ICD-10 Handbook APPLICATION MANUAL

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A P P LI C A TI O N M A N U A L

ICD-10 Handbook

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Revenue Cycle Management | Business Intelligence | Systems Integration | EMR Technology

855.499.9333 | [email protected] | m3meridian.com

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Parameters ...5

System Wide Defaults ...5

System ...5

Patient Definition ...6

Insurance Section ...6

Patient Case Window ...6

Status Section...6

Inquiry Section...7

Transaction Explosion...7

Activities/Forms ...8

Patient Chart...8

Problem List Section...8

Posting ...8

Charge Posting ...8

Switching From ICD-10 to ICD-9 Billing in Charge Posting ...9

Switching from ICD-9 to ICD-10 Billing in Charge Posting ... 11

Batch Verification ... 13

Transaction Update ... 13

PQRS Work List (Formerly PQRI Work List) ... 13

Suspense Posting ... 13

Switching from ICD-10 to ICD-9 Billing in Suspense ... 13

Switching from ICD-9 to ICD-10 Billing in Suspense ... 14

Suspense Reports ... 15

Scheduler ... 16

Patient Appoint ment Window ... 16

EMRge ... 17

Orders ... 17

Charting... 17

Charge Capture ... 17

Hospital Rounds... 17

Hospital Rounds Definition... 17

Radiology ... 18

Reports ... 20

System ... 21

Diagnosis Code Listing... 21

Patient... 21 Appoint ments ... 21 Practice Reporter ... 21 Miscellaneous ... 21 Patient ... 21 Financial ... 21 Insurance... 21 Managed Care... 21

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Legal Notifications

Disclaimers

Management. It may not, in whole or part, be copied, photocopied, reproduced, translated, or reduced to any electronic medium or machine-readable form without prior consent, in writing, from Meridian Medical Management.

It is possible that it may contain technical or typographical errors. Meridian Medical Management provides this publication “as is” without warranty of any kind, either expressed or implied. All patient names, provider names, and offices are fictional. Any resemblance to actual persons or locations is purely coincidence.

Meridian Medical Management reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty or documentation regarding the product or service featured.

Contact your Meridian Medical Management Representative for the most current information and/or inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein.

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Wilbraham, MA 01095

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Meridian Manager ®, Meridian Appointment Scheduler ®, Meridian Practice Reporter ®, Meridian Collector ®, Meridian Client Center ®, and Meridian EMRge ® are registered trademarks or Meridian Medical Management. Microsoft ®, Windows XP ®, Windows Vista ®, and Word ® are registered trademarks of Microsoft Corporation. All other products and company names are trademarks of their respective owners.

Limitations and Conditions of Use

Meridian Medical Management furnishes this document to you, a current Meridian Medical Management customer, as Meridian Medical Management confidential information pursuant to a non-disclosure agreement (NDA) or the confidentialit y provisions of a service contract between you and Meridian Medical Management. If you are not (i) a current Meridian Medical Management customer, and (ii) subject to contractual obligations of confidentiality to Meridian Medical Management, you are not authorized to access this document.

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Posting Tab in Transaction Code Definition.

Note: The Support ICD-10 Billing Parameter must be enabled before ICD-10 codes can be selected in Transaction Code Definition. See the Parameters Section of this manual for more information.

 To view the ICD-9 code that was originally linked to the selected Transaction Code, click the

Switch to ICD-9 Link.

Diagnosis Codes

ICD-10

 ICD-10 codes can be added, changed, and deleted from the ICD-10 Diagnosis Code Table. Note: The ICD-10 Diagnosis Code Table is pre-populated from CMS when the Practice is updated to the latest version of the Origin Practice Suite.

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 Highlight an ICD-10 code in the table and then click the ICD-9 Button to view the ICD-9 code that is linked to the selected ICD-10 code.

Note: From the ICD-9 Diagnosis Code Table, click the ICD-10 Button to return to the ICD-10 Diagnosis Code Table.

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PQRS Measures (formerly PQRI Measures)

 ICD-10 codes can be selected in the PQRS ICD Detail Definition Window.

Note: After enabling ICD-10 billing, all PQRS measures with associate diagnosis codes must be re-defined with ICD-10 codes.

 Click the Switch to ICD-9 Link to view the ICD-9 codes that were previously linked to the PQRS Measure.

Parameters

System Wide Defaults

System

 Click the Support ICD-10 Billing Checkbox to enable the appropriate ICD-10 fields in Transaction Code Definition and the Posting Area.

 Click the Support ICD-10 Clinical Checkbox to enable the appropriate ICD-10 fields in the Charting Area.

 If a date is entered in the ICD-10 Live Date field, charges created prior to this date will not require ICD-10 codes.

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Note: If this field is not populated with a date, ALL charges in the Suite will require an ICD-10 code in order to be saved, regardless of when the original charge was posted. This will include

resubmitting charges.

Patient Definition

Insurance Section

Patient Case Window

 8 diagnosis code fields are available when creating and editing an insurance case. The entered diagnosis codes default accordingly in the Posting Area and the Suspense Area.

 Click the Switch to ICD-9 Link in the Patient Case Window to view the ICD-9 codes that were previously listed.

Note: When viewing ICD-9 codes, click the Switch to ICD-10 Link to return to the Patient Case Window with the ICD-10 codes listed.

Status Section

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 Click the Switch to ICD-9 Link to view the ICD-9 codes that were listed in the diagnosis code fields prior to enabling ICD-10 billing.

Inquiry Section

Transaction Explosion

 The Transaction Explosion Window displays the eight (8) diagnosis code fields available for ICD-10 billing.

 Click the ICD9/ICD10 Link to look up ICD-10 codes that are linked to an ICD-9 code and vice versa.

 For charges posted using ICD-9 standard billing, click the Switch to ICD-9 Link in the Transaction Explosion Window to view the ICD-9 codes that were originally posted with the transaction.

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Activities/Forms

The following reports and forms reflect ICD-10 diagnosis codes:

 Patient Receipt

 Submission History Listing

 Referral Tracking

 Radiology Flash Reports

Patient Chart

Problem List Section

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ICD-9 and ICD-10 information from charted problems is saved to the Problem List Section of the Patient

Chart. To view the ICD-10 information, open a problem and click the blue View ICD-10 Codes Link.

Note: This feature requires that the ICD-10 Clinical Support Parameter be enabled. Problems charted prior to

the parameter activation will not display ICD-10 information.

Posting

Charge Posting

 The Charge Posting Window displays the eight (8) ICD-10 required diagnosis code fields. Transactions with up to eight (8) diagnoses can be posted.

Note: The Support ICD-10 Billing Parameter must be enabled for the additional diagnosis code fields to display.

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Note: The Diagnosis 1 - Diagnosis 4 Fields must be filled before the user may tab from Diagnosis 5 Field through Diagnosis 8 Fields.

Switching From ICD-10 to ICD-9 Billing in Charge Posting

The ICD9 Link to the right of the diagnosis code fields can be clicked to post charges using ICD-9 standards.

To switch from ICD-10 to ICD-9 billing:

1. Click the ICD9 Link to the right of the diagnosis code fields.

Note: Only one method of billing can be used at a time. If the ICD9 Link is selected, the ICD10 Link is grayed out and visa versa.

2. Once clicked the following message window is displayed. Click the Yes Button to display the Transaction ICD Selection (ICD-9 Preferred) Window.

Note: If the No Button is selected, the user will be returned to the Charge Posting Window with ICD-10 billing still enabled.

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3. Select the appropriate ICD-9 codes in the ICD-9 Selection Column to the left. The linked ICD-10 codes display in the ICD-10 Selection Column to the right.

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Note: The diagnosis code fields are now read-only and will remain so until a different patient is selected. To make changes, click the ICD9 Link again.

Switching from ICD-9 to ICD-10 Billing in Charge Posting

For transactions entered into a batch using ICD-9 billing, the ICD10 Link can be used to switch to ICD-10 billing.

To switch to ICD-10 billing:

1. From the Charge Posting Window, click the ICD10 Link to the right of the diagnosis code fields. The following message window displays:

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3. The previously entered ICD-9 codes are listed in the ICD-9 Selection Column. The linked ICD-10 codes are listed in the ICD-10 Selection Column. Additional ICD-10 codes can be entered in the ICD-10 Selection Column as needed. Any linked ICD-9 codes are displayed in the ICD-9 Selection Column to the right.

4. When finished entering the necessary 10 codes, click the OK Button. The selected ICD-10 codes are displayed in the Charge Posting Window.

Note: The diagnosis code fields are now read-only and will remain so until a different patient is selected. To make changes, click the ICD10 Link again.

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will look to the ICD-10 codes on the Status Section of Patient Definition.

PQRS Work List

(Formerly PQRI Work List)

Note: After enabling ICD-10 billing, PQRS measures with linked diagnosis codes must be re-defined with ICD-10 codes.

 The PQRS Posting Window displays the linked ICD-10 codes.

Suspense Posting

 The Suspense Posting Window displays the eight (8) ICD-10 required diagnosis code fields. Transactions with up to eight (8) diagnoses can be posted in Suspense.

 The Diag 1 Column in both the Suspense Work List and the Suspense Work List - All Errors Windows display the ICD-10 code linked to the transaction.

Switching from ICD-10 to ICD-9 Billing in Suspense

The Switch to ICD9 Link can be clicked to post charges using ICD-9 standards.

Note: Only one method of billing can be used at a time. If the ICD9 Link is selected, the ICD10 Link is grayed out and visa versa.

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Switching from ICD-9 to ICD-10 Billing in Suspense

For transactions entered into Suspense using ICD-9 billing, the Switch to ICD10 Link can be used to switch to ICD-10 billing.

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Suspense Reports

 When the Support ICD-10 Billing Parameter is enabled, the following errors are verified in the Suspense Transaction Error Report:

o 32. Diagnosis Code 1 Invalid (ICD-10) o 33. Diagnosis Code 2 Invalid (ICD-10) o 34. Diagnosis Code 3 Invalid (ICD-10) o 35. Diagnosis Code 4 Invalid (ICD-10) o 36. Diagnosis Code 5 Invalid (ICD-10) o 37. Diagnosis Code 6 Invalid (ICD-10) o 38. Diagnosis Code 7 Invalid (ICD-10) o 39. Diagnosis Code 8 Invalid (ICD-10)

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o All Suspense Transactions Report

Scheduler

Patient Appointment Window

 ICD-10 codes can be selected from the Diagnosis Field.

 Click the Switch to ICD-9 Link to view the ICD-9 code that was previously linked to the selected Appointment Type.

Note: When viewing ICD-9 codes, click the Switch to ICD-10 Link to return to the Patient Appointment Window with the ICD-10 code listed.

 7 additional diagnosis fields are available in the Additional Diagnosis Codes Window. Note: The Additional Diagnosis Codes Window is available from the Activities Menu within the appointment.

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Note: This feature requires that the ICD-10 Billing and Support Clinical Parameters are enabled.  ICD-10 codes display in the Print Preview and on the printed requisition.

Note: If ICD-9 and ICD-10 codes are used, both will display in the Print Preview and on the printed requisition.

Charting

If the selected ICD-10 is linked to multiple ICD-9 codes, the user is prompted to select the desired code.

Charge Capture

When the ICD-10 settings are enabled, ICD-10 codes can be linked to CPT codes in order, making them available in Charge Capture/E-Superbill.

Note: This feature relies on both the Enable CPT/ICD9-ICD10 linking in charting Parameter and the Enable CPT/ICD9-ICD10 linking in charting Parameter.

Hospital Rounds

Hospital Rounds Definition

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 Click the Switch to ICD-9 Link to view the ICD-9 codes that were previously linked to the Hospital Round.

Radiology

 The Procedure Detail Window displays the eight (8) diagnosis code fields.

Note: For procedures entered prior to enabling ICD-10 billing, the diagnosis code fields are blank. Click the Switch to ICD-9 Link to view the previously entered ICD-9 codes.

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 The Primary Diagnosis Column in the Patient Flash Window displays the ICD-10 diagnosis code description.

Note: For procedures entered prior to enabling ICD-10 billing, the ICD-9 code previously entered is displayed.

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 ICD-10 codes are verified by Transcription Charge Release.

 The following error codes are validated in addition to the existing error codes and displayed on the Release Transaction Detail Report:

o 29. Diagnosis Code 1 Invalid (ICD-10) o 30. Diagnosis Code 2 Invalid (ICD-10) o 31. Diagnosis Code 3 Invalid (ICD-10) o 32. Diagnosis Code 4 Invalid (ICD-10) o 33. Diagnosis Code 5 Invalid (ICD-10) o 34. Diagnosis Code 6 Invalid (ICD-10) o 35. Diagnosis Code 7 Invalid (ICD-10) o 36. Diagnosis Code 8 Invalid (ICD-10)

Reports

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Appointments

 Appointment No Show Detail Report

Practice Reporter

Miscellaneous

 Batch Verification - On Demand Report  Daily Log - On Demand Report

 Delinquency Follow-Up Transactions Report  Financial Class/Transaction Report

 Collection Letters Sent Report

Transaction

 Transaction Code Breakdown Report

Patient

 Detailed Patient History Report

Financial

 Adjustment/Payment History Report

Insurance

 Insurance Pending Report

 Insurance Detail Reimbursement Report

Managed Care

 Clinical Research Report  History Revenue Report

 History Revenue by PARN Report

 History Revenue by Charge Posted Date Report  History Revenue by Payment Posted Date Report

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 Insurance History Revenue Report  Productivity History Revenue Report  Top Diagnosis Codes Report