Agenda ● What we’re doing here ● Background information ● Overview of the software ○ 4.1.9.X - ICD-10/DSM-5 functionality ○ Additional medication functionality ● Summary / where to go from here ● Q&A
•Setting the Stage • ICD-10 is nearly here (Yikes!) • What should be done by now (or ASAP) • SMART’s regular updates since May >
Setting the Stage ● support.smartmgmt.com
ICD 10 – Preparation & coordination across the organization ● ● ●
Coordinating with billing department DSM-5 All patients have a current diagnosis
Clinical and Medical
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Hardware and software meets requirements for 4.1.9.1 and HIPAA HITECH
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Awareness of coding changes
IT/MIS
ICD-10
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Familiar with ICD-10 codes Contact carriers about “Crossover Week”
Billing
Administrative Team
Preparation What your organization needs to have done / do ASAP: • All patients must have a current diagnosis code • A report can be generated, contact support • Review hardware/software requirements • Clinical and billing teams mapping ICD-9 to ICD-10 conversion • Contact carriers to confirm crossover week configuration • Note that there are SMART database structure changes • Clinics testing should have sent test files by now
A Look at the New Version(s) Overview of 4.1.9.X ● Administration Items ○ DSM-5 Diagnosis descriptions to ICD-10 ○ ICD-9 to ICD-10 Configuration ○ Migrating ICD-9 to ICD-10 ○ Configuring carriers for “crossover” week ○ ICD-10 Diagnosis List Management ● ICD-10 Searches ○ Registering a HIPAASpace Token ● Problem List ○ Diagnosis ○ Consolidated problem list ○ Master Problems Entry ○ Dr. First Sync with Patient Problem List ○ New Problem List Report ● Billing ○ Claim generation
Centralized diagnoses entry and editing Appears in admission, discharge summary, case history Can show “Active Only” (defered & referred out) or “All” Active problems can be ranked by severity or patient priority
Patient Problems Tab - Case History
● Problems tab is new ● Diagnoses tab has been renamed DSM-4 (for backward compatibility)
Patient Problems Tab - Case History
● Adding a new problem
Patient Problem Information
● Live-search results for DSM-5 diagnosis and ICD Description ● Shows results in real time
Patient Problem Information
● Live-search results for DSM-5 diagnosis and ICD Description ● Shows results in real time
Patient Problems Tab
● Entering a DSM-5 diagnosis will automatically select the corresponding ICD-10 description (if configured) and vice-versa (after Oct 1)
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Patient Problems Tab
● DSM-5 Diagnosis is now entered along with a corresponding ICD-10 code for billing ● We provide ~100 DSM-5 substance abuse diagnoses already mapped to ICD-10 16
Problems List Report ● More suitable to DSM-5 ● Displays singular list of diagnoses rather than axis designation ● Respects the “All” or “Active only” option ● Previews before printing ● Available only from the bottom of the “Problems” tab
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HIPAASpace.com Token
● HIPAASpace token must be registered for and entered in the system to perform ICD-10 code searches
Registering/Entering a HIPAASpace Token
● Current Token: Shows current (if entered) ● New Token: Enter a new code / update existing ● Link goes to registration for a token on hipaaspace.com 19
● Sign up with an email address ● 1 code per individual performing searches on HIPAASpace.com
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HIPAASpace Token
● Click “update” to apply the new token
ICD-9 to ICD-10 Mapping
ICD-9 to ICD-10 Mapping ● Transition date is defined here in the software
ICD-9 to ICD-10 Mapping
ICD-9 to ICD-10 Mapping
ICD-9 to ICD-10 Mapping
Migrating Patients from ICD-9 to ICD-10
● Administration > “Migrate ALL patients from ICD-9 to ICD-10” ● Cannot be performed prior to September 30th
Migrating Patients from ICD-9 to ICD-10
● Confirmation screen will show progress and confirm ● Unmapped entries can be added after but we highly recommend completing all codes
Master Problem Information ● “Problem Information”renamed “Master Problem Information” ● Different from “Problem Entry” screen ● Think of it as “Treatment Plan Master Problems” ● Can no longer add diagnosis in this window - “Add new Diagnosis” button has been removed ● Added ICD and DSM at the top ● ICD is taken from Problems Tab
Standard Treatment Plan
● ICD-10 codes will automatically appear in the location shown when appropriate
Version 4.1.9.X Billing
Crossover Week Fee-for-Service Billing ● Automatically splits between two separate claims during crossover week.
Comprehensive billing ● Each payer should be contacted about how to handle the crossover week ● Configured in the “ICD-10 Crossover” window
“Crossover” Week Configuration ● Comprehensive charges that span the week must be billed as one or the other ● The system will not submit comprehensive billing for that week without a code checked
ICD-10 Code Management
● Manage ICD Diagnosis List is used going forward ● Diagnosis Code list is for legacy data support only ● ICD Codes can be added, edited, or retired
Billing ● There is no longer a “Default Diagnosis Code” ● Code must be entered before services can be billed ● Diagnosis Codes: Patient Problem list is now the source throughout the software.
Claim Generation ● Claim will not generate if the service date is: ○ before Oct. 1 and code is ICD-10 ○ after Oct. 1 and code is ICD-9 ● ICD-9 claims can be resubmitted after Oct 1. if the service date was prior ● Codes cannot be mixed on a single claim for the crossover week (Codes are also checked in billing to ensure accuracy) ● Claim forms have been revised to be ICD-10 compliant: Electronic: 837-5010-i 837-5010-p Paper: UB-04 CMS-1500
New Medication Functionality
The Short Version: • If you only dispense methadone, it will look (slightly) different, but you won’t need to configure anything • If you dispense tablets or film, then you need to know about this
Overview • • • • •
New handling of medication Looks similar but much more powerful “behind the scenes” More capability in types and dosages of medications Puts control in the hands of the clinic Provides more streamlined and flexible billing
NDC ID Configuration ● Must be assigned for every form and strength of medication ● Existing medications should already be configured for you ● Additional medications can be added at any time.
Modality Settings ● Configured medications are listed in the Modality Settings screen ● Supports all unretired medications including pre-configured and any added to the system by the clinic
Entering New Medications • Updated to allow for new medication functionality • Information has been categorized into tabs
Strength Tab ● Up to 6 strengths per medication ● New strengths are entered in the Configure New Strength section ● Cut number - Maximum number of pieces into which the medication can be cut
Dosing Tab Dispensing strategy - Minimum pills or minimum cuts
Inventory New interface, no functionality changes
Inventory Management ● Configured medications are listed if marked as “Managed in inventory” ● Medication can also be received and reconciled based on configured strengths
Dispensary ● Supported medications are now a pop-up list rather than checkboxes ● Only one liquid medication via pump per dispensary
TX Medical Order Entry ● Medication is accessed via a pop-up menu ● For an active medication order, type and dosage will autopopulate
Incremental Dose Scheduler ● More concise and easier to read and understand ● No longer possible to specify increments in percentages for solid-form medications
Enter and post take-homes Easier to read and understand
Medication Administration • New service categories for: ● Medication Reimbursement ● Dispensary medication administration ● Take-home medication administration • In short, everything * can be configured * Types of doses, medications, rates, procedure codes, medication-based comprehensive services, etc.
Medication Billing
Medication Administration ● Billable medications must be entered in this window to be billed
Comprehensive Service Checkbox defines whether comp. rates are medication-based
Comprehensive Service If “Comprehensive rates are medication based” is NOT checked, billable medications are not configured separately on this screen
Comprehensive Service If “Comprehensive rates are medication based” IS checked, billable medications are configured at the bottom of this screen rather than in the Medication Administration screen.
Comprehensive Service Medications are configured via the Add/Edit Medications screen
Medication Reimbursements
● Create a service type for the reimbursement service.
Medication Reimbursements ● Create strengths by clicking Add button
Medication Reimbursements ● Available strengths are in the drop-down menu
Where to go from here •Regroup internally and discuss •Revisit the email updates on •support.smartmgmt.com •This presentation happens: •
Tue and Thu, 11 a.m. and 1 p.m. through September
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Share with anyone who might benefit
Where to go from here •We’ll be sending out a survey •Send us your feedback
