ICD 10 Transition and Updated Instructions

Agencies will need to obtain Main Office Software version 5824 dated 9/29/2015 and Clinical Point of Care Software version 2364 dated 9/29/15.  The ICD 10 Instructions found on the main menu screen have been updated.  Previous instructions included direction for two different OASIS and PPS billing scenarios.  The update will include directions for additional OASIS and PPS billing scenarios in the form of a billing chart.

Please note,   Start Of Care episodes with a Start of Care date 9/27 thru 9/30 and a M0090 date as the date the assessment was completed as 10/1/15 or later will need to be in ICD 10 format.  These assessments will need ICD9 Billing Override codes populated for RAP billing.  ICD 9 Billing Override codes data entry fields may be found in Edit PPS billing screen for the assessment or in the Changes button for the assessment that can be found in the View screen.   Recertification assessments completed (M0090 date) 9/27/15 thru 9/30/15 whose certification period is 10/1/15 or later will need to be in ICD 9 format.  The ICD 10 Transition codes will need to be completed for these Recertification assessments and will be used for RAP and Final claims.

Please monitor Allegheny messages for notification of software version updates over the next week as we continue with the transition to ICD 10 to ensure your agency software is updated to accommodate any additional programming changes.

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Updates Are Available to Correct Access Violation Errors

Agencies who received an Access Violation Error when opening the Demographics section of Comprehensive Assessments in the software will need the most recent software update.  The Main office software version dated 9/23/15 is 5820.  The Clinical point of Care software version dated 9/23/15 is 2360.

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PECOS

A new PECOS file is available for download.

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ICD 10 Instructions

ICD 10 Instructions are now available from a button located on the Main Menu screen of HHC 3000 with verion updates dated 9/1/2015 or later.

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Medicare Plan of Care Physician Recertification Language

Physician Recertification language  has been added to the Plan of Care Print Form available with Main Office software versions dated 9/2/2015 or later.  The language will only be available with the Free Form/Generic format of the 485/Plan of Care.  The software will automatically populate the language for Recertifications based upon the Start of Care date and current certification Period entered on the 485/Plan of care.  The language will allow the Physician to enter the estimated length of time services will be required.  The language and space for documenting the time frame will print just above the Physician signature line on the 485/Plan of Care.

For those agencies whose Plan of Care does not require the physician to enter the estimated length of continued service, an override has been added in Other Set, System Overrides to turn the language off.  In System Overrides, the 485/Orders tab under the heading for 485’s a check box can be found to, “Do Not display recertification episode time period estimate box.”

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ICD 10 Transitional Code fields in 485’s

Available with Main office software version dated 8/18/15 or later ICD 10 Code fields will be available in the Additional Diagnosis tab in the 485 Document.  Fields for Transitional ICD 10 codes have been available with previous version updates for the Primary and Secondary Diagnosis in the 485.  The Transitional ICD 10 codes will be included on the Print Form for non-Medicare 485’s.  The ICD 10 codes will print with the label, “ICD 10 Transition Diagnosis Effective 10/12015”, for 485’s whose Certification period will cross the October 1, 2015 time point.  The Transitional codes are included on the print form for Fee for Service Payers who may require Clinical Documentation and when providers request authorizations for dates of service 10/1/2015 or later.

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Required Main and Clinical Point of Care Software Restructure for ICD 10 Implementation

Main and Clinical Software version updates performed on or after 8/18/15 will require additional restructuring for ICD 10 implementation.  This is a one time event.

Main office software updates may take up to an additional 30 minutes to perform the restructure.  Agencies with a large volume of comprehensive documentation may take up to 3 hours or more.  Please allow the additional time frame,  based upon the volume of documentation, to complete the update.  Once the responsible employee completes the update process, they must open the software.  Restructuring will then begin.  No other employee should open the software during the restructure.  Opening the software during the restructure will cause errors and require additional technical support.  Agencies utilizing the Clinical Point of Care software with the data pipe for data synchronization, will need to turn off the data pipe while the restructure is occurring.

Clinical software updates will also require restructuring.  Clinical software restructures may take up to 5 minutes to complete.  Clinicians will be asked to restructure upon opening the clinical software after the update to the current version number has been completed.  Clinicians should select the ‘YES’ option in the window with the prompt to restructure.

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Additional Field for Ohio Medicaid Invoice Rate Override is now available.

Available with Main Office software version 5795 dated 8/5/15 an additional field has been added to Services, Insurance Company Rates, Rates tab for agencies invoicing Ohio Medicaid.  Agencies in Ohio who report on claims a consistent visit billing rate for all invoiced visits that matches the reported rate on their Medicare claims can now enter this billing dollar amount in the new field “Invoice Rate Override”.  The Invoice Rate Override will display as the visit dollar amount on invoices.  The set up screens for Ohio Medicaid Tier rates and Unit Alternatives should remain completed as previously instructed for the software to calculate the actual units and payment dollar amounts.  The software will calculate the difference between the Invoice total using the Invoice Rate Override value and the actual visit amount calculated with the tier rates.  The difference will post as a contractual allowance when AR is updated.

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Converting Scheduled Visits to a Missed Visit Record

Available with Main Office software version 5790 dated 7/31/15, a button has been added to the top of the Patient Activity screen allowing users to add a Missed Visit record.  When the missed Scheduled Visit is highlighted in the Patient Activity grid, a button will display at the top with a picture of two pieces of paper and MV.  If the Scheduled Visit was missed, the software will offer the Missed Visit Record for completion when the button is selected.  Upon exiting the Missed Visit record the software will provide agencies with the option to Delete the Scheduled Visit record.  If ‘Yes’ is selected the highlighted Scheduled Visit will be deleted.  The Missed Visit record will remain.

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New Override to Lock Changes to Time In, Time Out, Hours, and Miles on Visit Assessments

A new override is now available on Main Office Software Version 5788 dated 7/29/15, for agencies to indicate the agency preferred number of days that the Time In, Time Out, Hours, and Miles can be changed on Visit Assessments.  The software previously  defaulted automatically to 5 days from the time the addendum was initiated and data entry fields in the visit assessment were closed from changes.  This default has now been opened so agencies can now indicate the preferred number of days from the time the visit assessment closes that the Time In, Time Out, Hours, and Miles can be changed.  The override can be found by selecting the Other Set Up button on the Main Menu screen, then selecting System Overrides tab then Security tab.  At the bottom of the screen you will see the new override which states,”Number of days after a visit assessment is closed that time in, time out, hours, and miles can be changes.  If the override is left to display a zero, there will be no limit set for modifying these fields.

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