Episodes starting on August 3, 2015 will have an end date of October 1, 2015. This will require the RAP to be billed with ICD-9 coding and the FINAL with ICD-10. To expedite coding processes for agencies, we have implemented a dual coding option in the OASIS-C1 assessments to allow for dual coding prior to October 1, 2015.
In the information below we will cover several different scenarios to help you navigate how the dual coding will work based on the certain date ranges.
OASIS SCHEDULED JULY 29 – AUGUST 2, 2015
If an OASIS is scheduled in the five-day window prior to August 3, 2015. (July 29 – August 2, 2015) and the clinician enters a completion date (M0090) from July 29 through August 2, 2015 – any Assessments with dates within the stated date range in M0090 will display the dual coding functionality for both ICD-9 and ICD-10 in M1020/M1022/M1024.
Note: All other areas that need diagnosis codes will be in ICD-9. e.g., M1010/M1016.
On the Patient History and Diagnosis page, you will see options for ICD-9 and ICD-10 coding. (Currently, only ICD-9 coding is REQUIRED, ICD-10 is optional.)
Note: ICD-10 codes do not auto-populate like ICD-9 codes. You must press enter to trigger a search by diagnosis or by code.
The Print Preview will display both code sets for Quality Assurance review.
The PDF (print out) will display only ICD-9 coding as that is the only required coding at this time.
SOC AND EPISODE START DATE AFTER AUGUST 3, 2015
For any episodes with a Start of Care (SOC) and Episode Start date on or after August 3, 2015, the SOC will have the dual code feature option as well.
Just as the Recertification did not require ICD-10, this SOC will not either. ICD-9 is the only required coding at this time. ICD-10 is optional.
Note: ICD-10 codes do not auto-populate like ICD-9 codes. You must press enter to trigger a search by diagnosis or by code.
The Print Preview will display both code sets for Quality Assurance review.
The PDF (print out) will display only ICD-9 coding as that is the only required coding at this time.
RECERTIFICATION SCHEDULED M0090 DATE PRIOR TO OCTOBER 1, 2015
For a Recertification that is scheduled in the five-day window prior to an episode starting on or after October 1, 2015, the OASIS will contain dual coding, if the M0090 date is PRIOR to October 1, 2015.
NOTE: ICD-9 is still the only required coding. However, dual coding will need to be completed in order to bill the RAP and FINAL, as it will require ICD-10 coding for proper billing, as the episode has a start date within the effective ICD-10 dates.
Note: ICD-10 codes do not auto-populate like ICD-9 codes. YOU must press enter to trigger a search by diagnosis or by code
The Print Preview will show ICD-9 and ICD-10.
The PDF (print out) will show ICD-9 only.
RECERTIFICATION SCHEDULED M0090 IS OCTOBER 1, 2015 or AFTER
If the M0090 date is October 1, 2015 or after, the OASIS will require ICD-10 single coding.
Note: ICD-10 codes do not auto-populate like ICD-9 codes. YOU must hit enter to trigger a search by diagnosis or by code.
The Print Preview will only show ICD-10.
The PDF (print out) will only show ICD-10.
SOC AND EPISODE START DATE OF OCTOBER 1, 2015 or AFTER
Any episode with a Start of Care and Episode Start date of October 1, 2015 or later will be single coding for ICD-10 only.
Note: ICD-10 codes do not auto-populate like ICD-9 codes. YOU must press enter to trigger a search by diagnosis or by code.
The Print Preview will be ICD-10.
The PDF (print out) will be ICD-10.
For all scenarios above, the 485/Plan of Care will contain the coding that corresponds to the primary coding. For example:
1. If an OASIS requires ICD-9 only, it will generate a 485 with ICD-9 coding.
2. If an OASIS requires ICD-10 only, it will generate a 485 with ICD-10 coding.
RAPS for episodes with a start date between August 3, 2015 and September 30, 2015 will be billed with ICD-9 coding. FINALS for episodes with end dates on or after October 1, 2015 will be billed with ICD-10 coding.
The Axxess ICD-10 Code Lookup Tool is an easy to use innovative tool; designed to help agencies navigate through the ICD-10 diagnosis coding.
The ICD-10 Lookup tool is located under the Help tab and found under the ICD-10 section.
This tool is strictly a Look-Up feature with the ability to search for an ICD-10 code by Category, Diagnosis, ICD-10 Code, or ICD-9 Code.
(This tool is not a substitute for native coding i.e. using the most current ICD-10 manual to remediate).
