CHARTS Patch090 Documentation
Patch090– July 2015 Update - Complete CHARTS Release
The update includes: 1) instructions on migrating to ICD 10, 2) updates to 270/271 eligibility reporting to eMedNY and CMS and 3) instructions for entering information related to Employer Provided Health Care Coverage required for 2015 IRS reporting.
Migrating to ICD 10
Effective October 2015 the health care world is moving to ICD-10 for diagnosis coding.
With this deadline less than 3 months away, facilities are encouraged to actively start entering ICD-10 codes for all residents currently in the facility and for all new admissions to the facility.
General notes about the change to ICD-10:
There are over 68,000 ICD-10 codes as opposed to 14,000 ICD-9 codes currently being used.
The ICD-10 codes are 3 to 7 characters in length, with a decimal point after the first 3 characters. For example, A69.20 is the ICD-10 code for Lyme disease.
The breakdown of ICD-10 codes is very specific, this results in extremely long descriptions. The short description for ICD-10 codes is 62 characters.
There is no one for one correspondence between ICD-9 codes and ICD-10 codes. The facility will need to involved in the transition and crosswalk from ICD-9 to ICD-10.
The CHARTS Transition to ICD-10:
Up to 16 ICD-10 codes are available for each resident.
ICD-10 codes are date sensitive.
Verification is done upon ICD-10 code entry - invalid ICD-10 codes will not be allowed.
ICD-10 code entry is centralized in a single data entry screen (as with ICD-9).
Diagnosis codes can be marked as 'Use on Part A - R&B', 'Use for Medicare Part B', 'Use for Clinical Reporting' or 'Use for ALL Billing and Reporting' (the default)
ICD-9 and ICD-10 data are stored in separate areas. This allows for a facility to get started entering ICD-10 information without effecting the current ICD-9 information.
ICD 10 codes MUST be entered by the facility.
The software is date sensitive to the October 1, 2015 ICD 10 start date. Billing for September 2015 service dates will be billed using ICD 9 codes, while billing for October 2015 service dates will be billed using ICD 10 codes.
Diagnosis Entry ICD-10:
Change Resident ICD-10 Codes [CC, 5, 5]
The fields are the far right of the screen are used to indicate - 'A' - Use in Part A / R&B bill, 'B' - Use for Medicare part B bill, 'CL' - Use for clinical reporting. Mark 'Y' or 'N'.
Note that if left blank - the ICD-10 code will be used in all instances - that is, for Part A, Part B and in all clinical reporting.
General Equivalence Mappings (GEMs)
RHS has made use of the GEMs code set to create a report that can be used to assist the facility in the conversion from ICD-9 to ICD-10.
Mappings between ICD-9 and ICD-10 will play a critical role in
the successful transition to ICD-10. The Centers for
The GEMs act as a translation dictionary to bridge the language gap between ICD-9 and ICD-10. They help users understand, analyze, and manage the translation of one code set to the other. They also help users create their own applied mappings as needed.
The GEMs are more complex than a simple one-to-one crosswalk. They reflect the relative complexity of the code sets clearly so that applications that use them can be managed effectively.
The GEMs were developed to serve a specific, limited, short-term need—to allow the industry to migrate systems, applications, and data from ICD-9 to ICD-10. They are intended to be used primarily for translations of code lists or code tables used by an application or other coded data when codes in one code set are the only source of information.
The GEMs are not intended to be a substitute for using ICD-9-CM and ICD-10-CM/PCS directly. The code sets should be used to look up the applicable codes if the health record or the clinical terms describing a diagnosis or procedure are available.
The report can be accessed by typing GEMS from any menu [CC, 5, 6].
Eligibility Verification (270/271) - Medicaid NYS and Medicare
Eligibility checking Medicaid (eMedNY) or Medicare (CMS) 270/271 - ELIG270 [AR, 3, 8, 8]
The Medicaid (eMedNY) eligibility verification program has been updated with the following enhancements since earlier releases:
Surplus data from eMedNY is displayed on the report - an '*' denotes is there is a difference of more that one dollar from the amount on file in CHARTS
A message is displayed when an 'N7' is found in the 271 response file indicating that the resident is required to register with an MLTC
The Medicare (CMS) eligibility 271 Excel file has been updated with the following enhancements:
Hospice information is available in the file
MSP information is available in the file
Part C payer information is made available for 'future dates'
The selection criteria on the screen allows for the selection of All active residents, New Admissions / Readmissions only.
Affordable Care Act (ACA) Employer Reporting Requirements
Under the Affordable Care Act starting in 2015 (for filling in 2016) large employers are required to provide information statements to employees and to provide information returns to the IRS that contain details about employees' health care coverage benefits.
Statements to employees must be provided annually by January 31st. IRS forms must be submitted when filing on paper by February 28th or March 31st when filling electronically.
Facilities are encouraged to contact their accounting or legal advisors so that they become familiar with the new reporting requirments.
This update contains a preliminary release of the screen that can be used to enter data that is required for reporting purposes.
ACA- Employee Offer and Coverage [PR, 8, 9]