icd-10 slideshow 1 icd-10 slideshow 1 icd-10 slideshow 1

ICD-10 Testing at Kaiser Permanente

Written by Bryan C. Matsuura

As an integrated healthcare system, Kaiser Permanente is in a unique position when it comes to testing ICD-10. In order to become ICD-10-compliant, the company must test from the position of both a provider (caregiver) and a payer (insurance plan). During the coming months, Kaiser Permanente is targeting to test nearly 200 remediated applications individually and internally...

Protecting MS-DRG Integrity in ICD-10

Written by Lisa Roat, RHIT, CCS, CCDS

One of the most sophisticated reimbursement models in the United States involves hierarchical logic for grouping a coded health record into a designated payment group based upon the Medicare Severity Diagnosis Related Group (MS-DRG). This is the basis of payment used in the Medicare Inpatient Prospective Payment System (IPPS). The undertaking by the Centers for Medicare & Medicaid Services...

Discerning Truth Behind ICD-10 Headlines

Written by Mandy Willis, CCS, CPEHR

Not everything you read about ICD-10 is true. I know, it’s shocking. Sarcasm aside, I feel it is an important point to make since there is a lot of information floating out there about ICD-10 and it takes a level of discernment to ascertain what is the truth and what may just be someone’s idea of the truth. Case in point: I read the following headline...

Feature Stories

Chronic Diseases and an ICD-10 Value-Add for Better Care

Chronic diseases are having a massive effect on our healthcare system and our society. According to testimony provided to the U.S. Senate Finance Committee last week, chronic disease care accounts for 93 percent of all Medicare spending. That figure is really something... Read more...

ICD-10: Using Extra Time to Your Advantage

It has been an ongoing struggle to keep physicians, hospitals, and others motivated in the ICD-10 implementation process. From my experiences with my own clients, I gauge that about 50 percent of providers are continuing to forge ahead...Read more...

David S. Muntz Named First Advisor to AHIMA

EDITOR’S NOTE: The American Health Information Management Association (AHIMA) recently announced the appointment of David S. Muntz, CHCIO, FCHIME, LCHIIME, FHIMSS, as its first advisor to the board of directors. Muntz began this volunteer, non-voting position at the July 10 board meeting. Muntz, the senior vice president and CIO of GetwellNetwork, served as the first principal...Read more...

  1. Dual Coding
  2. CDI
  3. Physician Education
  4. Payers
  5. Rehabilitation
  6. Technology
  7. Billy's World
  8. Poll Results
  9. Testing
  10. How to Code
  11. Reimbursement
  12. Coding
  13. Chiro
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  16. Coding Tips
  17. Radiology
  18. Root Operations
  19. Practice Management
  20. PCS Character Series

Dual Coding: Tracking Your Output

October, 15 2013 / Kim Carr

Roseanne Barr once said that she likes facts and data because they help her think clearly. With dual coding, it is easy to rationalize the reasons and justify the means. But what really matters is the output. Dual-coding efforts must produce useful information to prepare your organizations for ICD-10. Measuring, monitoring, and tracking dual-coding data ensures that investments in time, money, and staff produce a solid return. Business intelligence gleaned from dual-coding data helps accurately measure ICD-10’s productivity, quality, and financial impacts. With dual coding already underway, now is the time to build your arsenal of ICD-10 data... Read more...

Multiple Treating Physicians, Conflicts, Clarity, and Coding Queries

February 11, 2014 / Paul L. Weygandt, MD, JD, MPH, MBA, CCS, AHIMA-Approved ICD-10-CM/PCS Trainer and Angela Carmichael, MBA, RHIA, CDIP, CCS, CCS-P, AHIMA-Approved ICD-10-CM/PCS Trainer

Industry-wide, there is substantial interest in specialty-specific ICD-10 education for physicians. Recognizing that physicians will not, and reasonably cannot, take a broad approach to learning ICD-10 as do coders and clinical documentation specialists, education is increasingly being focused on those specific areas relevant to a given clinical practice. This is coming at a time when more and more hospital care is being coordinated by hospitalists, who typically act as the attending physician or “captain of the ship.”... Read more...

ICD-10: Physician Engagement: Managing the Delays

June 03, 2013 / Paul Weygandt, MD, JD, MPH, MBA, CPE

On April 1, 2014, when the Protecting Access to Medicare Act of 2014 (Pub. L. No. 113-93) was enacted, most of us were caught off-guard. Along with once again patching the SGR methodology for physician payment, ICD-10 implementation was delayed at least until October 1, 2015. On May 1, CMS announced it would be publishing an interim final rule including a mandatory compliance date of October 1, 2015... Read more...

Pressure and Progress Line the Road to ICD-10 Readiness for Payers

January 21, 2013 / Janis Oppelt

Just a year ago, the idea of actually being ready for ICD-10 implementation by October 1, 2014, seemed a distant dream, full of confusion and panic. Since then, a lot of people have done a lot of work to get the ball rolling in the right direction, and the guests on the January 13 edition of the “Talk-Ten-Tuesday” broadcast, produced by ICD10monitor, shared the progress they’re making in two important areas: payer readiness and physician education... Read more...

So Much to Do, So Little Time — IRFs Need to Prepare Now

March 12, 2013 / Patricia Trela, RHIA

The “ostrich” approach will not work in this case, because ICD-10 is not going away. There is much to be done prior to implementation. Two different sets of ICD codes are required, one set for the IRF PAI, and another set for the UB-04.

The ICD-9-CM guidelines for assignment of codes for inpatient discharges by facilities paid under the Inpatient... Read more...

Best Use of the Fourth ICD-10 Delay: Refine Testing… Then Help Others

June 3, 2014 / Juliet A. Santos, MSN, CCRN, FNP-BC

One of the challenges of the previous October 1, 2014, deadline was the “rush factor” that seemed to cause organizations to circumvent the details of testing all systems, which could overwhelmingly affect their level of success. In addition, during the WEDI Conference in Hollywood, Calif., on May 12-15, participants once again discussed a major gap in healthcare IT today. Because healthcare has never really had an end-to-end test ... Read more...

Inpatient Blessings

July 22, 2014 / Billy Richburg, M.S., FHFMA

As expected, as usual – OK, as required by law – the Centers for Medicare & Medicaid Services (CMS) has published the proposed rules for all the various types of inpatient services and now is taking comments to incorporate into the final rule (which, also by law, should be available on Aug. 2). What is changing, assuming that most of the proposed rule carries over to the final rule? Not much, really, and nothing we didn’t expect. Here are a few key points to show... Read more...

WHAT OUTPATIENT SERVICE LINES ARE PAYERS SAYING THEY WILL REQUIRE PCS CODES FOR?

Podcast Date: 8/27/2013 Are any payers saying they will require ICD-10-PCS for outpatient services? Response Ratio A. Outpt Surg/ED/GI 10% B. Observation 4% C. Ancillary Services 2% D. Combination of A, B and C 33% E. Not appliccable 51%...

CMS Decision not to Engage in End-to-End Testing Presents ‘Dangerous Precedent’

June 20, 2013 / Mark Spivey

Much of the healthcare industry only discovered through announcements made during the HIMSS ICD-10 Leadership Forum this week that the Centers for Medicare & Medicaid Services (CMS) does not plan to engage in end-to-end testing – but Mark Lott, CEO of the Lott QA Group and testing director of the HIMSS WEDI ICD-10 National Pilot Program, said Wednesday that he first heard about it a couple of weeks ago... Read more...

Reclassification of Codes for Transient Cerebral Ischemia

July 9, 2013 / Lauri Gray, RHIT, CPC

Transient cerebral ischemia is defined as a temporary loss of blood flow to an area in the brain. In ICD-9-CM, codes for transient cerebral ischemia are classified under circulatory system diseases and are found in Chapter 7, Diseases of the Circulatory System. Conditions classified as transient cerebral ischemia are listed in category 435 and include basilar artery syndrome (435.0), vertebral artery syndrome (435.1), subclavian steal syndrome (435.2), and vertebro-basilar artery syndrome (435.3)... Read more

ICD-10 Myths Part 2: Coding Specificity

June 03, 2014 / Joseph C. Nichols, MD

There is a widely held belief that ICD-10-CM is much more “granular” and will require much greater specificity. It is true that ICD-10-CM will support the reporting of much more specific and detailed information about risk, severity, complexity, comorbidities, and complications, and other key parameters of patient evaluation. There’s a little secret that is seldom mentioned, however: You can be just as vague in ICD-10 as you were in ICD-9... Read more

Procedure Classification Systems: ICD-10-PCS Represents a Long-Term Solution

April 1, 2014 / Angela Carmichael

Hospital inpatient procedure reporting is governed primarily by the Uniform Hospital Discharge Data Set (UHDDS) reporting criteria, in addition to payer-specific guidelines. The UHDDS indicates that all “significant procedures” should be reported in the short-term, acute-care hospital setting. It defines “significant procedures” as those that meet any of the following criteria: being surgical in nature, carrying a procedural or anesthetic... Read more

ICD-10 Guidelines that Chiropractic Physicians Should Remember

December 13, 2013 / Evan M. Gwilliam, DC, CPC, NCICS, CCPC, CCCPC

Depending on the publisher, there are about 30 pages of guidelines in the ICD-10-CM code set. The bulk of these guidelines, from section 1.C, are chapter-specific. Chiropractic physicians typically use codes from just four or five of the 21 chapters available in ICD-10-CM. These include, but are not necessarily limited to, the codes from Chapter 6 (Diseases of the Nervous System), Chapter 13 (Diseases of the Musculoskeletal System and Connective Tissue), Chapter 18... Read more

CMS Hammers Home Message: No ICD-10 Implementation Delay, No Enforcement Delays

July 23, 2013 / Janis Oppelt

If leaders from the Centers for Medicare & Medicaid Services (CMS) have said it once, they’ve said it a hundred times: The October 1, 2014, implementation date for ICD-10 will not change, and the healthcare industry must be ready or face the consequences. In fact, CMS’s attorneys have advised the agency that it cannot provide enforcement delays as it did for the 5010. This is just one of the messages that CMS representatives stressed during a July 15 agency listening session... Read more

Career Step

Career Step has over 20 years of experience successfully training healthcare professionals. This experience in online adult learning has been combined with the ICD-10 expertise of YES HIM Consulting, Inc. in the development of The ICD-10 Solution, which is... Read more

100 Tips for ICD-10-PCS Coding: Tips 91-100

November 26, 2013 / Lolita M. Jones, RHIA, CCS

ICD-10-PCS represents a major departure from ICD-9-CM procedure coding, and as such, many coding specialists find ICD-10-PCS much more challenging to learn than ICD-10-CM (which still shares many similarities with ICD-9-CM). In order to ease the transition from one code.... Read more

Building an ICD-10-PCS Foundation for Radiology Procedures

March 26, 2013 / Donna Richmond, BA, RCC, CPC

When October 1, 2014, rolls around, the ICD-10-PCS (procedural coding system) will replace the ICD-9-PCS currently used for inpatient procedures. Code assignments under this system will be very different for all inpatient coding professionals, starting with the idea that they will need to “build” a seven-character code—either for medical-surgical procedures or ancillary services, which include imaging, nuclear medicine, and radiation oncology... Read more

The Various Procedures of the Medical & Surgical Root Operations

March 19, 2013 / Rebecca DeGrosky, RHIT

In the Medical and Surgical section (first character 0), there are 31 root operations with standardized terminology and no procedure names, no diagnostic information, and no eponyms. So far, we have covered 24 of them, and today will bring us to the remaining ones. We have gone over the notion that a fracture reduction is the root operation reposition, and that there is no appendectomy listing in ICD-10-PCS. Coders... Read more

Working with your Practice Management System Vendor Ensures a Successful Transition to ICD-10

July 1, 2014 / Tim McMullen, JD, CAE

Whether you were annoyed or relieved by the announcement of another delayed implementation of ICD-10, the benefit of having additional time to ensure a smooth transition can work to your favor. The expertise that is held by your practice management system (PMS) vendor is a key component that can contribute to a smooth transition. Many PMS vendors have integrated ICD-10 within their systems, so these vendors are ready and have the ability to test now. You likely have been getting updates from your vendor... Read more

ICD-10-PCS Character Analysis: Test Your Knowledge of Character 1

April 15, 2014 / Lolita M. Jones, RHIA, CCS

While the implementation of ICD-10-CM/PCS has been delayed until at least October 2015, you shouldn’t delay your training in and mastery of ICD-10-PCS, the more complicated of the two classification systems. In the coming months, we will use the delay to test your knowledge of each of the seven characters used to build an ICD-10-PCS code. The process of constructing codes in ICD-10-PCS is designed to be logical and consistent: individual letters and numbers called "values" are selected in sequence... Read more

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ICD University Featured Resources

ICD Webcast

Improve Value-Based Purchasing Scores: Helpful Tips for Documenting Secondary Diagnoses

Beware! How you report certain secondary diagnoses will impact your reimbursement in 2015. That's correct—how you code, document, and report certain secondary diagnoses today will impact your reimbursement under the CMS Value-Based Purchasing (VPB) methodology beginning October 1, 2015.

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A Best Practice Roadmap to ICD-10 Readiness

A Best Practice Roadmap to ICD-10 Readiness

While the extension of the ICD-10 compliance deadline to October 1, 2015 seems almost certain following an April 9, 2012 rule proposed by HHS, healthcare organizations must still move forward with the transition that CMS says will help improve patient care and better facilitate the exchange of healthcare data.

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