Sep 11, 2015
 | 
The Bottom Line

With the ICD-10 implementation date just around the corner, facilities need to be ready now. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Account­ability Act (HIPAA) and all providers regardless of the healthcare setting. In addition, all payers and vendors, including clearinghouses that process claims on behalf of providers, will also be required to transition to this new system.

Aug 07, 2015
 | 
The Bottom Line

In ICD-10 Compliance: Process Improvement and Maintenance for Long-Term Care, authors Maureen McCarthy and Kristin Breese, help SNF organizations consider the impact of reimbursement mapping.

Because of the complexity of mapping options in the GEMs (General Equivalence Mappings), CMS developed a standardized Reimbursement Mapping tool to convert ICD-10 codes to ICD-9 codes primarily for use in legacy systems on a short-term basis. Because of the compromises that had to be made, CMS recommends users modify Reimbursement Mapping to address ICD-9 codes used by their legacy systems that are not mapped. We further recommend users test the mapping using their own frequency data to ensure it adequately addresses the population to which the scheme will be applied.

Jun 30, 2015
 | 
The Bottom Line

In ICD-10 Compliance: Process Improvement and Maintenance for Long-Term Care, authors Maureen McCarthy and Kristin Breese, help SNF organizations determine the impact of converting to a new diagnosis coding system.In order to accurately determine the impact converting to a new diagnosis coding system will have on any organization, the importance of an assessment phase cannot be understated. A thorough assessment will enable the team to address and reinforce inadequate systems, or provide time to effectively plan the transition to another vendor, should your current vendor choose not to participate in the ICD-10 transition. SNFs will need to know which areas of operations will be affected and if their current or anticipated vendors and payers will be ready.

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