August 8th, 2014

ICD-10 Update for PAG/TAG

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Contents

Topic Page

ICD-10 Project Update• Project Timeline• Project Status• Upcoming Activities

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Provider Outreach and Resources 9

ICD-10 Project Update

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Countdown to ICD-10 Implementation

We are now one year, one month and 23 days away from the ICD-10 Implementation!

DAYS

What are your next steps to prepare for the transition?

October 1st, 2015

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MaineCare’s ICD-10 Phase 2 Project Timeline

Activity 2012 2013 2014 2015

O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D

MaineCare Phase 2 ICD-10 Plan

Project Management

Communication

Code Mapping

Analysis & Design

Development

Testing/Validation

Training

Implementation/ Deployment

Stabilization

Monitoring PeriodToday

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MaineCare’s ICD-10 Delay Timeline

MaineCare has developed an alternate project plan to meet the ICD-10 compliance deadline of October 1, 2015.

• Complete key in-progress activities

• Ramp down workstream activities on a gradual basis

• Consolidate completed and ongoing work to prepare for February 2015 ramp up

• Monitor ICD-10 developments from CMS

• Track any program changes that may impact ICD-10 implementation

• Conduct periodic touchpoint meetings

• Ramp up to resume project

• Coordinate testing with providers

• Continue final efforts for ICD-10 implementation

Continue Progress

Present – 09/30/2014

Key Activities

TimelineMonitor Developments

10/01/2014 – 01/31/2015

Resume Implementation Activities

02/01/2015

It is critical that providers use this additional time to continue preparing for the ICD-10 transition!

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MaineCare’s ICD-10 Phase 2 Key Accomplishments

The MaineCare ICD-10 project is currently in the Testing Stage.

Key Accomplishments

• Finalized clinical and functional translation for 2014 GEMS ICD-10 code changes

• Completed development of DSS reports impacted by ICD-10

• Completed Systems Integration Testing, User Acceptance Testing and Regression Testing for the System Configuration and Information Technology work streams 

• Completed partner and vendor testing for system interfaces

• Completed development of all training materials for MaineCare employees

• Completed Coordination of Benefits Agreement (COBA) Testing

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MaineCare’s ICD-10 Phase 2 Activities

System changes and supporting business processes are being tested to confirm that they meet ICD-10 requirements. Training materials for MaineCare employees are being finalized and development of communication material is ongoing.

Recent and Ongoing Activities

• Developed dental service and billing agent forum presentations

• Coordinated with vendors and additional stakeholders regarding their ICD-10 remediation plans

• Developed ICD-10 job aids for MaineCare employees

• Continued System Integration (SIT) and User Acceptance Testing (UAT) for Operations and Data Analytics work streams

• Developed contingency plans to manage project changes due to ICD-10 delay

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MaineCare’s ICD-10 Phase 2 Upcoming Activities

System changes will go through several testing stages before training is provided to MaineCare employees.

Key Upcoming Activities

Operations and Data Analytics System Integration Testing (SIT) User Acceptance Testing (UAT)

Finalization of training materials

Implementation Activities

System Configuration and Information Technology Remediation

Provider Outreach and Resources

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On April 1, 2014, Congress enacted a law that delayed the implementation of ICD-10.

MaineCare distributed a listserv on July 25, 2014 containing information on CMS’s interim ruling on the ICD-10 implementation date and MaineCare’s response.

CMS has recently released a final ruling to confirm that October 1, 2015 will be the official date for the ICD-10 implementation.

Now that this final rule has been issued, it is critical that providers continue preparing for ICD-10 in order to be ready for the transition. 

Given the ICD-10 compliance delay, pilot testing is now targeted for spring 2015.

ICD-10 Delay Update

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MaineCare’s ICD-10 website contains ICD-10 related resources:

o ICD-10 Background

o ICD-10 FAQs

o PAG/TAG Meeting Materials

o Regional Forum Presentation and Recording

o Provider Type Specific Presentations

MaineCare also encourages providers to access CMS resources about ICD-10 on the CMS Provider Resources webpage.

Examples of resources for providers include the following tools:

o Online ICD-10 Implementation Guide – Roadmap and tools for transitioning to ICD-10 for small, medium, and large providers

o ICD-10 Coding Basics – Video describing the differences between ICD-9 and ICD-10, including how to determine appropriate codes in ICD-10

o Talking to Your Vendors About ICD-10: Tips for Medical Practices – Tip sheet for discussing ICD-10 readiness with vendors

ICD-10 Provider Resources

Both MaineCare and CMS have developed a variety of resources containing information on ICD-10 for providers.

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Additional Resources

For more information, please refer to the following resources:

Centers for Medicare and Medicaid Services Provider Resources Webpage

http://cms.gov/Medicare/Coding/ICD10/ProviderResources.html

Office of MaineCare Services ICD-10 Webpage

http://www.maine.gov/dhhs/oms/icd-10/

Office of MaineCare Services ICD-10Email Box

MaineCareICD10@MolinaHealthCare.com

Questions and Answers

for being part of this important initiative!

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