Advanced ICD-10 for Physicians Including Worker’s Compensation and Personal Injury

1: Introduction to Worker’s Compensation and Personal Injury in ICD-10

2: Structure Overview of the "2015 ICD-10-CM"

• Code structure basics
• Using ICD-10 Overview

3: Components of ICD-10 and Their Usage

• ‘Z’ codes and their importance in Worker’s Compensation/Personal Injury
• A basic 7-Step process for Diagnostic coding
• A basic 7-step process case example
• 6-category process for injury coding

4: Provider Requirements

• Combination codes
• 7th character codes
• Greater level of detail required
• External cause codes
• External causes of morbidity (transport and other)

5: Worker’s Compensation, Personal Injury and Drug or Chemically Induced Diabetes

• Diabetes Mellitus discussion
• Use of flow charts for diabetes
• Diabetes flow charts
• 2015 ICD-10-CM draft release expert edition – diabetes mellitus section

6: Worker’s Compensation and Personal Injury Billing Guide

• Personal injury example – case #1
• Worker’s compensation example – case #2
• Worker’s compensation example – case #3
• Billing for physical therapy
• Billing for injections
• Billing for x-rays
• Billing for minor surgical procedures

7: Commonly Used Diagnosis Codes

• Abdominal pain – ICD-10 category R10
• Carpal Tunnel Syndrome in Worker’s Compensation and Personal Injury
• Psychosocial discussion

8: Complex Examples and Worksheet section

• Example of whiplash case
• Example on pain management
• Example on carpal tunnel syndrome with multiple other injuries
• Example on Agreed Medical re-evaluation from an Internal Medical or Cardiovascular standpoint
• Example on medical sleep disorder evaluation
• Example on Orthopaedic Agreed Medical evaluation – complicated by Straph Infection following surgery
• Example on Psychiatric Agreed Medical re-examination

9: Causation and Apportionment in Worker’s Compensation and Personal Injury

10: Dilemma of the Independent Medical Evaluator

• The Law of Unintended Consequences
• Overview for Independent Medical Evaluators

Appendices:

Appendix 1: Medicare coverage, diagnosis requirements and coding edits

• Correct Coding Initiative (CCI) Edits
• ICD-9 Diagnosis Codes are used in Current LCD’s

Appendix 2: Worker’s Compensation and Medicare Set asides

Appendix 3: Implementation Guide for ICD-10

Appendix 4: Discussion of ICD-10 Crosswalks

Appendix 5: Crosswalk from ICD-9 to ICD-10 of common diagnosis codes used in Worker’s Compensation and Personal Injury with notes on potential problem areas

Appendix 6: Glossary

Appendix 7: General Sample Fee Slip

Appendix 8: New California Worker’s Compensation Forms

Appendix 9: Web Links for additional information

Biography

Eugene Fukumoto is President and General Manager of Health Claims Services, Inc., a consulting firm that manages the billing and collection for sole proprietors and medical groups including provider disputes with Insurance Companies. He is an authorized billing vendor for the Regents of the University of California, and has contracted with the USC School of Medicine and UCLA. He previously was General Manager for Health Computer Systems, a referenced Hewlett-Packard software vendor of medical billing systems which developed the first electronic billing software for medical practices. He is the author of numerous publications including Conquering ICD-10 for Chiropractors and Conquering ICD-10 for Family Physicians and General Practice.