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April 2015 ICD 10 Open Line Friday: Provider Testing Progress & Trading Partner Readiness
1. 900-3571-0213
Open Line Friday: ICD-10 Edition
ICD-10 Provider Testing Progress &
Trading Partner Readiness
April 17,2015
9:30 a.m. – 10:30 a.m. EST
Dial Toll-Free: (800) 882-3610 or (412) 380-2000
Conference Passcode: 6829655#
900-930-0415
Follow us on Twitter @FLBlue
2. Open Line Friday
Panelists*
Deborah Stewart, MD
Medical Director
Florida Blue
Gale Scott
EDI Regulatory Compliance Administrator
Tampa General Hospital
Laurie Darst
Revenue Cycle Regulatory Advisor
Mayo Clinic (MN)
Matthew Ketterman
Director, Business Solutions
Availity®1 LLC
Stanley Nachimson
Principal
Nachimson Advisors, LLC
Deborah Enfield
ICD10 Project Manager
Baptist Health South Florida
Diana Brijbag
CMM, CPC, CCP, CMSCS, HITCM-PP
Office Manager
The Springs Family Medical Center
George Vancore
Senior Manager, Delivery Systems
Mandates and Compliance
Florida Blue
*Panelists are subject to availability.
1 Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit www.availity.com
2
Joseph Nichols, MD
Principal
Health Data Consulting
Follow us on Twitter @FLBlue
Mary Rita Hyland
RN, BS, MBA, CHP
Healthcare Industry Consultant
3. Open Line Friday
Agenda
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1. Objectives
2. Healthcare Industry Regulatory Update
3. ICD-10 Provider Testing Progress &
Trading Partner Readiness
4. Next Steps
Follow us on Twitter @FLBlue
4. Objectives
1. Promote 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 opportunities and 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 continue (or begin) your ICD-10 journey.
**** Please remember that during the call all attendees will be placed on “mute”
except for any guest speakers and all panelists. If you have a question, please
email it to FloridaBlueOpenLineFriday@FloridaBlue.com.
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Open Line Friday
5. Open Line Friday
Health Care Industry & Regulatory Update
• Medicare announced two rounds of ICD-10 testing with physicians/provider:
• Functional Acknowledgement Testing: this is where you test the “chain of trust” partners from the
provider to the payer (Medicare) using an ICD-10 coded claim; Medicare will edit and compliance check the
claim and return a response to the sender; there is no claim adjudication or ERA is being generated during this
round of testing; test claims can be sent to Medicare anytime up to the October 1, 2015 implementation date;
• Special Functional Acknowledgement Testing Weeks: Medicare submitters will have access to
real-time help desk support during the weeks of November 17th through the 21st, 2014; March 2nd through the
6th, 2015 and June 1st through the 5th, 2015.
• End-to-end testing: this is where ICD-10 coded claims are sent to the Medicare (the payer), adjudicated
and an ERA is generated back to the provide; participation in Medicare’s end-to-end testing requires enrollment
and selection by your MAC; on a national basis, Medicare is limiting the number of testing providers to 2550.
• For additional details, please see the following:
• http://medicare.fcso.com/ICD-10/267332.pdf
• www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
MLN/MLNMattersArticles/Downloads/SE1409.pdf
• http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
MLN/MLNMattersArticles/Downloads/MM8858.pdf
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6. Health Care Industry & Regulatory Update (cont’d)
• NUCC changed the CMS 1500 professional paper claim form to accommodate ICD-10
(see www.nucc.org); the transition to this new form began in January 2014 and continues
across the health care industry.
• Partial code freeze continues until one year after the implementation of ICD-10:
• Only codes for new diagnosis or new technologies will be considered for exception inclusion.
• Last regular updates to ICD-9-CM and ICD-10 occurred on October 1, 2011.
• Regular ICD-10 updates will begin on October 1, 2016.
• Miscellaneous health care industry and regulatory updates will be provided from our
panelists when applicable and when time permits.
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Open Line Friday
7. 7
Open Line Friday
A Florida Blue Update
Win a Gift Card! Take our 2-minute Assessment.
We are assessing where the provider community is in preparation for ICD-10. Please
respond to our simple 7-question, 2-minute assessment located at www.floridablue.com/icd-10
so we can include you in our weekly $25 gift card drawing through April.
Don't delay, assessment closes April 30 at midnight.
Gift card winners are announced at
www.floridablue.com/icd-10
8. 8
Open Line Friday
A Florida Blue Update
“As we approach the Oct. 1, 2015 ICD-10
Compliance deadline, the Florida Blue
ICD-10 testing window of opportunity is closing.
Florida Blue encourages providers to contact us either
via e-mail @ ICD-10Testing@FloridaBlue.com or
simply visit www.FloridaBlue.com/ICD-10 to
jump start your ICD-10 testing.
While capacities still exist,
now is the time to test ICD-10 with Florida Blue.
DON’T WAIT”.
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Visit www.floridablue.com/icd-10 and select the Test ICD-10 Icon:
ICD-10 Provider Testing
Testing ICD-10 is one of the more critical success factors in achieving ICD-10 compliance and managing
your revenue interruption risk. Florida Blue is recommending ICD-10 provider testing in the three phases
below. Links to testing instructions and other important details are available below for initiating testing with
us. Questions? Email us at ICD-10Testing@floridablue.com.
Testing Results may be accessed following Phase III Instructions below.
ICD-10 Testing Phase
Start
Date(s)
Instructions for Test Phase
Phase I
“Code Validation”
Now
Phase I testing (click here for overview) involves coding a selection
of clinical diagnosis scenarios developed by Florida Blue Nurse
Coders. You can print out the scenarios for your staff to code in both
ICD-9 and ICD-10 for you to compare. This is a manual process and is
available for you on a self-service basis. Clinical Scenarios are
available in the instructions below.
Phase I Instructions: (click here)
ICD-10 Testing Phase
Start
Date(s)
Instructions for Test Phase
Phase II
“Internal End-to-End”
Now
Phase II testing (click here for overview) consists of electronic
receipt and internal processing of ICD-10 coded claims transactions
that were previously processed by Florida Blue with ICD-9 codes.
The instructions contain contact information for a Florida Blue ICD-10
testing coordinator in order to initiate Phase II testing
Phase II Instructions:
Providers (click here)
Vendors (click here)
ICD-10 Testing Phase
Start
Date(s)
Instructions for Test Phase
Phase III
“Round-Trip”
Now
Phase III testing (click here for overview) pertains to the “Round-
trip” processing of ICD-10 coded electronic claim and remittance
advice transactions. Phase II testing is a prerequisite.
(click here)
Phase III Instructions:
Providers (click here)
Vendors (click here)
Open Line Friday
A Florida Blue Update
10. 10
Our February and March ICD-10 tweet chats were a hit! We will continue hosting
monthly Tweet Chats every third Wednesday of each month until further notice. Our
next session is Wed, May 20, noon – 1pm. The dialogue will continue to address some
of the more pressing ICD-10 topics.
A tweet chat is a pre-arranged chat that happens on Twitter through the use of Twitter
updates (called tweets) that include a predefined hashtag (keyword preceded by the #
symbol). The hashtag is used to link those tweets together in a virtual conversation.
Shadow along or join in on the conversation. Follow us on Twitter @FLBlue and
tag your posts #FLBlueChat!
Open Line Friday
A Florida Blue Update
11. .
Send ICD-10 questions, comments, or your request
to be added to our email distribution to
floridablueopenlinefriday@floridablue.com.
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Open Line Friday
12. Next Steps
Next Steps
Test with us and your trading partners!!!
• Florida Blue testing details available at www.floridablue.com/icd-10
• Testing questions? Email us ICD-10testing@floridablue.com
Visit the CMS “Road to 10” tool (www.roadto10.org) and get busy if
you’re not already preparing for Oct. 1, 2015!
Visit the Availity Learning Center (www.availity.com/learningcenter) for
ICD-10 education. (To add, change or remove your email and contact data visit
www.availity.com, select Payer Resources, Florida Blue and Update My Email Information with
Florida Blue, then follow the prompts).
REMEMBER to visit www.floridablue.com/icd-10
for ICD-10 testing, Open Line Friday and podcast information,
FAQs, our toolkit and more.
Follow us on Twitter @FLBlue
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Open Line Friday: ICD-10
13. 13
May 19, 2015 - Jacksonville
Two Training Sessions Offered:
Select 9-11 am or 1-3 PM
To register, visit:
http://www.roadto10.org
and refer to the “Events” tab
located at left
Space is limited.
Register today!
Visit www.floridablue.com/icd-10
for PDF copy of flyer.
15. Addendum
ICD-10 Helpful Resources and Reference Material
• 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
• www.AAPC.com
For regular CMS ICD-10 email updates, subscribe at:
https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_608
WEDI's 2014 Survey on Industry ICD-10 Readiness:
http://www.wedi.org/news/press-releases/2014/08/04/WEDI-Releases-ICD10-Readiness-Survey
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:
The links below were referenced during this presentation. The actual URLs below are provided for your convenience:
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Open Line Friday: ICD-10