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

To Shift or Not to Shift, That is the Question

Written by Maria T. Bounos, RN, MPM, CPC-H

’s that time of year again: now that all of the major 2015 Federal Register Final Rules are published, many of us find ourselves scurrying to assess how these payment systems, Inpatient, Outpatient, and Physician, just to name a few, are going to affect our business. Although the Inpatient Prospective Payment System for 2015 did not change much from a code-set perspective, the ICD-10 implementation date is right around...

Cost of Physician I-10 Conversion Study Challenged

Written by Stanley Nachimson

While I welcome attempts to refine and improve the estimates produced by the recently released 2014 Nachimson Advisors study, the American Health Information Management Association (AHIMA) journal article unfortunately contains several misstatements and invalid assumptions that render its conclusions misleading at best. I will point out several of these to show that the title and conclusion should be disregarded. First, I note that my study includes costs for all of the tasks that should...

Documenting Autism in ICD-10

Written by Kathy Pride, CPC, RHIT, CCS-P

Comedian Jerry Seinfeld shocked the nation recently when he announced he “might be on the autism spectrum” and subsequently created an uproar in the autism community. Many have viewed his statement as a play for attention and as an insult to those who are severely autistic. However, one must look at the context of the statement before rushing to judgment. Mr. Seinfeld did not claim to have autism; his reflective words implied he may...

Feature Stories

Autism – Clinical Documentation for Autistic Patients: Self-Care vs. Right Reimbursement

I have written several articles for ICD10monitor over the years as we as an industry grapple with ICD-10 compliance. Like many of you, I have become a bit ICD-10-weary, but I have found a new breath of energy in the topic of autism and ICD-10. Autism is a vague diagnosis to many, and the fact that there is a spectrum of symptoms complicates the clinical picture, and thus could complicate how ICD is applied. I am not going to attempt to be an expert on how to code a complicated...Read more...

Value-Based Payments and the Transition to ICD-10

Those of you who are listeners of our weekly Talk-Ten-Tuesday Internet broadcasts may have heard my “Follow the Money” segment and my comments on the financial implications regarding the implementation of ICD-10. Recently I gave some general statistics on the growth in value-based payments (VBP) and how both the federal government and commercial payers are quickly moving larger and larger portions of provider payments...Read more...

Inoculate Your Emergency Department Staff Against ICD-10 Stress Syndrome

According to the most recent statistics from the Centers for Disease Control and Prevention (CDC), there were 129.8 million visits to emergency departments across America last year. Almost 38 million were injury-related and 13.3 percent of those seeking treatment were admitted. To put that into perspective, during that same reporting period, the total population of the U.S. was roughly 308 million, meaning that the equivalent of 41 percent of the population visited the emergency... Read more...

Agency Holds National Call to Outline its Own Roadmap for ICD-10 Adoption

During the Nov. 5 MLN Connects™ national provider call on transitioning to ICD-10, Centers for Medicare & Medicaid Services (CMS) speakers covered a variety of topics, providing very useful information to audience members preparing for the Oct. 1, 2015 compliance date. A transcript of the call will be available at a later date, while slides used during the session are available on the MLN Connects website now. Denesecia Green with the CMS Administrative Simplification Group... Read more...

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

Responding to Physician Criticism of ICD-10

August 19, 2014 / 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 in 2010, regarding President Obama’s landmark healthcare legislation... Read more...

The Role of Payers and Providers in Improving Healthcare Data

August 21, 2013 / Joseph C. Nichols, MD

As the healthcare industry moves into a changing world of reform, the importance of reliable, accurate, and complete data has never been more critical. Historically, the transactional data we rely on to understand the burden or illness of the population and the risk, complexity, and severity of health conditions has been limited. In a recent article for ICD-10monitor (ICD-10 Myths Part 2: Coding Specificity),I reported on an analysis of three years of claims data representing more than 15 million professional claims. According to this analysis... Read more...

Major Depression No Laughing Matter: Serious Diagnosis Requires New Documentation, Coding and Privacy Focus

September 9, 2014 / Kimberly Janet Carr, RHIT, CCS, CDIP, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer

The recent death of world-renowned actor and comedian Robin Williams came as a shock to many. Like many dealing with major depression and other mental health conditions, Mr. Williams suffered in silence. His diagnosis was just another little-known fact in a very celebrated and public life. Dr. Debra Peel, a practicing psychiatrist and founder of Patient Privacy Rights, recently stated that some “10 percent of all hospital admission patients have some type of ... Read more...

Technology and ICD-10

August 21, 2014 / Mark Morsch, MS, AHIMA-approved ICD-10 trainer

Technology continues to play an important role in supporting facilities and physicians engaged in the transition to ICD-10. Many organizations have purchased technology such as computer-assisted coding (CAC), clinical documentation improvement systems, natural language processing (NLP) and/or coding workflow solutions. These technologies hold the promise of significant benefits to key functions such as clinical ... Read more...

Let’s Be Honest

September 15, 2014 / Billy Richburg, M.S., FHFMA

Honestly, have you noticed how almost everyone around you seems “comfortable?” Most of us live and work in environments where everything is systematized, laid out as rules or policies or (the worst) “best practices.” And then, on top of the things we do to ourselves, we have local, state, and federal governments applying their own rules and policies and (dare I say it) “best practices,” except they call them “ordinances,” “statutes,” “regulations,” “policy statements,” and “laws.” (We interrupt this essay with an appeal to whomever/whatever you hold in your belief set: “Deliver us from bureaucrats... 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

There’s a Code for That

August 19, 2014 / 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 on things that are truly irrelevant, though entertaining... Read more

ICD-10 Testing Consultants Dish Out the Good, the Bad, and the Ugly

October 27, 2014 / Juliet Santos

As we continue to move toward the new ICD-10 coding and reimbursement system, new challenges are facing healthcare providers above and beyond those associated with other high-profile federal mandates. New focuses demanding our attention and resources include the fearsome Ebola virus and Enterovirus D68 (EV-D68), which is more easily communicable than Ebola and appears to have spread to children in 45 states and the District of Columbia (as well as other humanitarian crises overseas that now are impacting the U.S.) Although we often prefer to distance ourselves from diseases that we’ve not treated in the past, the reality is that many of these diseases could eventually find their way to the U.S. if we’re not able to contain... Read more...

CMS to Feature ICD-10 Codes on its CMS-2728 End Stage Renal Disease Patient Registration Form

November 3, 2014 / Oniel Delva

On July 31, 2014, the Centers for Medicare & Medicaid Services (CMS) formally announced that the U.S. Department of Health and Human Services (HHS) had finalized Oct. 1, 2015 as the new compliance date for healthcare providers, health plans, and healthcare clearinghouses to ICD-10. At that time, all entities covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) must transition to this new set of codes for electronic healthcare transactions. In support of this change and to help ensure that all Medicare-certified dialysis facilities and transplantation centers throughout the United... 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

Will You be Required to Comply with Both ICD-9 and ICD-10 Mandates? What is Your State’s Property & Casualty Requirement?

August 21, 2013 / Sherry Wilson and Tina Greene

Just like “Where’s Waldo?” the property & casualty (P&C) industry that includes workers’ compensation and auto billing also requires the tracking of state healthcare requirements to highlight whether ICD-9 or ICD-10 is required when submitting bills to payers. Payers, vendors, and providers that bill P&C across states are required to comply with each state’s requirements. There are numerous... 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 7 – Qualifier

November 11, 2014 / Lolita M. Jones, RHIA, CCS

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 to occupy the seven spaces of the code, called "characters." In ICD-10-PCS the seventh character defines the qualifier – i.e., an additional attribute of the procedure, if applicable..... Read more

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