ICD-10 – Texas Children's News

October 6, 2015

Bench and Bedside is a digest of the previous month’s stories about the clinical and academic activities of our physicians and scientists. We welcome your submissions and feedback.

September 2

Pulmonary hypertension team hosts the painting party, proceeds benefit PHA

Physicians and staff with Texas Children’s Pulmonary Hypertension Program hosted a tile painting party on August 22 where patients transformed ceramic tiles into colorful pieces of art. The event benefited the Pulmonary Hypertension Association. Read more

September 9

Texas Children’s Hospital West Campus expands urology services

Urology services at Texas Children’s Hospital West Campus have been extended to meet the needs of patients in Houston and its surrounding area. Read more

September 9

Dormans sets sights high for future of Orthopedics Department

Chief of Orthopedics Dr. John Dormans joined Texas Children’s three months ago and has already developed a plan to make the Texas Children’s Orthopedics Department one of the top programs in the world. His plan focuses on three main areas – recruitment, operations and facilities, and reputation and expertise. Read more

September 9

Hair receives 2015 Clinical Faculty of the Year Award

Dr. Amy Hair, a neonatologist and director of neonatal nutrition at Texas Children’s, recently received the Baylor College of Medicine’s 2015 Clinical Faculty of the Year Award for demonstrating “exemplary performance of activities that are above and beyond the scope of assigned responsibilities.” Read more

September 9

New program offers emotional healing for parents of special-needs children

Texas Children’s Geneticist Dr. Christian Schaaf and his colleagues developed a support program that helps parents cope with the emotional challenges of caring for children with developmental disabilities by learning to let go of things they cannot control. Read more

September 15

Clinical Research Center/Research Resources Office presents research award to Dr. Wenderfer

The Clinical Research Center/Research Resources Office presented the Clinical Research Award for Third Quarter 2015 to Dr. Scott Wenderfer, Department of Pediatrics-Renal, Baylor College of Medicine. Wenderfer’s research activities focus on Inflammatory Kidney Diseases and Lupus Nephritis. Read more

September 15

Texas Children’s patients, staff create shared memories at Camp Spike N Wave, Camp Periwinkle

Every summer, Texas Children’s staff and their patients make the 90-mile trek to Camp for All, a 100-acre, barrier-free recreational facility where children with complex medical conditions experience the thrill of camping just like other kids their age. More than 185 children with epilepsy attend Camp Spike N Wave and roughly 185 patients from Texas Children’s Cancer Center go to Camp Periwinkle. Read more

September 29

Dormans presides over 50th annual meeting of SRS

Dr. John Dormans, chief of Orthopedics at Texas Children’s Hospital, completed his year as president of the Scoliosis Research Society (SRS) at the 50th anniversary meeting in Minneapolis September 30 to October 3 and presented one of six special lectures titled, “Neural Complications in Spinal Deformity: Detection and Avoidance.” Read more

September 29

Dr. Swathi Bataji joins Pediatric Surgery

Dr. Swathi Balaji has joined the Pediatric Surgery Research Laboratory at Texas Children’s Hospital. Balaji also has been appointed assistant professor in the Department of Surgery at Baylor College of Medicine. Read more

September 29

ICD-10 debut: New coding system launchess at Texas Children’s October 1

On October 1, Texas Children’s and other hospitals around the world switched to the ICD-10 coding system that will allow greater detail and precision in reporting patients’ diagnoses and procedures. For more than a year, Texas Children’s ICD-10 preparedness teams worked diligently to ensure all employees were prepared for the mandatory October 1 conversion. Read more

September 29

Heart Center physicians perform two cases broadcasted to live audience

Heart Center physicians performed two pediatric interventional cardiac care cases for the Pediatric and Adult Interventional Cardiac Symposium. The cases, which were performed at the Main Campus, were transmitted live to the conference in Las Vegas, Nevada via satellite. Read more

September 29, 2015

On Thursday, October 1, Texas Children’s will join other hospitals across the world and switch from ICD-9 to the expanded ICD-10 code sets to report patients’ diagnoses and procedures.

The ICD-10 system will allow greater detail and precision in describing patient care and acuity. This increased level of detail will improve our clinical providers’ ability to track data, enhance the measurement of care quality and safety, refine the claims reimbursement process and ultimately, improve clinical, financial and administrative performances.

For more than a year, Texas Children’s ICD-10 preparedness teams have worked diligently to ensure all employees are prepared for the mandatory October 1 conversion. As of today, 100 percent of our clinicians, nurses and nonclinical support staff have reached full compliance with the required training and education necessary to ensure organization-wide readiness.

While previous ICD-10 delays prompted some organizations to pause during their preparations, Texas Children’s has continued forward with technical application remediation, provider training and education to all impacted service areas.

“We would not be able to achieve this level of preparedness without the tremendous support we received from leaders across our organization,” said Texas Children’s Director of Health Information Management Austin Frazier. “Your commitment and the support from our executive team helped us achieve this milestone as we transition to this important shift in health care. Thank you!”

As we start the final countdown to ICD-10, here are some helpful resources to consider:

1. Where do I go for additional information on ICD-10?

Below are links to a quick fact sheet and helpful sites with basic information on ICD-10 to see how this change will impact your own medical record documentation:

ICD-10 Video

ICD-10 Fact Sheet

ICD-10 Industry Updates

ICD-10 Myths and Facts

2. What if I have technical issues on or after October 1 related to ICD-10?

Contact the IS Help Desk at Ext. 4-3512 for all system related questions and concerns. Clinicians can contact the 4 Epic team for support

3. Is there a crosswalk tool to assist me?

Yes. Revenue Cycle has developed a tool for quick code translation to support the organization. Those users who will be heavily impacted will be able to reference this SharePoint site directly.

4. Who should I contact if I have additional questions about ICD-10?

For other questions or concerns, email Frazier or call him at Ext. 4-1605.

July 21, 2015

In less than 72 days, the codes that health care organizations use to report medical diagnoses and inpatient procedures will become standard across the globe. The federally-mandated conversion from ICD-9 to the expanded ICD-10 coding system will be implemented on October 1. This universal system will help us gather more accurate data, make more informed decisions and ultimately help us achieve better outcomes for our patients.

Texas Children’s ICD-10 preparedness teams have been working diligently for more than a year to ensure we are ready systemwide for this transition. We need you to be prepared as well. If you are a provider or a coder or work in any of the other impacted roles, make sure you complete the required training and education needed to ensure readiness.

Our goal is to reach 100 percent compliance by September 1, which is less than six weeks away.

Based on the latest education compliance statistics, we have a lot of work ahead of us to successfully achieve this organization-wide endeavor. Currently, 11 percent of Texas Children’s providers and 7 percent of nonclinical employees have completed their mandatory educational requirements. By educating ourselves over the next few weeks, the result will be a smooth transition come October 1.

Texas Children’s has partnered with Baylor College of Medicine to provide e-learning videos for our medical staff. Each clinical service area and identified departments have been assigned a self-paced learning module. The ICD-10 education team has prepared an area-specific curriculum for nonclinical employees that is available online through Health Stream.

To access the ICD-10 physician learning modules:
Go to www.healthstream.com/hlc/bcom.

Step 1: Enter your user name and password to log in:

Baylor providers – enter your current Baylor user ID and your employee identification number (typically a 5 or 6-digit number. If you need to reset your password, contact the Baylor Help Desk at 713-798-8737.
Texas Children’s and Texas Children’s Pediatrics providers – enter your NT login (Epic login). Then, enter this password: icd10. You will be prompted to reset your password.

Step 2: Access your specialty’s courses:

Select the My Learning tab at the top left of the screen
View the list of courses required for your specialty
- Note: The assessment at the end of the course must be completed in order for the course to be marked as complete.
Optional: If you are interested in accessing other courses:
Click on the Catalog tab
Type in the specialty of interest to enroll in an additional course

All of the courses have been reviewed and approved by the appropriate section lead.
Note: CME credits are available for the general courses. These courses require a pre- and post-quiz to fulfill CME credits, and only on their completion will the courses be marked “complete.”

If you have questions with the Precyse learning modules, email Marcy Medlak at mamedlak@texaschildrens.org

To access the ICD-10 nonclinical learning modules:

To view, log into Health Stream (http://decisioncritical.ad.texaschildrenshospital.org/)

Step 1: Choose student/manager role. The courses are directly assigned to you.

Step 2: Click “Enroll in this course” to view.

Below are links to a quick fact sheet and helpful sites with basic information on ICD-10 to see how this change will impact your own medical record documentation:

ICD-10 Video
ICD-10 Fact Sheet
ICD-10 Industry Updates
ICD-10 Myths and Facts

April 28, 2015

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On October 1, Texas Children’s will join other hospitals across the nation and switch from ICD-9 code sets to the expanded ICD-10 code sets to report patients’ diagnoses and procedures. For the first time in more than 30 years, this transition to ICD-10 will streamline the management of health care records to ensure even better outcomes for our patients.

The implementation of the ICD-10 coding system was delayed last year after Congress passed a new law to postpone cuts to the Medicare reimbursement rate for physicians. President Barack Obama recently signed legislation on April 16 that permanently replaces Medicare’s sustainable growth rate formula, putting a rest to the likelihood of another ICD-10 delay.

For more than a year, Texas Children’s ICD-10 preparedness teams have worked diligently to ensure all employees are prepared for the mandatory October 1 conversion. The most important action we can take is to educate ourselves and be ready for the transition, as it will impact physicians, coders, billing staff, nurses, labs, front desk and many other areas.

“We believe that communicating the change clearly and consistently will help ensure a smooth transition,” said Texas Children’s Chief Safety Officer Dr. Joan Shook. “Some of the tools we’ve developed – like a fact sheet that answers frequently asked questions – are specific to this change, while other times we use existing hospital and provider publications to keep everyone informed.”

Unlike the ICD-10 coding system, the 30-year-old ICD-9 codes use outdated terminology, lack specificity and is running out of room as hundreds of new diagnosis codes are submitted annually. The United States is the only country that uses ICD-9, and the switch to ICD-10 will enable more accurate comparisons of health care data with other countries.

With more than 140,000 diagnostic and procedural codes, ICD-10 will give our physicians, researchers and others a more accurate picture of our patient care by allowing greater specificity and precision in describing a patient’s diagnosis and classifying inpatient procedures.

ICD-10’s more expansive coding system also will help health care providers better track data to measure the quality and safety of care, process claims for reimbursement, and improve clinical, financial and administrative performance.

The two roles most affected by the ICD-10 conversion are physicians and coders. Texas Children’s has partnered with Baylor College of Medicine to provide e-learning videos for physicians to explain how the new coding system will affect their specialties. Coding staff have completed “boot-camps” to learn about the ICD-10 codes and have begun coding some accounts in ICD-9 and ICD-10. For others, the ICD-education team has prepared an area-specific curriculum that is available online through Healthstream.

The deadline for Physician providers to complete required online training is Tuesday, September 1. Click here to access the e-learning modules specific to your specialty.

“We want to ensure our providers are prepared as the ICD-10 implementation moves forward,” said Texas Children’s Director of Health Information Management Austin Frazier. “The latest education completion statistic is 10 percent, but our goal is to achieve 100 percent compliance by September 1.”

Texas Children’s continues to train its staff on the ICD-10 system and make system upgrades to the hospital’s electronic health record and other ancillary systems to ensure it is compatible with the ICD-10 code set.

Below are links to a quick fact sheet and helpful sites with basic information on ICD-10 to see how this change will impact your own medical record documentation.

For more information:
ICD-10 Video
ICD-10 Fact Sheet
ICD-10 Industry Updates
ICD-10 Myths and Facts

April 8, 2014

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On March 27, the U.S. House of Representatives voted to delay the implementation of the ICD-10 coding system for hospitals and providers – which was to replace the current ICD-9 coding system – by one year. Originally, all hospitals and providers were to have implemented ICD-10 by October 2014. The new deadline for implementing ICD-10 is October 2015.

The Senate passed the legislation on April 1, and the bill was signed into law April 2. The law is called the Protecting Access to Medicare Act of 2014 and is effective immediately.

How Does This Affect Texas Children’s?

The hospital has been working on its education plan for providers for more than a year. The education component will move forward as planned.

Providers still can access the education modules that explain how the new coding system will affect their specialties, beginning this month.

What does change is the deadline to complete the education courses. That deadline has been extended to July 2015.

In the meantime, the hospital will continue to train its billing staff on the ICD-10 system, and will continue to make system upgrades to the hospital’s electronic health record (EHR). Those upgrades ensure that our EHR is compatible with the ICD-10 system.

By continuing with our efforts to make the switch to ICD-10, the transition will be that much easier come next October.

March 11, 2014

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When the American Medical Association (AMA) petitioned the government on February 12 to delay the start of ICD-10 many wondered what would happen. What will happen at Texas Children’s is pretty clear – the conversion to ICD-10 will go live October 1.

“Here at Texas Children’s, we started working on this process more than a year ago,” said Myra Davis, senior vice president of Information Services. “We’re making the necessary changes to our systems, as well as implementing an education program for providers and coding staff that will make the transition as smooth as possible.”

On October 1, Texas Children’s and health care organizations nationwide will transition to ICD-10, the coding system used to report and code diagnoses, injuries, impairments and other health problems and their manifestations. It will replace ICD-9, the current coding system used at Texas Children’s.

Everyone has acknowledged that implementing a new coding system won’t be easy. In fact, the AMA estimates that even small physician practices can expect to spend between $57,000 and $226,000 to get ready for the change. But everyone agrees that the result will be better data for providers, patients and researchers.

While the AMA continues to seek a repeal of ICD-10, it nonetheless remains a federal mandate and physicians are urged to prepare for the October 1, 2014 compliance deadline.

On February 27, the head of the Centers for Medicare and Medicaid Services (CMS) said that nothing has changed with the ICD-10 deadline. Marilyn Tavenners spoke to a group of IT professionals at a national conference when she made that announcement.

“There are no more delays, and the system will go live on October 1,” Tavenner said. “We’ve delayed this several times, and it’s time to move on.”

A quick timeline

In 2008, the U.S. government agreed that America should join with other nations in implementing ICD-10. They originally set October 1, 2013, as the deadline, but that was extended to 2014. The new codes will impact the hospital’s electronic medical record (EMR) and affect codes for both diagnoses and procedures. All told, the number of diagnosis codes will increase from 14,000 to 69,000, while the number of procedure codes will grow from 14,000 to 71,000.

The last time the U.S. changed its national coding system was in 1979. That’s when hospitals and providers moved from ICD-8 to ICD-9. People who favor the next move to ICD-10 point out that when ICD-9 first was implemented, people still could smoke in hospitals.

“Medicine has evolved so much, it only makes sense to update our systems,” Davis said. “Think of how many new treatments have been developed in the last 25 years. The old code set wasn’t designed to capture those innovations, while the new code set better describes what’s happening in medicine today.”

In the end, Texas Children’s is committed to meeting the October 1 deadline to implement ICD-10, no matter what the chatter is in the industry.

For more information
ICD-10 Fact Sheet
ICD-10 Industry Updates
ICD-10 Myths and Facts

March 4, 2014

Most people receiving care probably assume their medical records include details like whether their condition is acute or chronic, how their illness is progressing or, at a minimum, which side of the body an injury may have occurred.

Believe it or not, there has not been a standard way to document basic information like this in patients’ medical records across the U.S. The new coding system – ICD-10 – will change that.

On October 1, Texas Children’s and healthcare organizations nationwide will transition to ICD-10, the coding system used to report and code diagnoses, injuries, impairments and other health problems and their manifestations. It will replace ICD-9, the current coding system used at Texas Children’s.

Why make the change?

In 2009 the U.S. Dept. of Health and Human Services formally adopted ICD-10 as America’s new national coding system and set October 1, 2014 as the deadline for facilities and providers to implement the new system.

ICD-10 is important because a patient’s record is a legal document. It notes exactly what care a patient has received, when they received it, why they received it and treatment plans going forward.

Before, a record could show that a patient had uncontrolled diabetes but had no additional documentation. Now, with the increased specificity of ICD-10, the record will show whether the diabetes was caused by an underlying medical condition or whether it was triggered by an external factor, like medication or chemicals. The new codes specifically ask for the type, any complications and the manifestations of a certain diagnosis.

“It’s all about improving the documentation of the care a patient receives,” said Texas Children’s Chief Safety Officer Dr. Joan Shook. “It’s critical because it can improve the quality of care. It ensures our compliance with CMS (the office responsible for Medicare and Medicaid) regulations, and it affects the hospital’s revenue.”

Know the two parts of ICD-10

There are two types of ICD-10 coding: ICD-10-CM, which means “clinical modification” and refers to diagnosis coding. The other is ICD-10-PCS, which stands for procedure coding system and refers to coding for inpatient hospital procedures. Both will be implemented at Texas Children’s on October 1.

How Texas Children’s physicians are preparing

Because ICD-10 will change the hospital’s Epic system, which is our electronic medical record (EMR), members of the hospital’s Epic support team have been meeting with physicians since November to determine the best way to refine it. Physicians will participate in “clinical documentation assessments” to determine what tools need to be refined or added to Epic to make it ICD-10-ready.

The hospital has partnered with Baylor College of Medicine to provide e-learning videos for the doctors about ICD-10. Each specialist will take three to four e-learning courses this summer, along with an e-learning course on Epic.

Throughout the process, a team of ICD-10 physician champions will serve as liaisons to the medical staff. Each specialty also has its own Epic physician liaison should they have any questions or comments.

How others at Texas Children’s are preparing

The coding staff is attending “boot camps” to learn the ins and outs of the new system.

Additionally, the hospital has been educating providers’ offices through the Texas Children’s Health Plan newsletter since last year.

How the rest of us can prepare

Even if you do not work in a role where you have to document or understand documentation codes, you should understand, in general, what’s happening and how it may impact your own medical record documentation. The best thing you can do in the months ahead is learn as much as you can about ICD-10. Below are links to a quick fact sheet and helpful sites with basic information.

For more information

ICD-10 Fact Sheet
ICD-10 Industry Updates
ICD-10 Myths and Facts

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