5010, ICD-10 Agenda. Tuesday, July 13, :00 9:00 AM Registration, Continental Breakfast

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1 3 rd WEDI 5010, ICD-10 Implementation Forum Advancing Down the Implementation Highway: Building A Bridge from Planning to Implementation July 13-15, 2010 Fairfax Marriott at Fair Oaks Fairfax, VA 5010, ICD-10 Agenda Tuesday, July 13, :00 9:00 AM Registration, Continental Breakfast 9:00 9:15 AM Welcome, Introductions 9:15 10:45 AM 5010 Migration/Transition Issues, Part I Transitioning from 4010A1 to 5010 In these first two sessions, we will discuss the challenges the industry may encounter as they transition from 4010A1 to The first session will identify transition issues associated with specific transaction migration, (e.g. 837, 835, etc). Migration concepts will be presented and attendees will be encouraged to participate in an interactive discussion on how to mitigate some of the transition challenges. Deborah Meisner, VP, Regulatory Compliance Strategy, Emdeon Corporation; WEDI SNIP Workers Comp/Auto, Property & Casualty SWG Co Chair 10:45 11:00 AM Break 11:00 12:30 PM 5010 Migration/Transition Issues, Part II Transitioning from 4010A1 to The second session will identify transition challenges across transactions. Topics will include: migration of all transactions - is there an ideal order or phase in process? Are there transaction dependencies that need to 1

2 12:30 1:30 PM Lunch be considered? What are other migration challenges? A number of migration concepts will be discussed and Forum attendees will be encouraged to participate in an interactive discussion on how to mitigate some of these challenges. Laurie Burckhardt, EDI Manager, WPS Insurance; WEDI SNIP Transactions Workgroup Co Chair 1:30 3:00 PM 5010 Testing This session will cover 5010 testing challenges. Topics that will be discussed are: Creating partner migration test plans Identifying and pursuing migration pilots Scheduling partner migration activity Monitoring partner readiness Applying lessons learned from pilot migrations Readying both front-end and application systems for partner testing Operating both 4010A and 5010 during the 2011 transition period 3:00 3:15 PM Break 3:15 4:00 PM 5010 Survey Results WEDI has recently completed a second survey on the status of the industry s implementation of the 5010 standards. Conclusions and recommendations based on the survey results will be presented and offered for audience reaction, discussion, and suggestions. We will also look for suggestions on improving the survey and getting information from additional sources to validate our results. Stanley Nachimson, Principal, Nachimson Advisors, LLC 4:00 4:45 PM 5010 Next Steps Based on some of the concepts presented, education and outreach to the healthcare industry is essential. The participants will discuss outreach opportunities to help facilitate 5010 awareness. As part of the outreach initiative, participants will also hear about a few Errata (technical changes) that are currently under consideration for Gail Kocher, Director, Health Information Technology, Blue Cross and Blue Shield Association; WEDI SNIP Steering Committee Co Chair, WEDI SNIP NPI SWG Co Chair 2

3 4:45 5:00 PM Closing Comments, Adjourn Wednesday, July 14, :30 8:00 AM Registration, Continental Breakfast 8:00 8:15 AM Recap of Tuesday s Discussion + Today s Plan 8:15 9:15 AM CMS Update CMS to provide an update on Medicare's 5010 implementation as well as status of Medicare's internal testing. CMS will provide an update on Claim Module Edits and their plans to roll out standard acknowledgement reports. Laurie Burckhardt, EDI Manager, WPS Insurance; WEDI SNIP Transactions Workgroup Co Chair CMS Representative being confirmed 9:15 10:15 AM Acknowledgements This session will provide a brief overview of health plans issues related to implementing acknowledgments, Forum attendees will be encouraged to participate in an interactive discussion on how payers, providers, and vendors plan to utilize acknowledgments. Laurie Burckhardt, EDI Manager, WPS Insurance; WEDI SNIP Transactions Workgroup Co Chair 10:15 10:30 AM Break 10:30 11:30 AM Health Care Reform There will be a brief review of the Administrative Simplification provisions outlined in the Patient Protection and Affordable Care Act (HealthCare Reform) led by interactive discussion on how some of these provisions will impact the 5010 transactions and might factor into 5010 implementation. 3

4 12:00-1:00 PM Registration, Lunch All Forum Registrants Invited 1:00 1:15 PM Welcome, Introductions Cathy Graeff, Catherine C. Graeff, R.Ph, MBA; WEDI SNIP ICD- 10 Education SWG Co Chair 1:15 2:45 PM CMS ICD10 Implementation Update CMS/OESS has been focused on their ICD10 initiative for some time. Hear where they are with their Medicare ICD10 implementation, how they plan to use the GEMS in their implementation, and how they plan to address some of the crosswalk issues. Participant will also hear an update on the overall State Medicaid readiness. Mayo Clinic; WEDI Education 2:45 3:00 PM Break 3:00 4:30 PM Bridging the Compliance Date As the October 1, 2013 date approaches, there will be an increasing number of instances where information associated with a HIPAA transaction or an encounter may bridge the compliance date. Examples include a prior authorization sent before October 1, 2013 for services that would be delivered after the compliance deadline and interim bills for hospital in-patient stays that cross the compliance date. This session will highlight a number of these situations and solicit audience discussion on suggested best practices for accommodating them. Don't miss out on this exciting dialogue. Jim Daley, Director, IT Risk & Compliance, BSBS of South Carolina; WEDI SNIP ICD-10 WG Co Chair; WEDI SNIP ICD-10 Virtual Implementation SWG Co Chair 4:30 5:00 Closing Comments, Wrap Up Andrea Danes, Senior Principal, CSG Government Solutions; WEDI SNIP ICD-10 Education SWG Co Chair 4

5 Thursday, July 15, :30 8:00 AM Registration, Continental Breakfast 8:00 8:15 AM Recap of Wednesday, Review of Today s Agenda Cathy Graeff, Catherine C. Graeff, R.Ph, MBA; WEDI SNIP ICD- 10 Education SWG Co Chair 8:15 9:45 AM The Virtual Implementation Project (a pilot study) The Virtual Implementation Project is a WEDI project that uses volunteer participants to assess the variance in coding and cross walking practices for a set of defined scenarios. In the pilot for this project, participants were asked to read a set of brief clinical scenarios and identify the best possible ICD9 and ICD10 diagnosis code(s) that capture the medical concepts presented in those scenarios. They were also asked to translate a set of ICD9 codes to ICD10 and ICD10 codes to ICD9. The test scenarios and codes were prepared by the VIP sub-workgroup. Jim Daley, Director, IT Risk & Compliance, BSBS of South Carolina; WEDI SNIP ICD-10 WG Co Chair; WEDI SNIP ICD-10 Virtual Implementation SWG Co Chair Joe Nichols, MD, Health Data Consulting; WEDI SNIP ICD-10 Virtual Implementation Project SWG Co Chair 9:45 10:00 AM Break 10:00 10:45 AM Leveraging SNOMED CT and ICD-10-CM/PCS Relationships for Better Data Do you know what SNOMED-CT is and how it will impact your future? This session will tie the importance of SNOMED CT to ICD-10 in your health care future. Current requirements for meaningful use specify ICD-9 or SNOMED CT for problem list management; future recommendations for problem list coding include ICD-10 or SNOMED CT in 2013, with a suggested transition to SNOMED CT alone for Hear why ICD-10 should be the administrative billing vocabulary and SNOMED-CT the clinician facing vocabulary, and how adopting both codes will enhance the quality of healthcare. Providers, payers and vendors need to be thinking about this now. Andrea Danes, Senior Principal, CSG Government Solutions; WEDI SNIP ICD-10 Education SWG Co Chair 5

6 Rita Scichilone, Director, Practice Leadership, AHIMA (American Health Information Management Association) 10:45 11:30 AM Industry Survey Update The third round of the WEDI industry survey will be completed in May. Results of the survey will be analyzed and specific recommendations will be brought to the forum attendees for discussion and suggestions. Additional ideas for survey topics will also be solicited. Stanley Nachimson, Principal, Nachimson Advisors, LLC; WEDI SNIP ICD-10 Timeline SWG Co Chair 11:30 12:30 PM The Truth about Cross Walking ICD-10 This session will begin a brief overview of the various crosswalks that exist today around ICD-10 and will clarify what a crosswalk is and is not. ONC will discuss their thoughts on ICD Coding Crosswalks as addressed in the Patient Protection and Affordable Care Act. Hear what the Feds plans are to convene a stakeholder meeting to address the crosswalk, revision of the crosswalk, utilization of the crosswalk, and future revisions of crosswalks as required in the new healthcare reform law. BCBS will share their plans for the use of ICD crosswalks and the process they re using to create a common crosswalk. RHI will address their analysis on cross walking groups of codes in one code set to groups of codes in another code set when working with aggregated data. This session will close with a lively interactive discussion of these concepts. Kristine Weinberger, Manager of Consulting, ACS, Inc.; WEDI SNIP ICD-10 Crosswalks SWG Co Chair Speakers: Gail Kocher, Director, Health Information Technology, Blue Cross and Blue Shield Association Lisa Taylor, Clinical Terminology Analyst, Resolution Health, Inc. (invited) 12:30 1:30 PM Lunch 1:30 2:45 PM ICD-10 Testing A New Way of Thinking about Test ICD-10 has forced us to think about testing differently than our traditional testing methodologies. Join us in discussing why it is critical to build this new test framework based the results of your Impact Assessment before any Implementation begins. 6

7 2:45 3:00 PM Break Impact Assessment provides what is impacted by ICD-10. These impact results are the basis of developing a test approach using a new concept which allows you to define your testing strategy before any implementation begins. What you will discover is the testing approach will be based on business processes changes versus system changes. We will also have an interactive discussion of the other layers of factors that need to go into your ICD-10 test plan. Lisa Miller, Chief Information and Compliance Officer, XeoHealth; WEDI SNIP ICD-10 WG Co Chair Sid Hebert, Program Manager, Humana, Inc. 3:00 3:45 PM ICD-10 Mind Mapping An Exercise in Collective Industry Intelligence Join the ICD-10 Impact Assessment subworkgroup for this interactive session. The session will begin with an overview of what mind mapping is and how it captures the collaborative concepts. After a review the current ICD-10 mind maps. These maps are the collective industry consensus describing the current ICD-10 impact universe. Be part of this innovative approach by adding your experience and thoughts to the ICD-10 mind map. At the end of the session, the latest mind maps will be ed to all participants. Your participation is vital in completing this body of work, perhaps for the first time the industry will have a clear picture of the potential impact of ICD-10 on the industry. Peggy Honts, Vice President, Consulting Services, Axiom Systems, Inc.; WEDI SNIP ICD-10 Impact Assessment SWG Co Chair 3:45 4:00 PM Recap, Next Steps Andrea Danes, Senior Principal, CSG Government Solutions; WEDI SNIP ICD-10 Education SWG Co Chair 7