Magical Black Box: October 1, 2015, and Beyond

Transcription

1 Magical Black Box: October 1, 2015, and Beyond Tara Altenritter, OTR/L Clinical Technology and Testing Supervisor Uniform Data System for Medical Rehabilitation 2015 Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc. CareTrend PRO, FIM, UDS-PRO Doc, UDS-PROi, UDSMR, and the UDSMR logo are trademarks of Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc. HL7 is a registered trademark of Health Level Seven International.

2 Agenda Overview of the IRF-PAI changes effective 10/1/2015 UDS-PROi software demonstration, highlighting software changes specific to the new IRF-PAI form, including ICD-10 codes HL7 updates for 10/1/2015 Highlight various UDSMR software product enhancements, including UDS-PRO Doc enhancements and the move toward Internet browser independence Q&A 2

3 New IRF-PAI Form, Version 1.3 (Effective October 1, 2015) All IRF-PAI data sent to CMS for patients discharged on or after October 1, 2015, must be submitted on version 1.3 of the IRF-PAI IRF-PAI effective 10/01/2015: for-service- Payment/InpatientRehabFacPPS/Downloads/IR F-PAI_for_FY2015_final.pdf Pages 1 and 3 have additional fields, and all ICD code fields are changing from ICD-9 to ICD-10 Pages 2, 4, 5, 6, 7, and 8 have not changed! 3

4 IRF-PAI Version 1.3: Overview of, Page 1 ICD-10 codes will be required for coding fields 22 and 24 Two additional fields (22B and 22C) added for etiologic diagnosis codes New yes/no field (24A) added as an indicator for compliance with arthritis codes 4

5 IRF-PAI Version 1.3: Overview of, Page 3 ICD-10 codes will be required for coding fields 46 and 47 Addition of therapy information section O0401, used to record totals of individual, concurrent, group, and co-treatment PT, OT, and SLP for the first two weeks of the stay 5

6 The following scenarios explain which form you will see in the software when you enter cases in the case listing: Current form (IRF-PAI effective 10/01/2014): Case has a discharge date between 10/01/2014 and 09/30/2015 Case has an admission date prior to 10/01/2015, and the discharge date is blank (see slide 8 for details) 6

7 The following scenarios explain which form you will see in the software when you enter cases in the case listing: New form (IRF-PAI effective 10/01/2015): Case has an admission date and a discharge date on or after 10/01/2015 Case has an admission date prior to 10/01/2015 and a discharge date on or after 10/01/2015 (see next slide for details) 7

8 A case with an admission date prior to 10/01/2015 and a discharge date, entered at a later time, on or after 10/01/2015 will use the new IRF-PAI form A warning message in the software will inform you that the new IRF-PAI form must be used to enter case data The message will explain that any data entered in the fields that have been changed or deleted from the current IRF-PAI will not be carried over into the new IRF-PAI form Once you click the OK button to accept the message, the software will load all applicable case data for that record into the new form, after which you can continue using the new form to enter case data into the software 8

9 Facility Setup module: Moved fields for Medicare Cost Reporting Period, Facility Fiscal Year, Facility MAC/FI and Facility Type from the Accounts Payable Contact subsection of the General Contact Information section in Facility Contacts to the PPS section of the Facility Setup module 9

10 Facility Setup module: These fields are not required, but if you enter them, they will be used to indicate the compliance period at a case level (see next slide) 10

11 Case Listing dashboard: Added fields Compliance-1 and Compliance-2 Both fields will be displayed on all cases using version 1.3 of the IRF-PAI If the Medicare Cost Reporting Period is entered in Facility Settings, the compliance period of the case will be highlighted in green New Compliance-1 and Compliance-2 fields 11

12 Compliance-1 indicates the presumptive compliance status for the case based on presumptive compliance codes in use for compliance review periods beginning prior to October 1, 2015 Compliance-2 indicates the presumptive compliance status for the case based on presumptive compliance codes in use for compliance review periods beginning on or after October 1,

13 CMS has published files containing the presumptively compliant ICD-10 based codes related to both Compliance-1 and Compliance-2 at Payment/InpatientRehabFacPPS/Downloads/ICD- 10-CM-DataFiles.zip Compliance review periods associated with different cost-reporting periods are specified in a detailed table in chapter 3, section of the Medicare Claims Processing Manual at Guidance/Guidance/Manuals/Downloads/clm104c0 3.pdf 13

14 Case Listing Admission tab: new fields New Etiologic Diagnosis Fields New arthritis field 14

15 Case Listing Admission tab: ICD-10 Suggested Codes dialog 15

16 Case Listing Admission tab: ICD-10 Code Lookup dialog Select tier and/or compliance criteria Select compliance period Select code and any additional codes required for tier and/or compliance 16

17 Case Listing Admission tab: ICD-10 Advanced Comorbid Conditions dialog 17

18 Case Listing Admission tab: ICD-10 case codes 18

19 Case Listing Therapy Information (new tab) 19

20 Preadmission Listing dashboard and Diagnosis tab New etiologic diagnosis fields New arthritis field 20

21 Preadmission 21

22 Reports: On-demand, software, profile, and published reports are being updated to include new and changed data, including ICD-10 codes and compliance information Fourth quarter aggregation is on track for timely release Import/export functionality: UDSMR will release new versions of the comprehensive import/export specifications and the CMG export specifications Most of the previous exports are still supported 22

23 UDSMR HL7 Integration Finalizing specification updates with all facilities that use an HL7 interface The updates include ICD-10 codes, therapy minutes, and all new IRF-PAI fields Continually developing and increasing close relationships and communication for interfacing with large EMR vendors such as Epic, Cerner, and Meditech 23

24 UDS-PRO Doc System Updated preadmission module to incorporate ICD-10 codes and new fields Enhanced therapy documentation to track types of therapy provided within the clinical document templates Enhanced all nursing documentation to incorporate required QI documentation Added new automatic therapy tracking log and QI tracking to the CareTrend PRO module to ease the burden of data collection for the IRF-PAI Updating diagnosis code manager to incorporate ICD-10 codes 24

25 UDS-PRO Doc System New Health Record Integration Tool allows facilities to move clinical documentation between large EMRs and the UDS-PRO Doc System 25

26 Internet Browser Independence We are currently in the process of updating our websites and products to be browser-independent! This means that our software will work on most of the current browsers and devices, such as: Internet Explorer, Safari, Firefox, Chrome iphone, ipad, Mac, Android, etc. We estimate that we will complete this project at the end of the second quarter of 2016 Released in modules The FIM credentialing module is slated to be released first 26

27 Contacting UDSMR Technical support department: Clinical support department: ICD-10 coding support: UDS-PRO Doc support:

28 Q&A Thank You! 28