MCO Task Force WELCOME

Transcription

1 MCO Task Force WELCOME

2 Agenda Welcome and Introductions Review of Last Meeting Circumcision coverage Substance Involved Pregnancy/ Substance Exposed Newborns Breast pump funding Reimbursements Prenatal Clinical Services Complaints and Grievances Overview ICD-10 Coding effective 10/01/2015 Next Steps Adjournment

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4 OBJECTIVES 1 ICD-10 BASICS REVIEW 2 BILLING UPDATES 3 ADDITIONAL INFORMATION & RESOURCES 2

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6 ICD-10 BASICS REVIEW ICD-10 was created to replace the current coding system, ICD-9. Florida Medicaid, following the federal mandate, requires that ICD-10 codes MUST be used for all professional claims with dates of service on or after 10/01/2015. Institutional claims MUST also use ICD-10 for all claims with discharge dates on or after 10/01/2015. BENEFITS OF ICD-10 INCLUDE Greater accuracy and detail within a single code Improved patient care management Boost efficiencies by identifying specific health conditions, diagnoses, and procedures More precise quality measures 6

7 ICD-10 BASICS REVIEW GREATER ACCURACY & DETAIL WITHIN A SINGLE CODE A single ICD-10 code contains more detail and can include laterality and encounter data. ICD-9 has nearly reached its capacity for growth at approximately 13,000 codes. With the implementation of ICD- 10, the number of available codes will increase to approximately 68,000. Sense organs are now separate from nervous system disorders. Injuries are grouped by anatomical site (ex. injuries of the head, injuries of the leg) instead of injury category (fracture, bruise). Postoperative complications are now part of the specific body system chapter. 7

8 ICD-10 BASICS REVIEW IMPROVED PATIENT CARE MANAGEMENT Improve patient care in targeted areas. Identify candidates as their diagnosis will be more specific. Track severity of conditions and measure a patient s progress if their disease becomes less severe. Identify disease clusters and design education programs and care management programs for patients. 8

9 ICD-10 BASICS REVIEW INCREASED EFFICIENCIES ICD-10 codes could provide an opportunity for more efficient care and processing of claim payments. Ability to identify procedures that are more effective and cost efficient leading to greater savings. More information provided on the claim which may reduce the need to request additional information from providers in making payment decisions. 9

10 ICD-10 BASICS REVIEW MORE PRECISE QUALITY MEASURES Use more specific diagnostic information to determine whether patients are getting the right care at the right time. Measure the severity of patient conditions enabling plans to track improvement in a patient s health. Perform comparisons among providers, among treatment patterns, and between the health care covered population and other populations. 1 0

11 ICD-10 BASICS REVIEW ICD-10 CONSISTS OF TWO PARTS 1 ICD-10-CM (Clinical Modification) Refers to ICD-10 s diagnosis coding system. ICD-10 2 ICD-10-PCS (Procedure Coding System) Refers to ICD-10 s inpatient surgical procedure coding system. 1 1

12 ICD-10 BASICS REVIEW ICD-9-CM VERSUS ICD-10-CM DIAGNOSIS CODES ICD-9-CM DETAILS 3-5 Characters First character is alpha or numeric Characters 2-5 are numeric Always at least 3 characters Use of decimal af ter 3 characters ICD-10-CM DETAILS 3-7 Characters First character is alpha Second character is numeric Characters 3-7 are alpha or numeric Always at least 3 characters Use of decimal af ter 3 characters 10

13 ICD-9-CM VERSUS ICD-10-CM DIAGNOSIS CODES CODE COMPARISON EXAMPLE 1: DIABETES ICD-9-CM Moderate nonproliferat ive diabetic retinopat hy ICD-10-CM Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema E Category Location Category Extension Cause Etiology, Anatomic Site, Severity 13

14 ICD-9-CM VERSUS ICD-10-CM DIAGNOSIS CODES CODE COMPARISON EXAMPLE 2: ANKLE SPRAIN ICD-9-CM Sprain of ankle, unspecified site ICD-10-CM Sprain of unspecified ligament of right ankle, initial encounter S A Category Location Category Extension Cause Etiology, Anatomic Site, Severity 14

15 ICD-9-CM VERSUS ICD-10-CM DIAGNOSIS CODES CODE COMPARISON EXAMPLE 3: BIPOLAR DISORDER ICD-9-CM Bipolar 1 disorder, manic ICD-10-CM Bipolar disorder, current episode manic without psychotic features, unspecified F Category Location Category Extension Cause Etiology, Anatomic Site, Severity 15

16 ICD-10 BASICS REVIEW NO DIRECT CROSSWALK Due to the increased specificity of ICD-10-CM, there may not always be a direct one-to-one code conversion between ICD-9 and ICD-10. Therefore the use of GEMs (General Equivalence Mappings) tools developed by CMS (Centers for Medicare & Medicaid Services) and the CDC (Centers for Disease Control and Prevention) can guide code conversion and training activities, but it is not a direct crosswalk of ICD-9 and ICD- 10 codes. Providers should not rely on GEMs as a substitute for implementing ICD-10, learning to use the ICD-10 code sets, and coding directly in ICD-10. ICD-9 CROSSWALK ICD-10 16

17 ICD-10 BASICS REVIEW NO DIRECT CROSSWALK One-to-One Some ICD-9-CM codes map easily to ICD-10-CM in a simple one-to-one conversion. For example, the ICD-9-CM code (Elevated blood pressure reading without diagnosis of hypertension) converts directly to ICD-10-CM code R03.0. However, an exact map does not always mean that the codes match in detail. 1:1 1:24 One-to-Four Other codes will require additional information to map for possible solutions. For example, the ICD-9-CM code (spotting complicating pregnancy) requires information about weeks in pregnancy to map. There are four options: O (spotting complicating pregnancy, first trimester), O (spotting complicating pregnancy, second trimester), O (spotting complicating pregnancy, third trimester), and (spotting 1:4 1:2,530 complicating pregnancy, unspecified trimester). One-to-Twenty-Four Some codes require significantly more specificity and map into many more ICD-10-CM code set selections. For example, the ICD-9-CM code (closed fracture of lumbar spine with spinal cord injury) has 24 corresponding ICD-10-CM codes, requiring a selection from one of the six scenarios, information about the type of injury and the level of lumbar spinal cord affected. One-to-2,530 In an extreme example, the ICD-9-CM code (other disorders of bone and cartilage, nonunion of fracture) has 2,530 corresponding ICD- 10-CM codes due to the degree of specificity required in ICD-10-CM. 17

18 ICD-10 BASICS REVIEW NO DIRECT CROSSWALK One-to-One Some ICD-9-CM codes map easily to ICD-10-CM in a simple one-to-one conversion. For example, the ICD-9-CM code (Elevated blood pressure reading without diagnosis of hypertension) converts directly to ICD-10-CM code R03.0. However, an exact map does not always mean that the codes match in detail. ICD-9-CM ICD-10-CM Elevated blood pressure reading without diagnosis of hypertension. R03.0 Elevated blood-pressure reading, without diagnosis of hypertension. 18

19 ICD-10 BASICS REVIEW NO DIRECT CROSSWALK One-to-Four Other codes will require additional information to map for possible solutions. For example, the ICD-9-CM code (spotting complicating pregnancy) requires information about weeks in pregnancy to map. There are four options: O (spotting complicating pregnancy, first trimester), O (spotting complicating pregnancy, second trimester), O (spotting complicating pregnancy, third trimester), and (spotting complicating pregnancy, unspecified trimester). ICD-9-CM ICD-10-CM Spot ting complicating pregnancy. O Spotting complicating pregnancy, first trimester. O Spotting complicating pregnancy, second trimester. O Spotting complicating pregnancy, third trimester. O Spotting complicating pregnancy, unspecified trimester. 19

20 ICD-10 BASICS REVIEW NO DIRECT CROSSWALK One-to-Twenty-Four Some codes require significantly more specificity and map into many more ICD-10-CM code set selections. For example, the ICD-9-CM code (closed fracture of lumbar spine with spinal cord injury) has 24 corresponding ICD- 10-CM codes, requiring a selection from one of the six scenarios, information about the type of injury and the level of lumbar spinal cord affected. ICD-9-CM ICD-10-CM Closed fracture of lumbar spine with spinal cord injury. SCENARIO 1 S34.109A or S34.119A or S34.129A with S32.009A SCENARIO 2 S34.101A or S34.111A or S34.121A with S32.019A SCENARIO 3 S34.102A or S34.112A or S34.122A with S32.029A SCENARIO 4 S34.103A or S34.113A or S34.123A with S32.039A SCENARIO 5 S34.104A or S34.114A or S34.124A with S32.049A SCENARIO 6 S34.105A or S34.115A or S34.125A with S32.059A 20

21 ICD-10 BASICS REVIEW NO DIRECT CROSSWALK One-to-2,530 In an extreme example, the ICD-9-CM code (other disorders of bone and cartilage, nonunion of fracture) has 2,530 corresponding ICD-10-CM codes due to the degree of specificity required in ICD-10-CM. ICD-9-CM ICD-10-CM Other disorders of bone and cartilage, nonunion of fracture. 21

22 ICD-10 BASICS REVIEW ICD-10-PROCEDURE CODING SYSTEM (PCS) PCS is a type of inpatient surgical procedure coding system new to ICD-10 and was created for inpatient hospital use ONLY. PCS codes require all 7 characters, unlike the current ICD-9-CM surgical procedure coding system that requires only 3-4 characters. Each character is either alpha (not case sensitive) or numeric. Letters O and I are not used to avoid confusion with numbers 0 and 1. The fourth character always refers to the body part involved in the procedure. 20

23 ICD-10 BASICS REVIEW FOUR MAIN GOALS ACHIEVED WITH PCS 1. Unique coding for procedures, so that they could be clearly distinguished. 2. Room for expansion, as new procedures and devices are used. 3. A standardized, common understanding of terminology that reflects the current practice of medicine. 4. A consistency in coding. 23

24 ICD-10 BASICS REVIEW ICD-10-PCS CODE STRUCTURE ICD-10-PCS Excision of right lower arm and wrist tendon, open approach 0 L B 5 0 Z Z Character 1 Character 2 Character 3 Character 4 Character 5 Character 6 Character 7 SECTION BODY SYSTEM ROOT OPERATION BODY PART APPROACH DEVICE QUALIFIER 1. SECTION Determines the broad procedure category where the code is found. Example: Medical and Surgical. 2. BODY SYSTEM Defines the general anatomical region involved. Example: Tendons. 3. ROOT OPERATION Defines the objective of the procedure. Example: Excision. 4. BODY PART Defines the specific anatomical site. Example: Lower arm and wrist, right. 5. APPROACH Defines the technique used to reach the procedure site. Example: Open. 6. DEVICE Depending on the procedure, there may or may not be a device left in place. Devices fall into four categories: Grafts and Prostheses, Implants, Simple or Mechanical Appliances, and Electronic Appliances. No device is represented by the value Z. 7. QUALIFIER Can specify an additional attribute of the procedure. No Qualifier is represented by the value Z. 24

25 ICD-10 BASICS REVIEW A CLOSER LOOK AT ICD-10-PCS To better understand ICD-10 Procedure Codes, we take a closer look and examine each character of ICD-10-PCS code OLB50ZZ. ICD-10-PCS Excision of right lower arm and wrist tendon, open approach 0 L B 5 0 Z Z Character 1 Character 2 Character 3 Character 4 Character 5 Character 6 Character 7 SECTION BODY SYSTEM ROOT OPERATION BODY PART APPROACH DEVICE QUALIFIER 25

26 ICD-10 BASICS REVIEW A CLOSER LOOK AT ICD-10-PCS ICD-10-PCS Excision of right lower arm and wrist tendon, open approach 0 L B 5 0 Z Z Character 1 Character 2 Character 3 Character 4 Character 5 Character 6 Character 7 SECTION BODY SYSTEM ROOT OPERATION BODY PART APPROACH DEVICE QUALIFIER A procedure is divided into sections that identify the type of procedure performed in a hospital inpatient setting. These sections are designated by an identifier which is a number or letter. In this example, the SECTION is Medical and Surgical, represented by the value of 0. There are sixteen sections, represented by the number 0 through 9 and the letters B through D and F through H. 26

27 ICD-10 BASICS REVIEW A CLOSER LOOK AT ICD-10-PCS 27

28 ICD-10 BASICS REVIEW A CLOSER LOOK AT ICD-10-PCS ICD-10-PCS Excision of right lower arm and wrist tendon, open approach 0 L B 5 0 Z Z Character 1 Character 2 Character 3 Character 4 Character 5 Character 6 Character 7 SECTION BODY SYSTEM ROOT OPERATION BODY PART APPROACH DEVICE QUALIFIER The body system is defined as the general physiological system or anatomical region involved. Each body system contains a list of anatomical region such as lower arteries, central nervous system, and respiratory system. In this example, the BODY SYSTEM is Tendons, represented by the value L. 28

29 ICD-10 BASICS REVIEW A CLOSER LOOK AT ICD-10-PCS ICD-10-PCS Excision of right lower arm and wrist tendon, open approach 0 L B 5 0 Z Z Character 1 Character 2 Character 3 Character 4 Character 5 Character 6 Character 7 SECTION BODY SYSTEM ROOT OPERATION BODY PART APPROACH DEVICE QUALIFIER The root operation or the objective of the procedure is the third character of an ICD-10-PCS code. Each anatomical region offers a list of procedures to choose from such as bypass, drainage, and reattachment. In this example, the ROOT OPERATION is Excision, represented by the value B. 29

30 ICD-10 BASICS REVIEW A CLOSER LOOK AT ICD-10-PCS ICD-10-PCS Excision of right lower arm and wrist tendon, open approach 0 L B 5 0 Z Z Character 1 Character 2 Character 3 Character 4 Character 5 Character 6 Character 7 SECTION BODY SYSTEM ROOT OPERATION BODY PART APPROACH DEVICE QUALIFIER The body part informs where the procedure was performed. The body part along with the body system provides a precise description of the procedure site. Examples of body parts are kidney, tonsils, and thymus. In this example, the BODY PART is Lower Arm and Wrist, Right, represented by the value 5. 30

31 ICD-10 BASICS REVIEW A CLOSER LOOK AT ICD-10-PCS ICD-10-PCS Excision of right lower arm and wrist tendon, open approach 0 L B 5 0 Z Z Character 1 Character 2 Character 3 Character 4 Character 5 Character 6 Character 7 SECTION BODY SYSTEM ROOT OPERATION BODY PART APPROACH DEVICE QUALIFIER The approach is the technique used to reach the procedure site. Examples of techniques are open, percutaneous, and percutaneous endoscopic. In this example, the APPROACH is Open, represented by the value 0. 31

32 ICD-10 BASICS REVIEW A CLOSER LOOK AT ICD-10-PCS ICD-10-PCS Excision of right lower arm and wrist tendon, open approach 0 L B 5 0 Z Z Character 1 Character 2 Character 3 Character 4 Character 5 Character 6 Character 7 SECTION BODY SYSTEM ROOT OPERATION BODY PART APPROACH DEVICE QUALIFIER There may or may not be a device left in place depending on the procedure performed. There are four categories to select from: grafts and prostheses, implants, simple or mechanical appliances, and electronic appliances. In this example, there is no DEVICE used in the procedure. The value Z is used to represent No Device. 30

33 ICD-10 BASICS REVIEW A CLOSER LOOK AT ICD-10-PCS ICD-10-PCS Excision of right lower arm and wrist tendon, open approach 0 L B 5 0 Z Z Character 1 Character 2 Character 3 Character 4 Character 5 Character 6 Character 7 SECTION BODY SYSTEM ROOT OPERATION BODY PART APPROACH DEVICE QUALIFIER The qualifier is the seventh character which specifies any additional attribute of the procedure. Qualifier choices will vary depending on the device selected. In this example, since there was no device used, there is no specific QUALIFIER applicable to this procedure. The value Z is used to represent No Qualifier. 31

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35 BILLING UPDATES PAPER CLAIMS CMS-1500 CLAIM FORM (VERSION 02/12) Important: As of April 1, 2014, Florida Medicaid discontinued use of CMS-1500 (version 08/05). Medicaid currently accepts only CMS-1500 form (version 02/12) for filing claims. 35

36 BILLING UPDATES PAPER CLAIMS CMS-1500 CLAIM FORM (VERSION 02/12) 1 2 Changes: Locator 21 Diagnosis or Nature of Illness or Injury 1.An ICD Indicator Field has been added to the claim form. Using this new ICD Indicator Field, providers will enter 9 if billing with ICD-9 codes or 0 if billing with ICD-10 codes. This will help Florida Medicaid determine how to process the claim. Claims that do not contain a 9 or 0 will be returned to the Provider (RTP). 2.In fields A-L, enter the codes to identify the patient s diagnosis and/or condition. List no more than 12 ICD-9 or ICD-10 diagnosis codes. For more information including training and documents, we encourage you and your staff to visit the CMS-1500 Transition page under the Agency Initiatives menu on the Florida Medicaid Web Portal. 36

37 BILLING UPDATES PAPER CLAIMS UB-O4 CLAIM FORM 1 2 Changes: Locator 66 and Location 74 1.Locator 66 field is used for diagnosis code indicator. Providers will need to enter the qualifier that identifies the version of ICD reported: 9 Ninth Revision 10 Tenth Revision 2.When filling an Institutional claim, Locator 74 field should display an ICD-10-PCS code. 37

38 BILLING UPDATES ELECTRONIC CLAIMS (WEB PORTAL) PROFESSIONAL AND INSTITUTIONAL CLAIMS 2 1 Changes: Version and Diagnosis Code 1.As of 10/01/2015, the version selection for the Diagnosis section on Professional and Institutional claims will default to ICD-10. Providers who file a claim with a date of service (DOS) prior to 10/01/2015 will need to change the version indicator to ICD-9. 2.Diagnosis codes should not be entered in the Web Portal with a decimal point after the third character. 38

39 BILLING UPDATES ELECTRONIC CLAIMS (WEB PORTAL) PROFESSIONAL AND INSTITUTIONAL CLAIMS 1 Change: ICD-9 Qualifier 1. Providers will now see a new qualifier in the diagnosis panel. Qualifiers will be systematically entered based on the submission of ICD-9 or ICD-10 codes. Currently, since only ICD-9 diagnosis codes are being accepted at this time, providers will see qualifiers indicating ICD-9 entries (BK and BF) via the Web Portal. Qualifier BK indicates the ICD-9 Principal Diagnosis Qualifier BF indicates all other ICD-9 Diagnosis 39

40 BILLING UPDATES ELECTRONIC CLAIMS (WEB PORTAL) PROFESSIONAL AND INSTITUTIONAL CLAIMS 1 Change: ICD-10 Qualifier 1. When submitting an ICD-10 claim on or after 10/01/2015, other qualifiers related to ICD-10 (ABK and ABF) will be systematically assigned to the claim. Qualifier ABK indicates the ICD-10 Principal Diagnosis. Qualifier ABF indicates all other ICD-10 Diagnoses. 40

41 BILLING UPDATES ELECTRONIC CLAIMS (WEB PORTAL) INSTITUTIONAL DDE (DIRECT DATA ENTRY) CLAIMS 1 Reminder: Enter a Procedure Code 1. When submitting an Institutional DDE claim, remember to enter a procedure code. 41

42 BILLING UPDATES ELECTRONIC CLAIMS (WEB PORTAL) ELECTRONIC CLAIMS SUBMISSION Single claims submitted electronically through our Electronic Data Interchange (EDI) system will need to indicate if ICD-9 or ICD-10 codes are being submitted. Batch claim files can contain both ICD-9 and ICD-10 codes. For all Professional and Institutional 837 transactions, providers will use the appropriate qualifier (BK, BF, ABK and ABF) in the header information to indicate whether ICD-9 or ICD-10 codes are included. 40

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44 ADDITIONAL INFORMATION & RESOURCES BILLING REMINDERS 1. Correct coding practice for Florida Medicaid includes coding to the most specific and appropriate diagnosis codes on all claims. 2. Always make sure to indicate whether your claim contains ICD-9 or ICD-10 codes, no matter how the claim is submitted to Florida Medicaid. 3. An Invalid Indicator message will display if the claim indicator is left blank or if numbers other than 9 or 0 are entered. 4. Claims must be submitted with EITHER ICD-9 or ICD-10 codes. Claims submitted with both ICD-9 and ICD-10 codes will be denied. Edit 701: ICD-10 IMPROPER INDICATOR This edit will post of an ICD-10 indicator ( 0 ) is included before t he October 1, 2015 ICD-10 implement at ion date. Edit 702: INVALID ICD INDICATOR This edit will post if any indicator ot her t han 9 or 0 is used or if t he indicator is left blank. 44

45 ADDITIONAL INFORMATION & RESOURCES BILLING REMINDERS Edit 703: DIAGNOSIS CODE IS MISSING INDICATOR PRESENT This edit will post if the indicator is included but there is no diagnosis code on the claim. Edit 704: CLAIM CONTAINS AN ICD-9 CODE This edit will post if an ICD-9 indicator ( 9 ) is included on claims that have ICD-9 codes with dates of service or discharge date after 10/01/2015. Edit 705: CLAIM CONTAINS ICD-9 AND ICD-10 DIAGNOSIS OR PROCEDURE This edit will post on claims that contain both ICD-9 and ICD-10 qualifiers. Edit 706: DATE SPAN BETWEEN ICD-9 AND ICD-10 This edit will post on claims where the date of service on claim spans between the September 2015 and October 2015 dates unless it is an exception. Edit 707: ICD INDICATOR AND DIAGNOSIS/PROCEDURE QUALIFIER MISMATCH This edit will post on claims when there is a mismatch between the ICD indicator and diagnosis/procedure qualifier. 45

46 ADDITIONAL INFORMATION & RESOURCES PROVIDER HANDBOOKS Provider Handbooks affected by the implementation of ICD-10 are currently being revised by AHCA. Any policy changes related to the ICD-10 implementation will be conveyed to providers via Provider Alerts. Please check the public Web Portal often for important updates and announcements related to ICD-10. Accessing Provider Handbooks To access Provider Handbooks follow these steps: 1.From the Public Web Portal main page, refer to the Provider left navigation menu. 2.Click Provider Support Provider Handbooks. 46

47 ADDITIONAL INFORMATION & RESOURCES ICD-10 PROVIDER ALERTS Sign up today for provider alerts by filling out the Florida Medicaid Health Care Alerts form at Provider Alerts are the primary way in which Florida Medicaid alerts the provider community to important changes and training workshops. Signing-up To Receive Provider Alerts To sign-up and receive provider alerts, follow these steps: 1.Enter First Name. 2.Enter Last Name. 3.Select Field Office. 4.Select Provider Type. 5.Click Submit. 47

48 ADDITIONAL INFORMATION & RESOURCES ICD-10 TESTING AHCA (Agency for Health Care Administration) continues to work alongside its fiscal agent HP to complete the remaining system changes. AHCA and HP look forward to working closely with the Provider Community, Managed Care Organizations, and Clearinghouses to ensure they are prepared for the ICD-10 changes in 10/01/2015. We encourage you to sign up for provider alerts to receive announcements regarding testing and to visit the Florida Web Portal frequently to learn more about ICD-10. For questions on testing with Florida Medicaid, 48

49 ADDITIONAL INFORMATION & RESOURCES CMS (CENTERS FOR MEDICARE & MEDICAID SERVICES) Visit the CMS website at for numerous pages containing informational ICD-10 resources, such as implementation plans, timelines, CMS-sponsored teleconferences, and more. 49

50 ADDITIONAL INFORMATION & RESOURCES CMS (CENTERS FOR MEDICARE & MEDICAID SERVICES) Exploring CMS s ICD-10 Coding Resources Numerous coding guides and indexes can be found on the CMS ICD-10 pages. Within these ICD-10 coding guides, health care providers can find information on coding that specifically pertains to their practice. Outlined on the next slide are general steps that can be taken by any specialty provider to find their own ICD-10 codes. CMS will continue to issue coding updates every year, but these same steps will also apply to future code tables and indexes. 50

51 ADDITIONAL INFORMATION & RESOURCES CMS (CENTERS FOR MEDICARE & MEDICAID SERVICES) Navigate to CMS s ICD-10 Pages To navigate to CMS s ICD-10 pages, follow these steps: 1.From the CMS.gov home page, select Medicare from the top menu. 2.On the Medicare page, scroll down until you see Coding. Under Coding, click ICD On the ICD-10 page left menu, click 2015 ICD-10-CM and GEMs. 4.On the 2015 ICD-10-CM and GEMs page, under Downloads, select 2015 Code Tables and Index zip file. Note: Once the download is complete, open the PDF file titled Tabular. 51

52 ADDITIONAL INFORMATION & RESOURCES CMS (CENTERS FOR MEDICARE & MEDICAID SERVICES) Finding ICD-10-CM Codes To find ICD-10-CM codes using the PDF file titled Tabular, follow these steps: 1.Start at the Table of Contents page and select a chapter related to the code for which you wish to obtain information. 2.Each chapter contains blocks that provide a list of code ranges and their description. Select a desired block to review. Note: Use the hyperlinks listed in the Table of Contents and in the chapters to quickly navigate through the document. 50

53 ADDITIONAL INFORMATION & RESOURCES THE ICD-10 PUBLIC WEB PORTAL PAGE The Florida Medicaid Web Port al has a dedicated ICD-10 page that contains three submenus: TRAINING PUBLICATIONS SUPPORT CONTENTS CONTENTS CONTENTS Quick Reference Guides (QRGs) PowerPoint Presentations Mont hly Newsletters Fast Facts Quick Reference Links Frequently Asked Questions (FAQ) ICD-10 Field Services Map Web Based Training (WBTs) Contact Support Modules Training Schedules 53

54 ADDITIONAL INFORMATION & RESOURCES ICD-10 WEB BASED TRAININGS (WBTs) View the interactive WBT under the Training section of the ICD-10 pages. The WBT includes narration and an overview of ICD-10 basics, benefits, and coding structure, as well as other important ICD-10 information. View Introduction to ICD-10 to learn more about: What is ICD-10? What are the Benefits of ICD-10? The Difference Between ICD-9 and ICD-10 Frequently Asked Questions Additional Resources Provider Alerts Contact Information View ICD-10 Coding Basics to learn more about: An overview of the ICD-10 Basics How to navigate the Centers for Medicare & Medicaid Services (CMS) website for coding resources 54

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56 SUMMARY In th is presentation, we ve discussed: 1 ICD-10 BASICS REVIEW 2 BILLING UPDATES 3 ADDITIONAL INFORMATION & RESOURCES 56

57 WE RE HERE TO HELP There are eight Provider Field Services (PFS) Representatives available throughout the state of Florida to assist providers with Florida Medicaid s ICD-10 Implementation. Contact us today , Opt ion 7 57

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59 Agenda Welcome and Introductions Review of Last Meeting Circumcision coverage Substance Involved Pregnancy/ Substance Exposed Newborns Breast pump funding Reimbursements Prenatal Clinical Services Complaints and Grievances Overview ICD-10 Coding effective 10/01/2015 Next Steps Adjournment

60 Let s work together to keep them ALL safe, healthy, and happy! Thank You!

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