Is your long-term care facility prepared to implement ICD-10 coding? Between the additional specificity required for code selection and the substantial increase in the number of codes, developing efficient processes is imperative to managing the increased workload.Train your staff now to ensure that effective and compliant processes are in place with ICD-10 Compliance: Process Improvement and Maintenance for Long-Term Care. This book focuses on process improvement before and after the October 1 implementation date. It highlights areas facilities can improve, including collaborating with physicians on documentation accuracy, working with vendors, analyzing revenue risks, claim reviews, and audits. It will help facilities continually monitor their processes to ensure everything is running smoothly.This resource provides: Various examples of effective processes that SNFs can integrate, including specific rationale behind each option Explanations on what could potentially prevent payments Guidance on how to ensure physician documentation accommodates ICD-10 coding Education on how to code new encounters Dual-coding examples Direction on how to untangle vendor issues to protect SNF Medicare dollars Table of ContentsChapter 1: Introduction to ICD Why ICD-10? Benefits of Implementing the ICD-10 Coding System Chapter 2: Planning the Transition to ICD-10 How to Get Started Critical Tasks Coding Impact How Would an Organization Finish the Transition if They Started? Chapter 3: Determining the Impact on Operations Determine Implementation Impact—Internal vs External Establishing a Transition Plan Chapter 4: Budgeting for the ICD-10 Transition Budgetary Impact—Implementation Costs Predictive Budgeting Chapter 5: Organizational Implementation/Transition Phase Training the Facility Coding Staff Preparing the SNF Physician for the Transition Value of Adoption of ICD-10-CM Assigning ICD-10 Codes Discharge Summary Examples Testing Phase Chapter 6: Claims Processing and Auditing Role of the MAC in Claims Edits and Education General Claims Submissions and Edit Information for All MACs Auditing for Valid Appropriate ICD-10 Codes Free or Low-Cost Resources Chapter 7: Auditing and Tracking Tools Auditing Claims for Errors Triple-Check Policy & Procedure Chapter 8: How SNF Diagnosis Coding Differs From Other Healthcare Settings Chapter 9: How to Use the ICD-10 Manual Episode of Care Additional Guidance in Coding Fractures How to Use the GEM Files Chapter 10: ICD-10-CM Official Guidelines for Coding and Reporting FY 2015 Chapter 11: Diagnosis Code Set General Equivalence Mappings ICD-10-CM to ICD-9-CM and ICD-9-CM to ICD-10-CM, 2014 Version, Documentation and User's Guide Section 1—Mapping and the GEMs Section 2—How to Use GEM Files Glossary Diagnosis Code Set, General Equivalence Mappings, 2014 Version Documentation, Appendix A—File and Format Detail Chapter 12: General Equivalence Mappings Documentation for Technical Users General Equivalence Mappings ICD-10 GEMs FY2015 Version Update DIAGNOSIS GEMs Chapter 13: ICD-10 GEMs FY2015 Version Update References Who should read this book? Administrators DONs Assistant DONs Nurses Staff educators Clinical managers Directors Nurse managers Coders Billers MDS Coordinators