined
based on ICD-10 codes
• Difficult to measure impact of change – is it because
of code set or because of changes in underlying
practice?
32

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Payers, Health Plans
Impact:
• Coverage determinations
• Payment determinations
• Medical review policies
• Actuarial projections
• Quality measurements

35. Page 34March 26-27, 2014
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Compliance Impact
• A huge potential for double billing exists if two
systems (ICD-9 and ICD-10) remain in use during the
transition period:
– This scenario could potentially create unintentional billing
compliance risks.
– The shortage of experienced coding professionals also
poses a risk since medical coders nearing retirement age
may elect to retire rather than learn a new system.
• Additionally, the General Equivalency Mappings (GEMS) do not
provide a definitive map from ICD-9 to ICD-10 with only 5%
mapping accurately 1:1 with ICD-10 codes
– Because ICD-9 codes could map into multiple ICD-10
codes, this risk rises even more.

36. Page 35March 26-27, 2014
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Coder Impact
• Need to know anatomy and physiology
• Need to know new code sets
• Decreased productivity – ICD-10 Watch:
Some studies suggest a 50% drop in coding
productivity
• Industry demand for more coding
professionals!

37. Page 36March 26-27, 2014
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ICD-10 Potential Financial Impact
• According to CMS, Estimated Organizational Cost by Bed Size
Bed Size Cost
400 + $1.5 Million – $5 Million
100 – 400 $500,000 – $1.5 Million
< 100 $100,000 – $250,000
Decrease in Cash Flow / Loss of Revenue
• Industry experts from CMS and AHIMA estimate the following:
– Denial rates will increase by 100% to 200%
– Accounts receivable days will be extended by 20% to 40%
– Healthcare organizations will be hindered with payment
declines for more than 2 years after the implementation
Date of October 1, 2014
– Claims-error rates will increase from 6% to 10% (The
average current rate is close to 3%)

38. Page 37March 26-27, 2014
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Expected Denial Reasons
Minich-Pourshadi, Karen. “ICD-10 Puts Revenue at Risk.” HealthLeaders Media Intelligence (July 2011), p. 22.

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There’s A Code For That!
Source: http://www.youtube.com/watch?v=yKYwr31s4bk

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Readiness and Implementation
Strategies

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Strategy
Convene Implementation Taskforce
Multi-disciplinary
• Clinical, IT, HIM, Finan
ce, Compliance, Com
munications, Payer/Ma
naged Care
Contracting, Operation
s
Key stake
holders
• Identify who is
impacted and what
needs to be done
• Establish timeline
and designate
leaders
Designate
Physician Champion

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Assessment
Organizational readiness
• Map a patient‟s encounter and look at every piece in the
organization touched by ICD-9
• Affected Areas
Financial/HIM/IT
• Billing systems, DRG
grouper, claims software, medical
record abstracting, encoding
software, case mix systems
Clinical
• Patient care protocols, medical
necessity, laboratory and pharmacy
systems, utilization, quality and case
management
Patients
• Patient registration and scheduling
systems, advance beneficiary
notice, preauthorization

43. Page 42March 26-27, 2014
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Implementation Process
Processes Reports Work Flow
Information
Systems and
Software
All Forms of
Documentation
Analysis of all Departments

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Roles
Role Task
Administrators Confirm capabilities, provide training, review processes
IT Staff Confirm integration in system and documentation
Providers
Outpatient: Document in support of ICD-10 code selected
Inpatient: CM and PCS codes will have to be supported
Billers
Understand how to look up codes, understand how to query
physicians, pull new LCDs
Coders
Understand ICD-10 guidelines and how to properly select ICD-10
codes base on documentation

45. Page 44March 26-27, 2014
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Vendor Readiness
• Identify vendors affected by ICD-10 (billing companies,
medical transcription, home health, DME – start with
your Business Associate Agreements)
− What system changes/upgrades are needed?
− What costs are involved? Are they included in existing
vendor agreements?
− What customer support (implementation, testing, training)
will the vendor be offering?

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Vendor Readiness
Our billing software vendor indicates they will be ready for
these transitions. What can I do in the meantime, besides train
for ICD-10 coding?
• Ask your billing software vendor for a detailed schedule of
deliverables and begin preparing to test implementation of the
modified software at your location.
• Be sure to verify the following:
– The vendor is addressing the ICD-10 upgrades
– The number and schedule of planned ICD-10 software releases
– Their ICD-10 conversion plan accommodates your clearinghouse
testing schedule
– Any related costs to your organization
– Customer support and training they will provide

47. Page 46March 26-27, 2014
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Payer Readiness
• As with vendors – establish dedicated contact
• Evaluate payer readiness
– What‟s their implementation plan/timeline?
– Are they implementing new rules for claims submission or
re-submission?
– Will contract terms for coverage and billing change? Will
they require the provider to report the code with the highest
specificity?
– Will their payment and reimbursement schedules change?
– Will the claims appeal process change?
• Add language to current contracts to require ICD-10 compliance
• Share your plans for ICD-10 changes with them
• Establish regular meetings, compare implementation plans,
review and update contracts as necessary
• Medicare and Medicaid - Are they on track? When will they be
ready for end-to-end testing? What are their contingency plans?

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Code Analysis
Review top 20-50 diagnosis codes
• Evaluate documentation currently in
the notes
• Crosswalk them to ICD-10
• Review new codes for additional
required codes, additional code
descriptions and “code also”
requirements
• Identify areas where additional
documentation will be required

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ICD-10 Impact on Physician Work Flow
• Will the EMR allow the physician to enter a descriptive
diagnosis rather than a specific diagnosis code?
• Is the physician prepared for the dramatic increase in
diagnosis codes now displayed on the drop-down list?
• How will the physician‟s workflow change when more
time is needed to assign the appropriate diagnosis
code?
• Can the EMR support a workflow that sends patient
encounters to coders for review and assignment of
the most specific diagnosis code based on the
physician‟s documentation?

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Budget
• Cost of training/decreased staff productivity
• Cost of hardware/software upgrades
• Forms redesign
• Testing costs/Consulting services
• Vendor readiness – external testing
• Temporary maintenance of dual systems
• Cash reserves for denials increase, payment
delays, decreased productivity
Determine financial impact, budget, resources,
cash reserve needed for ICD-10 migration

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Budget
How much emergency cash should providers keep in case of cash flow disruption?
• Review what happened to your organization with HIPAA 5010, this would be a good
baseline; with the transition of ICD-10 there will be delays in reimbursement.
• Vendors and clearinghouses have been working hard, but we will not know the true effects
until Oct. 1, 2014.
• It is recommended that you have up to several months' cash reserves or access to cash
through a loan or line of credit to avoid potential headaches.
• The amount of reserves you need to set aside will be impacted by the preparation work you
do for ICD-10.
• Will need to cover at a minimum practice operation expenses for three to six months:
– Medical supplies
– Payroll
– Rent

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Implementation Issues
Training
• Will be required for various users
• Will require coder retraining
– Coding rules and conventions are similar, but not exactly
the same
• Some short-term loss of productivity is expected during the
learning curve
• Will require changes in data retrieval/analysis
• Will require changes to data systems

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Training
Coding and Billing Staff
• Assess training needs and develop a plan
– Professional coding staff – ICD-10-CM
– Determine who will train staff and how
this will be accomplished
– Factor in time away from work, consider
post-testing and ongoing support
– Make ICD-10 proficiency part of your
coding staff‟s performance goals
» ICD-9-CM to ICD-10-CM Dual Coding
• Assign staff members to be the
“ICD-10 Experts” looking at the impact
from the billing to the clinical side

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Training
Clinicians
• Physicians – focus on codes germane to their practice
• Review clinical documentation improvement efforts and develop new
strategies
• Incorporate documentation improvement as component to compliance
training
• Ancillary staff – identify needs and level of training needed, nursing,
financial services, quality, utilization, ancillary departments…
Information Technology
• Training to ensure that codes are accurately cross-walked in
organization‟s IT systems

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Tiered Training Structure

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ICD-10 & EHR
• Analyze EHR for functionality and compliance
• Review templates, interfaces, default documentation, and level of detail
• Can the system accommodate the data format changes for ICD-10?
• What is the EHR vendor‟s timeline for the transition? When will their upgrades be available
for installation? Make sure that installation of upgrades is far enough in advance to
facilitate early testing.
• Will there be additional costs for the upgrade? Will multiple upgrades be required? Is there
a waiting list?
• Is the EHR vendor training its staff on ICD-10 system
upgrades?
• Can they ensure that the right components are in place to
select the more specific code?
• Will they have specialty specific codes?
• Will ICD-9 still be available for use and comparison?
• Does the system allow for dual coding?

57. Page 56March 26-27, 2014
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• Plan for dual ICD-9 and 10 codes for a brief period to address services rendered
before October 1, but discharged after October 1
• Monitor physician documentation to ensure ICD-10 compliance
• Monitor impact on claim-processing activity, claim denials, and rejections
• Audit coder productivity and accuracy
• Monitor patient satisfaction
• Post-transition Review
– What‟s working?
– What needs fixing?
• Schedule 30-day post-conversion claims assessment
ICD-10 Go Live, The Day After…

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Priority List
Create an ICD-10 impact awareness throughout the organization
Ensure your foundational IS structure is actively preparing for the transition
Define your change approach to ensure you have defined the proper structure and
sponsorship
Develop projections of operational needs, including staffing and internal educational
training
Identify specific documentation gaps to determine focused educational needs
Calculate potential impact on financial results

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ICD-10 is not just a coder’s issue!
This transformation entails foundational changes to ALL
HIPAA-covered entities and providers
• In a nutshell, here are some key points to keep in mind going forward:
Senior management‟s
involvement is critical to
successful implementation!
• Risks of late or no implementation must be
understood
Problems should be expected!
• Develop action plans to manage them
• Have a back-up plan
Establish a budget. Develop a timeline and follow it!

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The future?
WHO is currently working on ICD-11
• They will build upon ICD-10
• The first draft was made available
online in July 2011 for review
• The final draft is expected to be
submitted to WHO's World Health
Assembly for official endorsement
by 2017

61. Page 60March 26-27, 2014
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Key Resources
• ICD-10 Proposed and Final Rules
– http://edocket.access.gpo.gov/2008/pdf/E8-19298.pdf
– http://edocket.access.gpo.gov/2009/pdf/E9-743.pdf
• CMS Website on ICD-10
– https://www.cms.gov/ICD10/
• CDC Website on Classification of Diseases
– http://www.cdc.gov/nchs/icd.htm
• CMS ICD-10-CM Quick Reference Guide
– https://www.cms.gov/ICD10/11b14_2012_ICD10CM_and_GEMs.a
sp#TopOfPage

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There’s A Code For That!
Source: http://www.youtube.com/watch?v=IVhyUsGTxiE

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Questions?

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Contact Information
Denise Hall, RN, BSN
Principal
Pershing Yoakley & Associates, P.C.
678-441-0645
dhall@pyapc.com
www.pyapc.com
Julie Chicoine, Esq., RN, CPC, CPCO
Wexner Medical Center at
The Ohio State University
614-293-2007
julie.chicoine@osumc.edu
www.medicalcenter.osu.edu
Thank you for allowing us to share our thoughts and
expertise with you.