Medicare 20102011 POHMS（医疗保险2010 2011 POHMS）.ppt

* * Education and Training Education should begin approximately 6 months prior to implementation Large practices may need to begin earlier to accommodate all staff who need training Use various methods of training: on-line, distance, “Boot Camps” Training time depends on their role Physicians and coders/billers will need more training time than administrative staff * Policy Change/ Payment Impact After health plans complete and change medical policy for procedures and services a specialty provides Review new payment policies Identify opportunities to improve coding processes Communicate policy changes to applicable staff * Deployment of Code Should receive all updated software no later than 7/31/2013 for implementation of your charge documents. Vendor delivers software update with ICD-10-CM, but you should also know how long ICD-9 will be on-line. Vendors should Test system Integrate software into your systems Make internal customizations Test systems with clearinghouses, payers, electronic claims transmission (end to end) Ensure that the vendor will maintain updates to code during transition period * Implementation onPoint Oncology LLC * Make sure that your system accommodates both coding systems for a time. Have credit line established for claims rejections. Be prepared for re-dictation. Staff accordingly. * Other Considerations Consider use of electronic tools to facilitate coding process Could reduce costs and claims rejections Could increase productivity and coding accuracy Don’t convert superbills/charge documents too early Currently, ICD-10-CM is still updated annually 6 –12 months prior to implementation or after code set has been “frozen” Assign ICD-10-CM codes directly, not by applying ICD-9-CM to ICD-10-CM map—it’s good practice’!! * CDC’s Web Resources (FREE) General ICD-10 information /nchs/about/major/dvs/icd10des.htm ICD-10-CM files, information, and General Equivalence Mappings (GEM) between ICD-10-CM and ICD-9-CM /nchs/about/otheract/icd9/icd