The countdown is on. With less than a year to go before the scheduled implementation of ICD-10, healthcare industry chatter about the new code set is reaching a fever pitch. Because ICD-10 is about overall system readiness, the discussion focuses mostly on how to get ready, what barriers to overall readiness exist, and what the industry can do to remove those barriers. Problems will inevitably arise if only part of the industry is ready and other parts aren’t. With that in mind, certain groups are already hard at work...Read more...
It’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 the corner and will be here before we know it. It is imperative not to lose focus and assure...Read more...
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 be undertaken in any ICD-10 implementation process. These tasks have been described in many guides about ICD-10 implementation... Read more...
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 have what John Elder Robison referred to in a recent article in Psychology Today as the Broader Autism Phenotype... Read more...
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...
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...
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...
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...
November 17, 2014 / Ellen VanBuskirk
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 diagnosis like autism, but I want to present the importance of the diagnosis to the 1-88 or 1-66 families of children, whichever statistic one chooses. I think it is important... Read more...
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...
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...
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
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
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
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...
November 10, 2014 / Rhonda Taller, MHA
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 focused her remarks on CMS readiness efforts (including an update on CMS industry partnerships, such as training collaborations with the American Health Information Management Association, or AHIMA, the American Academy of Professional Coders, or AAPC), the Professional Association of Health Care Office Management, or PAHCOM, plus the National Association of Community Health Centers). Green said the purpose of the training arrangement... Read more
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
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
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
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
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
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
MS-DRG Validation: The Proven Process for Coding Accuracy
If you're experiencing incorrect code and MS-DRG assignment now in ICD-9 you'll be lost in ICD-10. So now's the perfect time to perform MS-DRG validation! And the results will have a positive impact at your facility on patient care, regulatory compliance and reimbursement.
2015 Comprehensive Radiology Coding Suite
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