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

Responding to Physician Criticism of ICD-10

Written by Paul Weygandt, MD, JD, MPH, MBA, CPE

Recently I was asked to respond to physician criticism of the transition to ICD-10. While there are legitimate concerns regarding the costs of the transition, the majority of issues being raised by physicians of late reflect a lack of knowledge about the system. Such criticism reminds me of the now-infamous quote from Nancy Pelosi, the U.S. House of Representatives Minority Leader...

Physicians and Payers: Alignment Seen As Possible

Written by Jon Elion, MD, FACC

Many people feel that physicians and payers are at opposite ends of the spectrum when it comes to reimbursement. I confess that I felt that way for many years, but of late, I have noticed greater and greater alignment of interests and goals. There is certainly is a great overlap when it comes to clinical documentation improvement (CDI). Payers want accurate and complete data, and bills that match...

There’s a Code for That

Written by Holly Louie, RN, CHBME, PCS

Recently, an article was published ridiculing ICD-10 by profiling the most obscure (and frankly, ridiculous) coding combinations that could be identified. “There’s a code for that” has become synonymous with these highly publicized codes, which cover scenarios such as turtle bites, water skis on fire, being hit by meteors, and other circumstances widely considered preposterous. Obviously, these authors are focused...

Feature Stories

Insight into ICD-10-CM Chapter for Mental, Behavioral, and Neurodevelopmental Disorders

Within the ICD-10-CM code set there are 21 chapters. The code range F01-F99 within Chapter 5 covers mental, behavioral and neurodevelopmental disorders. Within this chapter there are a variety of code blocks grouping mental disorders together and covering the following... Read more...

ICD-10 Training: Tailored to the Learner’s Sub-specialty and Practice Setting

There are 20 pediatric sub-specialties recognized by the American Board of Pediatrics today, and that doesn’t include surgical or radiological sub-specialties recognized and accredited by other board agencies. Specialists, who practice exclusively at one of 183 pediatric hospitals or 68 National Cancer Institute-designated cancer centers nationwide, have unique...Read more...

No ICD-10 Delay: Move to Take the Pulse of Financial Metrics Now

Transitioning to ICD-10 has been an ongoing challenge to providers due to resource demands and time and monetary restraints. Various providers have performed an initial assessment and until recently had been proceeding to do the following...Read more...

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

Protecting MS-DRG Integrity in ICD-10

July 29, 2014 / 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 (CMS) to switch from ICD-9 to ICD-10 is a significant project, and the preliminary results have been described... 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%...

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

It’s a Date! ICD-10 Testing: Let’s Finish What We Started

August 5, 2014 / Juliet A. Santos, MSN, CCRN, FNP-BC

We’ve got a date! Much of the healthcare industry was stunned on March 31, when Congress announced that due to passage of the Protecting Access to Medicare Act of 2014, ICD-10 could not be implemented before Oct. 1, 2015. Things looked dismal, as though all hope was lost for a time, with providers stuck not knowing whether ICD-10 was coming or going. Doubts, skepticism, confusion, and frustration initially... 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

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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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