ICD10 Readiness Guide

ICD-10-CM TRANSITION The Next Generation
WORKBOOK of Coding
Preparation is the key to success when transitioning your practice

from ICD-9 to ICD-10. The federally mandated compliance date is
October 1, 2015. This handbook provides a simplified guide to
support your practice with a transition plan.
ICD-10 Transition Guide 0

Practice Management and Physician Services
Advancing the distinctive philosophy and practice of osteopathic medicine.
This publication provides the following information on the International Classification of Diseases, 10th
Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS).
2015 by the American Osteopathic Association
Printed in the U.S.A.
Requests for permission to make copies of any part of this work should be made in writing to:
American Osteopathic Association

Practice Management and Physician Services
142 E. Ontario Street
Chicago, IL 60611
Version 1
August 2015

Introduction 3
ICD-10 The Facts 4
Medical Record Documentation 5
10 Steps in the Right Direction 6
ICD-10 Sample Timeline 8
Appendix 1: To Do List 9
Appendix 2: List of Contacts 10
Appendix 3: Documentation Audit 11
Appendix 4: Change Requirement Action Plan 12
Appendix 5: Crosswalk of Codes 14
Appendix 6 Form 1: Process and System Inventory (CMS Template Library) 15
Appendix 7 Form 2: Technology Vendor Assessment (CMS Template Library) 17
Appendix 8 Form 3: Billing Service Assessment (CMS Template Library) 19
Appendix 9 Form 4: Clearinghouse Assessment (CMS Template Library) 21
Appendix 10 Form 5: Payer 1 Assessment (CMS Template Library) 22
CMS ICD-10 Resources 32

Introduction
There have been unprecedented changes to the U.S.
health care system in a short period of time, many of
which impact physicians in ways we could not have
imagined. Keeping abreast of these changes can be
overwhelming and complying with them can be
difficult. There are so many pieces to the puzzle and
not putting them together within the required
timeframe can lead to detrimental outcomes.
This handbook provides a simplified guide to support
your practice with a transition plan for moving from
ICD-9 to ICD-10.
While we have done our best to make this a fully
comprehensive resource, the best source for the
most current ICD-10 updates is the CMS website.
Some practices may already have started the
transition and others may be getting ready to start.
Wherever you are along the journey, this workbook
will guide you to compliance and provide you with
some practical steps.

What is ICD Why Did the Codes Change?
The ICD-10-CM/PCS (International Classification of
Diseases, 10th Edition, Clinical Modification/ ICD-9 was about 30 years old and many of the codes
Procedure Coding System) is a classification system were not consistent with current medical practice.
which provides unique codes for all diagnosis, Also, due to the structure of ICD-9, there were
symptoms and procedures recorded in hospitals and limitations on how many new codes could be
physician practices. The manual consists of two developed. For example, ICD-10 has nine times more
parts: codes than ICD-9.
Applying ICD-10 codes mean that services provided
ICD-10-CM for diagnosis coding: This coding
need to be more precise with extensive
uses three-seven digits instead of three-five
documentation.
with ICD-9. The format of the code sets is
similar.
ICD-10-PCS for inpatient coding: This coding
uses seven alphanumeric digits, instead of
three-four used under ICD-9.
Code Structure
Quick Facts Quick Tips

ICD-10 is mandatory for all HIPAA covered entities
and must be used on all HIPAA transactions. Pay close attention to the instructions, especially
when you see the following words:
Before October 1, 2015 Cross references: see, see also and see
All claims must be in ICD-9 codes. category.
Notes: with/without and omit code.
On or after October 2015 Sub-terms: due to.
All claims must use ICD-10 for services rendered on Note boxes with instructions such as code by
or after October 1, 2015. site.
Any claim not submitted with ICD-10 codes will Select codes based on appropriateness by reading
be rejected. all instructional material.
ICD-10 has no direct impact on Current Procedural use additional code and code first underlying
Terminology (CPT). disease.
includes, excludes1 and excludes2 notes.
The World Health Organization updates the ICD code code also.
set every decade.
Remember to include characters four-seven.
Each encounter will take longer to document and
Age and sex symbols: = Female; = Male
code due to the large number of codes and the new
criteria for each.
Codes are derived from documentation in the medical
record, hence documentation is critical!

Know How to Document Legible Handw riting
To avoid managing the transition to ICD-10, some
organizations have elected to outsource services.
This is one way to ease the burden, however, the
onus is on the clinician to document correctly.
Documentation must reflect practice. Coding must
reflect documentation.
Remember: Its all in the documentation. What you Unacceptable Handw riting
document and how you document.
1. The patients name and date of service must
be documented on each page.
2. The documentation must be clear, concise and
complete, and legible.
3. All documentation entries must include a
signature, credentials and date. Handwritten
entries must be legible; electronic entries must
be authenticated and signature stamps must
comply with requirements.
4. Avoid using abbreviations when making entries
in the record. If an abbreviation is used, ensure Acceptable Handw ritten Signature /
that it is a recognized abbreviation not one
that is made up or only used within the practice. Initial w ith Credentials
5. Include all conditions related to the patients
health status, such as chronic and permanent Signature: SallyASample
diagnosis every time they are assessed or Sally A Sample, D.O. 3/17/2016
treated, or when there are considerations in the
patients care. Examples include infection,
dialysis status, paraplegia, etc. Initial: SAS D.O. 3/17/2016
6. Code the confirmed diagnosis and report Acceptable Signature Stamp
diagnosis codes to the highest level of
specificity. Must comply with state regulations for signature
Use appropriate descriptors. stamp authorization and include credentials.
Ensure the medical record reflects a true
and accurate record of the diagnosis Acceptable Electronic Signature
reported.
Clearly document how the condition was: Must be password protected and used exclusively by
Monitored the individual physician.
Evaluated Must include credentials.
Assessed / Addressed, or Must include authentication statements, such as:
Treated. Approved by.
7. If there is no confirmed diagnosis or the results Signed by.
are normal, code the symptoms that prompted Electronically signed by.
the tests which may have been ordered.
Unacceptable Signature
8. If tests were ordered in the absence of
symptoms, use the appropriate screening Signature without credentials.
code.
Typed name which is not authenticated by the
9. Code using the correct number of characters. provider.
Refer to the code structure on previous page. Signed by a non-physician or non-physician
extender (e.g., medical student) unless co-
10. If it isnt written, it did not happen!
signed by responsible the physician.

Planning Checklist
The following tips have been modified from the
CMS website and adapted to provide succinct
information on how to get started. CMS forms
and templates have been included as a resource
and can be found at the end of the handbook.
Start with a To Do list. Refer to sample list,
appendix 1.
1. Review your current systems and work
processes. CMS have developed a form
that can assist you with this step. The form
is available online in a Word version.
Complete appendix 6. Form 1: Process
and System Inventory Template 3. Think about the money!
2. Get savvy about your IT vendor Make a list of organizations you
requirements. conduct business with including billing
List your IT Vendors on Appendix 2. services and clearing houses.
Check your IT vendor contract to verify Contact each one and ask them what
that system upgrades are included in their plans are for the ICD-10
the agreement. If not, what are the transition. Where are they up to?
costs? What is their timeframe?
Call your IT vendor and ask them what Find out if they have tested their
updates they plan to make to your systems yet.
system for ICD-10. Get a timeframe. Importantly, find out how these
Confirm that they have upgraded to changes can impact your practice.
version 5010 standards. This version Work with the vendors to determine
refers to the revised HIPAA electronic conduct test transactions.
transaction standards and it Complete appendix 8. Form 3: Billing
accommodates ICD-10. Service Assessment.
Ask your vendor what support and Complete appendix 9. Form 4:
training is available. Clearinghouse Assessment.
Work with the IT vendor to determine
conduct test transactions. 4. Develop a list of payers; ensure that the
Complete appendix 7. Form 2: payers with whom you have the biggest
Technology Vendor Assessment. challenges with are on that list.
Contact each payer this is important
because the ICD-10 codes are more
specific than the ICD-9 codes.
Find out if they have modified the
terms of their contracts as a result of
ICD-10 changes.
Find out if payment schedules or
reimbursement has changed in any
way.
Work with the IT vendor to determine
conduct test transactions.
Complete appendix 10. Form 5: Payer
Assessment.

5. Review your documentation processes. Action plan, appendix 4.
Now that you have done your homework,
review your workflow for clinical processes Budget.
and make a to-do- list of priorities. Consider 8. Develop a budget:
the following:
Analyze the financial impact. Take into
Conduct a documentation gap analysis
consideration staff training; IT
(appendix 3) to determine if your
upgrades; resources including
documentation supports the level of
purchase of the ICD-10 manual and
detail found in ICD-10. Start by
companion workbook; additional time
selecting a sample of charts. Samples
it will take to dual code/overtime; etc.
may be selected based on:
Random samples. Review your lists of commonly used
Top diagnosis. DRG based claims and compare the
High dollar diagnosis. reimbursement to expected
Top coding challenges. reimbursement if the same DRGs
Clinical documentation: What needs to were derived from ICD-10 codes.
change? How can you improve 9. Develop a crosswalk of the codes most
efficiency and meet the deadline? frequently coded by your practice to create
Encounter forms: What needs to a cheat-sheet. Always refer to the ICD-10
change in order to comply and simplify manual itself when creating a cheat-sheet.
the process? While the crosswalk in this workbook
Quality and health reporting: What are provides a quick reference, individual codes
we doing/what are we not doing? must be verified and cross-checked with the
Develop a list of key words for content ICD-10 manual. The use of clinical
in medical notes. judgement in context to each individual
encounter is essential. See appendix 5.
Enter findings on an action plan. See
sample action plan, appendix 4. 10. Test your systems and your processes.
6. Identify business workflow changes and Generate a claim.
the impact that it may have on your financial Test your system with partners and
management and revenue cycle. Consider payers.
the following: If your system is not ready!
Pre-authorization.
Explore ways to submit claims to health plans.
Reimbursement and contract
structure. Visit the CMS website for free resources:
Scheduling. https://www.cms.gov/Medicare/Coding/ICD10/In
Productivity. dex.html
Admitting/registration.
Charges/coding.
Collections/follow-up.
Denials management.
Enter findings on an action plan. See
sample action plan, appendix 4.
7. Consider your practice education needs.
Identify who needs to know the new codes,
new IT operating system and
documentation requirements. Incorporate
education needs into the:

ICD-10 Sample Timeline
Step 1 Review Current Work Systems

Start with a To Do list
Complete a Process and System Inventory
Step 2 Make Lists & Ask Questions

List vendors and call or email with questions
IT / Clearing House / Billing & Coding Services &
Payers
Step 3 Complete A Gap Analysis

Review Documentation & Business Processes
Develop an Action Plan
Step 4 Plan & Do

Implement the action plan & educate staff & clinicians
Crosswalk commonly used codes
Step 5 Test Your Systems & Processes

Generate a claim
Test your system with partners and payers
If your system is not ready, explore ways to submit
claims to health plans
Step 6 Evaluate and Adjust

Re-group and evaluate effectiveness of actions
Adjust the plan & implement changes
Go Live date is October 1, 2015!

Appendix 1: To Do List
Action Date
Complete Process and Systems Inventory Template
List most common ICD-10 codes used
Review IT vendor contract
Contact IT vendor
Complete Technology Vendor Assessment
List billing service providers and contact details
Complete Billing Service Assessment
List clearing houses and contact details
Complete Clearinghouse Assessment
List payers and contact details including those which have

been challenging to work with past & present
Contact payers and complete Form 5: Payer Assessment
Complete Change Requirement Action Plan
Develop an education plan
Practice dual coding
Review gaps in documentation and educate

Appendix 2: List of Contacts
IT Vendor(s) Contact Name(s)/Role Phone
Billing Service(s) Contact Name(s)/Role Phone
Clearing House Contact Name(s)/Role Phone
Payer(s) Contact Name(s)/Role Phone

Appendix 3: Documentation Audit
Review files to determine if documentation supports the level of detail required in ICD-10.
1. Circle Sample Method:

Random Top diagnosis High dollar diagnosis Top coding challenges, e.g. E/M OMT
2. Under File Sample, enter the Medical Record Number (MRN)

3. In the compliant column indicate if the record documentation supports the level of detail required in
ICD-10 by entering Yes or No.
4. Finally, indicate what changes are required to documentation. This creates an education opportunity
and reduces future compliance risks.
File Sample MRN# Comments / Changes Required

1.
Compliant Select
Yes / No
2.
Compliant Select
Yes / No
3.
Compliant Select
Yes / No
4.
Compliant Select
Yes / No
5.
Compliant Select
Yes / No
6.
Compliant Select
Yes / No
7.
Compliant Select
Yes / No
8.
Compliant Select
Yes / No

Appendix 3: Documentation Audit
File Sample MRN# Comments / Changes Required

9.
Compliant Select
Yes / No
10.
Compliant Select
Yes / No
11.
Compliant Select
Yes / No
12.
Compliant Select
Yes / No
13.
Compliant Select
Yes / No
14.
Compliant Select
Yes / No
15.
Compliant Select
Yes / No
16.
Compliant Select
Yes / No
17.
Compliant Select
Yes / No
18.
Compliant Select
Yes / No

Appendix 4: Change Requirement Action Plan
Due
Change Requirement Action Plan
By
IT
Clinical Documentation
Medical Records
Coding & Billing
Reporting

Appendix 5: Crossw alk of Codes
ICD-9 Description ICD-10 Description

Appendix 6 Form 1: Process and System Inventory (CMS Template Library)
Diagnosis Code Impact Inventory Template

Processes and Forms Information Systems
Functional
Practice Lead Where Diagnosis Codes Where Diagnosis
Area
are Used Codes are Used
Patient
Registration and
Scheduling
Clinical
Documentation/
Health Records
Referrals and
Authorizations
Order Entry
Coding
Billing
Reporting and
Analysis
Other diagnosis-
related functions,
depending on
the nature of the
practice

Appendix 7 Form 2: Technology Vendor Assessment (CMS Template Library)
Company Name:
Address
Phone
Account/Sales Representative (Name & Title):
Phone Email
Technology Representative (Name & Title):
Phone Email
Customer Support
Phone Email
Vendor Solutions Used by the Practice
Name(s) Version(s)
Electronic Health Record (EHR) System Decision Support Tools

Practice Management (PM) System Reporting Applications
Type(s)
Coding Translation and Look-up Tools
Other:
Questions for Technology Vendor

Question Vendor Response
Application Circle Yes or No and Comment
1. Which of your applications are impacted by
ICD-10?
2. Are your applications remediated and are the Y/N
ICD-10 updates generally available?
3. Is there a separate fee for your ICD-10 Y/N
updates?
4. Will your systems use date of service to Y/N
determine the codes to use (ICD-9 or ICD-10)?
5. Will your systems support dual coding of Y/N
services rendered before the compliance date?
6. Are there 3rd party embedded products in your Y/N
software which need to be updated for ICD-10?
7. Is additional infrastructure (hardware, servers, Y/N
etc.) potentially needed to accommodate your
ICD-10 updates and store ICD-10 codes?
Code Set Updates
1. How frequently will ICD-10 diagnosis code
updates be applied to your applications?
2. How long do you plan to support ICD-9
diagnosis code reference files?

Questions for Technology Vendor
Interfaces Circle Yes or No and Comment
1. Have your HIPAA transaction sets been Y/N
updated to address ICD-10?
2. What other interface changes will be included
with your ICD-10 software updates?
Reporting
1. Which of your reports are impacted by ICD-10?
2. How will reports which are dependent upon
diagnosis code categories be handled?
3. How will longitudinal and historical reporting be
updated to accommodate ICD-10?
4. How will quality and public health reports be
updated to accommodate ICD-10?
5. Do any of your solutions require crosswalks Y/N
from ICD-9 to ICD-10?
6. Which crosswalks are you providing and can
they be customized?
Configuration
1. Do your applications have templates or tools Y/N
which can help practices document with a
greater degree of granularity and specificity?
2. Are you updating impacted rules and edits Y/N
(clinical decision support rules, claims edits,
etc.) with ICD-10 diagnosis codes?
3. List the specific rules, edits, forms, templates,
interfaces, reports and crosswalks the practice
is responsible for setting up on their own.
Testing
1. Will there be a test environment with ICD-10 Y/N
updates practices can use to perform testing?
2. Are there test cases or other testing materials Y/N
you make available to practices?
3. In what type of testing do you engage
practices? Which practice staff members are
generally involved?
4. What type of ICD-10 testing do you recommend
practices undertake on their own?
Training
1. What type of training do you make available as
it relates to your ICD-10 product updates? Is
there a fee practices incur for this training?
2. Will there be a training environment with ICD- Y/N
10 updates practices can use?

Appendix 8 Form 3: Billing Service Assessment (CMS Template Library)
Billing Service Contact Information

Company Name:
Address
Phone
Phone Email
Phone Email
Customer Support
Phone Email
Questions for Billing Service

ICD-10 Implementation Strategy Circle Yes or No and Comment
1. Are your solutions currently ICD-10 Y/N
compliant? If not, when will they be
updated?
2. Do you have a contingency plan to handle Y/N
transactions with payers and/or
clearinghouses which may not be ready to
accept ICD-10 codes on the compliance
date?
3. Are there ICD-10 software updates from Y/N
you that need to be installed at practices?
What is the process for installing these
updates? Are there specific set-up activities
for which practices are responsible?
4. Is there a separate fee for your updates? Y/N
5. Will your solutions use date of service to Y/N

determine whether to use ICD-9 or ICD-10
codes?
6. When will you stop billing ICD-9 codes?
7. Will you dual code services rendered before Y/N
the compliance date?
8. Will you bill ICD-9 and ICD-10 codes on the Y/N
same claim?
9. Will you perform split billing? Y/N
10. Are there specific process or documentation Y/N

changes you require practices to adopt?
Physician Practice ICD-10 Testing and Validation
1. Do you assess payer contracts to determine
if ICD-10 will impact practice Y/N
reimbursement?
Questions for Billing Service
2. Do you work with practices to evaluate how Y/N
payer ICD-10 policy and system changes
impact their payments and claim processing
timelines?
3. Which of the following data flows do you a. Y / N
validate as part of your ICD-10 testing b. Y / N
support? c. Y / N
a. Practice to Billing Service d. Y / N
b. Billing Service to Clearinghouse and/or
Payer
c. Clearinghouse and/or Payer to Billing
Service
d. Billing Service to Practice
4. Which of the following transactions do you e. Y / N
help validate with or on behalf of practices as f. Y / N
part of your ICD-10 testing support? g. Y / N
e. 270/271 Eligibility Inquiry/ Response h. Y / N
f. 278 Auth. Request & Response i. Y / N
g. 837P Claims Submission
h. 835 Claims Remittance
i. Other Transactions
5. Do you perform any other type of ICD-10 Y/N
testing with or on behalf of practices?
6. What is the process a practice should follow
to engage in ICD-10 testing with you? What
is the lead time needed to begin testing?
Communication and Education Circle Yes or No and Comment
1. How/will you share ICD-10 transition
progress with payers, vendors and
practices?
2. Do you provide advice to practices on how Y/N
they can map their superbills to ICD-10?
3. Do you offer ICD-10 education to practices? Y/N
What type of ICD-10 education? Is there a
fee?
4. Do you offer tools for practices to crosswalk Y/N
between ICD-9 and ICD-10?
5. What reports can you provide to help a. Y / N
practices with the transition to ICD-10: b. Y / N
a. Claim rejections and denials by ICD-9 c. Y / N
diagnosis code and by payer?
b. Commonly used unspecified ICD-9
codes?
c. Other?
6. Have you been working with practice Y/N
management, EHR and clearinghouse
vendors as part of your ICD-10 initiatives?
Which ones have you tested with? What
progress has been made?

Appendix 9 Form 4: Clearinghouse Assessment (CMS Template Library)
Clearinghouse Contact Information

Company Name:
Address
Phone
Phone Email
Phone Email
Customer Support
Phone Email
Questions for Clearinghouse

updated?
2. Do you have a contingency plan to handle Y/N

transactions with payers who may not be
ready to accept ICD-10 codes on the
compliance date?
3. Are there ICD-10 software updates from Y/N
you that need to be installed at practices?
What is the process for installing these
updates?
Are there specific set-up activities for which
practices are responsible?
4. Is there a separate fee for your updates? Y/N
5. Will your solutions use date of service to Y/N

determine whether to use ICD-9 or ICD-10
codes?
6. When will you stop accepting ICD-9 codes?
7. Will your solutions support dual coding of Y/N

services rendered before the compliance
date?
8. Will you accept ICD-9 and ICD-10 codes on Y/N
the same bill?
9. Will you accept split bills? Y/N

Questions for Clearinghouse
Physician Practice ICD-10 Testing Circle Yes or No and Comment
1. Do you perform ICD-10 testing with Y/N
physician practices? How are participants
selected?
2. Which of the following data flows do you a. Y / N
validate as part of your ICD-10 testing b. Y / N
support: c. Y / N
a. Practice to Clearinghouse? d. Y / N
b. Clearinghouse to Payer?
c. Payer to Clearinghouse?
d. Clearinghouse to Practice?
3. On which of the following transactions are a. Y / N
you able to perform ICD-10 testing with b. Y / N
practices: c. Y / N
a. 270/271 Eligibility Inquiry/ Response? d. Y / N
b. 278 Auth. Request & Response? e. Y / N
c. 837P Claims Submission?
d. 835 Claims Remittance?
e. Non-Standard Transactions?
4. What volume and type of claims will you
test?
Communication and Education Circle Yes or No and Comment
1. How/will you share ICD-10 transition Y/N
progress with payers, vendors and
practices?
4. Do you provide advice to practices on how Y/N
they can map their superbills to ICD-10?
fee?
5. What reports can you provide to help a. Y / N
practices with the transition to ICD-10: b. Y / N
a. Claim rejections and denials by ICD-9 c. Y / N
diagnosis code and by payer?
b. Commonly used unspecified ICD-9
codes?
c. Other?
6. Have you been working with EHR/practice Y/N
management vendors, payers and/or
medical billing companies as part of your
ICD-10 implementation? Which ones have
you tested with? What progress has been
made?

Appendix 10 Form 5: Payer 1 Assessment (CMS Template Library)
Payer Contact Information

Company Name:
Address
Phone
Provider Representative (Name & Title):
Phone Email
Customer Support
Phone Email
Questions for Payer

Question Payer Response
updated?
2. Will your systems crosswalk codes back to Y/N
ICD-9 or will they be programmed to
process ICD-10 codes directly?
3. Do you have a contingency plan if your Y/N
systems will not be ready on the
compliance date?
determine the codes to use (ICD-9 or ICD-
10)?
7. Will your systems support dual coding for Y/N
services rendered prior to the compliance
date?
the same bill?
Physician Practice ICD-10 Testing Comments

selected?
2. Which transaction types do you validate a. Y / N
with practices as part of ICD-10 testing? b. Y / N
a. 270/271 Eligibility Inquiry/ Response c. Y / N
b. 278 Auth. Request & Response d. Y / N
c. 837P Claims Submission e. Y / N
d. 835 Claims Remittance
e. Non-Standard Transactions

Questions for Payer
test?
Policy and Reimbursement Circle Yes or No and Comment
1. Will your fee schedules, capitation rates or Y/N
other payment models be changing as a
result of ICD-10? Please describe.
2. Will existing provider contracts be amended Y/N
for ICD-10 or will they be updated upon
renewal?
3. Will patient eligibility and/or benefits change Y/N
as a result of ICD-10? Please describe.
4. Will the following business or processing a. Y / N
rules change as a result of ICD-10? b. Y / N
a. Authorizations? c. Y / N
b. Utilization Review & Management? d. Y / N
c. Case Management? e. Y / N
d. Medical Policy? f. Y / N
e. Audit Policy? g. Y / N
f. Claim Editing and Scrubbing?
g. Payment Processing?
Please describe the impact to providers.
5. Will claim processing and payment timelines Y/N
change because of the ICD-10 transition?
Please describe.
changes you recommend that practices
adopt to reduce the risk of claim rejections,
denials and errors? Please describe.
Communication and Education
fee?
progress with physician practices?
management vendors, clearinghouses,
and/or medical billing companies as part of
your ICD-10 implementation? Which ones
have you tested with? What progress has
been made?

Form 5: Payer 2 Assessment (CMS Template Library)

Company Name:
Address
Phone
Phone Email
Customer Support
Phone Email
Questions for Payer

updated?
compliance date?
10)?
date?
the same bill?

selected?

Questions for Payer
test?
renewal?
Please describe.
fee?
been made?


Company Name:
Address
Phone
Phone Email
Customer Support
Phone Email
Questions for Payer

updated?
compliance date?
10)?
date?
the same bill?

selected?

Questions for Payer
test?
renewal?
Please describe.
fee?
been made?


Company Name:
Address
Phone
Phone Email
Customer Support
Phone Email
Questions for Payer

updated?
compliance date?
10)?
date?
the same bill?

selected?

Questions for Payer
test?
renewal?
Please describe.
fee?
been made?


Company Name:
Address
Phone
Phone Email
Customer Support
Phone Email
Questions for Payer

updated?
compliance date?
10)?
date?
the same bill?

selected?

Questions for Payer
test?
renewal?
Please describe.
fee?
been made?

ICD-10 Resources
ICD-10 Basics
These basic resources include overviews of ICD-10 tailored by audience. All resources are available
through the CMS ICD-10 website, cms.gov/ICD10:
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10Introduction20140819.pdf
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10BasicsforPractices20140819.pdf
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10SmallandRuralPractices20140819.pdf
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10BasicsforPayers20140819.pdf
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10NoncoveredEntities20140819.pdf
Communicating About ICD-10

Communication between health care providers, software vendors, clearinghouses and billing services is
an important part of the transition process. Learn how to get the conversation started with these
resources:
http://www.cms.gov/eHealth/downloads/eHealthU_TalkingToYourVendor.pdf
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10QuestionstoAskYourSystemsVendors.pdf
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10RoleOfClearinghouses1.pdf
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10TalkingtoCustomersforVendors.pdf
Road to 10 Small Physician Practices

Available on the Provider Resources page of www.cms.gov/ICD10, the Road to 10 tool is an online
resource built with the help of providers in small practices. This tool is intended to help small medical
practices jumpstart their ICD-10 transition and includes specialty references, webcast series and the
capability to build ICD-10 action plans tailored for their practice needs. Watch this brief video for an
explanation of the benefits of ICD-10 and an overview of the Road to 10 tool.
http://www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html
http://www.roadto10.org/
https://www.youtube.com/watch?v=_pLwSh09sGo&feature=youtu.be
ICD-10 Email Update Messages

CMS distributes regular email update messages with information about ICD-10. Past messages include:
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD-10NewsICD-
10TestingOpportunitiesforMedicareFFSProviders.pdf
http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10TrainingWebcastListserv.pdf
Medscape Education Modules

Medscape Education Modules offer an overview of ICD-10 tailored for small practices. Continuing
medical education (CME) and continuing education (CE) credits are available to physicians and nurses
who complete the learning modules, but anyone with a free account can take them and receive a
certificate of completion. Modules are available on the CMS ICD-10 website.
http://www.medscape.com/
Stay up to date on ICD-10!

Sign up for email updates:
http://www.cms.gov/Medicare/Coding/ICD10/CMS_ICD-10_Industry_Email_Updates.html

ICD10 Readiness Guide

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ICD10 Readiness Guide

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ICD-10-CM TRANSITION The Next Generation

Preparation is the key to success when transitioning your practice

ICD-10 Transition Guide 0

2015 by the American Osteopathic Association

Printed in the U.S.A.

American Osteopathic Association

ICD-10 Transition Guide 1

ICD-10 The Facts 4

Medical Record Documentation 5

10 Steps in the Right Direction 6

ICD-10 Sample Timeline 8

Appendix 2: List of Contacts 10

Appendix 3: Documentation Audit 11

Appendix 4: Change Requirement Action Plan 12

Appendix 5: Crosswalk of Codes 14

Appendix 6 Form 1: Process and System Inventory (CMS Template Library) 15

Appendix 7 Form 2: Technology Vendor Assessment (CMS Template Library) 17

Appendix 8 Form 3: Billing Service Assessment (CMS Template Library) 19

Appendix 9 Form 4: Clearinghouse Assessment (CMS Template Library) 21

Appendix 10 Form 5: Payer 1 Assessment (CMS Template Library) 22

CMS ICD-10 Resources 32

ICD-10 Transition Guide 2

ICD-10 Transition Guide 3

Quick Facts Quick Tips

ICD-10 Transition Guide 4

ICD-10 Transition Guide 5

ICD-10 Transition Guide 6

ICD-10 Transition Guide 7

Step 1 Review Current Work Systems

Step 2 Make Lists & Ask Questions

Step 3 Complete A Gap Analysis

Step 4 Plan & Do

Step 5 Test Your Systems & Processes

Step 6 Evaluate and Adjust

ICD-10 Transition Guide 8

List most common ICD-10 codes used

Review IT vendor contract

Complete Technology Vendor Assessment

List billing service providers and contact details

Complete Billing Service Assessment

List clearing houses and contact details

Complete Clearinghouse Assessment

List payers and contact details including those which have

Contact payers and complete Form 5: Payer Assessment

Complete Change Requirement Action Plan

Develop an education plan

Practice dual coding

Review gaps in documentation and educate

ICD-10 Transition Guide 9

IT Vendor(s) Contact Name(s)/Role Phone

Billing Service(s) Contact Name(s)/Role Phone

Clearing House Contact Name(s)/Role Phone

Payer(s) Contact Name(s)/Role Phone

ICD-10 Transition Guide 10

1. Circle Sample Method:

2. Under File Sample, enter the Medical Record Number (MRN)

File Sample MRN# Comments / Changes Required

ICD-10 Transition Guide 11

File Sample MRN# Comments / Changes Required

ICD-10 Transition Guide 12

Coding & Billing

ICD-10 Transition Guide 13

ICD-9 Description ICD-10 Description

ICD-10 Transition Guide 14