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A Physician’s Perspectives on EHR, ICD-10 and Healthcare Reform

Written by Andres Jimenez, MD

When it comes to healthcare I wear many hats that have broadened my perspective on the transformation we are currently experiencing in this industry. On most days I lead a physician training software company, on others I care for patients as a physician, and in yet others I mentor about a hundred high school children each year who dream of becoming doctors one day. This past month I put on a hat I haven’t worn in some time, having accompanied two family members...

October 2015 ICD-10 Compliance Date: What, Me Worry?

Written by Paresh K. Shah

During the first quarter of 2014, health systems worked very diligently to meet the Oct. 1, 2014 ICD-10 deadline. The level of preparedness among providers varied from high to low. In early spring, however, the compliance date was moved to Oct. 1, 2015, and the response from the healthcare industry varied – the question was to move forward as planned, or to slow down or stop the preparations? Now that summer is behind us, many providers are still...

ICD-10: What’s in it for the Physicians?

Written by Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CCS-P, CDIP, AHIMA-Approved ICD-10 Trainer

Recently, I wrote about how important it is to get ready for dual coding. That is critical for any successful transition to ICD-10. This month, let’s focus on physicians, who are another driving force in this area. One of the issues that keeps cropping up when working with hospitals and physician groups is that physicians are asking “what’s in it for me?” That is quite an obstacle to overcome. Granted, there is no monetary return associated with...

Feature Stories

HATA Launching ICD-10 Readiness Survey

Off the heels of the release of results from the most recent Workgroup for Electronic Data Interchange (WEDI) ICD-10 readiness survey, the Healthcare Administrative Technology Association (HATA) has launched a similar survey of its own, association Executive Director Tim McMullen announced this week. The HATA survey will query practice management systems vendors regarding their readiness. “Practice management systems are a vital component in the transition to ICD-10,” McMullen...Read more...

HIPAA 5010: Inability to View Version Indicator Fields

Here we go again. Just as we have previously reported here in the ICD10monitor e-news about the industry’s half-hearted approach to 5010 adoption, new questions continue to be raised and concerns expressed about just how compliant the nation’s hospitals are. The current issue focuses on the inability of some providers and practices to see the version indicator field. More on that later; first, let’s take a trip back in time. Historically, we know that the introduction of 5010... Read more...

Do No Harm; Next, Focus on Documentation Improvement

We’ve heard the concerns and questions from multiple corners of the healthcare industry: Will physicians, especially those in small practices, be ready for ICD-10 implementation? What can we do to motivate them to start moving toward the inevitable (or so we hope) change? How can we communicate the urgency to do so? Although there is no one-size-fits-all answer, a recent Talk Ten Tuesdays broadcast focused on fostering communication with small physician practices. Several guests shared the physician...Read more...

ICD-10: Think “Improvement”

If there’s anything that we can all get behind, it’s improvement. We’re constantly striving to improve our health, our homes, our brains, and our lives. There’s a whole industry of professionals dedicated to process improvement. We’ve all had the experience of working for an organization that was either in desperate need of process improvement or in the midst of it. Hence, the term “change management” was born, because ultimately we all have issues with change that make process improvement somewhat difficult sometimes. But I digress...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...

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...

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

Testing with Payers: Feedback and Good News from Two Blues and a Commercial Payer

September 22, 2014 / Betty Gomez

In my last article for ICD10monitor, I shared feedback that ZirMed received from our clients — individual providers as well as clinics, physician groups, and hospitals. As promised, this time around I’m going to share feedback from a few of the payers we’ve tested with; specifically, it was end-to-end testing with a Blue and a commercial payer, and syntax testing with another Blue. The feedback is detailed, so I won’t preface it with too much additional content. But I will point out one common theme: payers are just as concerned with testing as providers are... 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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