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

Start Introducing ICD-10 to Your Medical Staff Now

Written by Robert S. Gold, MD

Over the past 30 years, since institution of the DRG system for hospital reimbursement under the Medicare Inpatient Prospective Payment System (IPPS), hospitals would be marketed to by companies that had developed “the solution to all your problems” and would bring in experts to address maximizing Medicare reimbursement. Why? First of all, Medicare regulations indicate that hospitals should bill for all they are due in this system. They SHOULD optimize reimbursement. After all, why should you...

Coding Current Events

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

Recent news of the Enterovirus 68 is spreading as fast as the virus! In the past few weeks thousands of children have been treated in hospitals across the country. The Centers for Disease Control and Prevention (CDC) is watching this situation closely and helping states test specimens. When the news broke about this virus, my first thought was “I wonder what the ICD-10 code for Enterovirus 68 is?” With the increased...

ICD-10 Brings Value to Injury Data Like Domestic Violence

Written by Gloryanne Bryant, RHIA, RHIT, CDIP, CCS, CDIS ICD-10-CM/PCS-Approved Instructor

The international classification system for diseases in the United States is used for all general epidemiological, public health surveillance, reimbursement, and many health management purposes and for quality and outcomes use. Chapter 20 of the International Classification of Diseases, tenth revision, clinical modification (ICD-10-CM) allows for the reporting of external causes of morbidity and mortality. Codes from Chapter 20 are used for...

Feature Stories

Let’s Be Honest

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...Read more...

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...

Physicians and Payers: Alignment Seen As Possible

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...Read more...

  1. Dual Coding
  2. CDI
  3. Physician Education
  4. Payers
  5. Mental Health
  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. Property & Casualty
  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...

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...

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

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

Encouraging Results and Important Lessons from ICD-10 End-to-End Testing

September 9, 2014 / Betty Gomez

ICD-10 may have been delayed until 2015, but many payers are continuing with their original testing schedules. That means providers can’t wait either, because if they do, they risk missing out on opportunities that may not come around again. ZirMed conducted end-to-end testing with multiple payers this past spring and during the early summer months. The results ... 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

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 5 – Approach

September 9, 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 sections 0 through 4, 7, 8, and 9,the fifth character defines the approach—i.e., the technique used to reach the procedure site.... Read more

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