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Be Proud to Support ICD-10!

Written by Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer

Many across healthcare are continuing to move forward with preparations even despite legislative efforts to delay ICD-10. It’s unfortunate that H.R. 2126, has been introduced, as it doesn’t really represent the majority of our healthcare industry, nor does it recognize the many disease management processes that the new code set will be able to capture...

ICD-10 Transition Testing Proposed

Written by Chuck Buck

On the heels of H.R. 2126, a bill introduced by U.S. Rep. Ted Poe (R-Texas) “to prohibit the Secretary of Health and Human Services (HHS) from replacing ICD-9 with ICD-10 in implementing the HIPAA code set standards,” comes H.R. 2247. Unlike Poe’s bill, which was introduced two weeks ago, the latest piece of proposed legislation would require an 18-month transition period for the purposes of testing the submittal of ICD-10 claims. Titled the “Increasing Clarity for Doctors by Transitioning Effectively Now Act (ICD-TEN Act),” the bill was introduced...

ICD-10: Physicians to Payers: Speak Their Language

Written by Betty Bibbins, MD, CHC, CI-CDI, CPEHR, CPHIT

Physician to physician, we must acknowledge that healthcare is changing. ICD-10 is coming on Oct. 1, 2015, and this will add new depths to the language we use to communicate. As physicians, we are good at communicating physician to physician, clinically speaking, about the practice of medicine. However, when we speak to insurers, who pay for the care that's being provided to beneficiaries, it is important...

Feature Stories

Health Insurers Consortium Offering ICD-10 Preparation Webinars to Providers

A national consortium of health insurers is offering a series of free, hour-long ICD-10 educational webinars to healthcare providers seeking to prepare for the upcoming transition to the new coding set. The Payers Collaboration – a group that includes Humana, Blue Cross Blue Shield of Michigan, UnitedHealthCare, Priority Health, and the Health Alliance Plan (HAP) – has tailored the various... Read more...

ICD10 – Why Resiliency is a must for Project Managers

Dictionary.com defines resiliency as “the power or ability to return to the original form, position, etc., after being bent, compressed, or stretched; elasticity.” Many of us surely have seen the movie “Apollo 13.” The movie is about the seventh manned mission to the moon. The mission was aborted after an oxygen tank exploded – and working in uncharted territory, the mission managers’ resources and energy back home in Houston were stretched. They were able to develop...Read more...

Bill to Halt ICD-10: The Train Has Left the Station

Sure as shootin’, U.S. Rep. Ted Poe (R-Texas) couldn’t resist the temptation of coming back to the table for a second time with his latest distraction, H.R. 2126: a proposed bill “to prohibit the Secretary of Health and Human Services from replacing ICD-9 with ICD-10 in implementing the HIPAA code set standards.” And not surprisingly, Poe, who appeared with Fox News’s John...Read more...

Think “Process Improvement” to Mitigate Coder Productivity Loss in ICD-10

Everyone is anxious about how ICD-10 may affect coding productivity and quality. Although we won’t have specific answers until we’re in the thick of things after Oct. 1, there are plenty of strategies that health information management (HIM) directors and managers can use today to mitigate potential problems. Many of these strategies pertain to process improvement – that is, examining workflow more closely to identify...Read more...

  1. Dual Coding
  2. CDI
  3. Physician Education
  4. Payers
  5. Mental Health
  6. CHIRO
  7. MGMA
  8. Technology
  9. AHIMA
  10. Clearinghouses
  11. Reimbursement
  12. Coding
  13. Testing
  14. CMS
  15. AAPC
  16. Coding Tips
  17. Property & Casualty
  18. Root Operations
  19. Practice Management
  20. PCS Character Series
  21. ICD-11

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...

Does Your Documentation Have Attention Deficit Disorder?

April 27, 2015 / Laurie M. Johnson, MS, RHIA, CPC-H, FAHIMA

With the repeal of the sustainable growth rate (SGR) in the recently passed H.R. 2 bill, it appears that ICD-10 implementation is on again. Taking into consideration the weekends and holidays between now and Oct. 1, 2015, we barely have 90 working days to prepare for the adventure. Hopefully we will be able to maintain our sanity! Mental and behavioral health codes have undergone major revisions and may present some challenges under ICD-10-CM/PCS. What are the required documentation updates? Let’s take a look at some examples... Read more...

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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...

Newly Formed Consortium Working to Ease Transition to ICD-10

November 21, 2014 / Mark Spivey

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... Read more...

Autism Spectrum Disorder: Five Times the Codes in ICD-10

November 25, 2014 / Wilbur Lo, MD, CDIP, CCA

According to the National Institute of Mental Health, Autism Spectrum Disorder (ASD) is characterized by a wide range of symptoms and levels of impairment or disability that are typically recognized during the first two years of life. ASD is a complex clinical diagnosis and includes deficits in social communication and social interaction, as well as restricted, repetitive patterns of behavior, interests, or activities. The symptoms will cause... Read more...

Ten Minutes per Week for ICD-10 Documentation Proficiency

January 19, 2015 / Evan M. Gwilliam, DC, MBA, BS, CPC, NCICS, CCPC, CCCPC, CPC-I, MCS-P, CPMA

Unfortunately, chiropractic physicians have a reputation as the providers with the worst documentation. According to the 2013 CERT Annual Improper Payment Report, chiropractic services were paid improperly 51.7 percent of the time. Of those improper payments, reviewers determined that 92.5 percent of them were due to insufficient documentation. As a certified professional medical auditor and a chiropractor, I have performed chart audits and provided expert witness testimony on documentation issues... Read more...

A High-Impact, Low-Cost Approach to Physician Practice ICD-10 Implementation in 2015

January 5, 2015 / Robert M. Tennant, MA

As the healthcare industry transitions to the ICD-10 coding system in 2015, physician practices will need to have an aggressive action plan in place for meeting the many challenges associated with implementing the new code set. Many practices began their ICD-10 implementation processes in 2014 only to put those efforts on hold following passage of the Protecting Access to Medicare Act of 2014... 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...

The Future of ICD-10-CM/PCS

January 5, 2015 / Lou Ann Wiedemann, MS, RHIA, CHDA, CDIP, FAHIMA

In a December 2014 statement on the implementation of ICD-10, U.S. House of Representatives Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and House Rules Committee Chairman Pete Sessions (R-Texas) called the new coding set "an important milestone in the future of healthcare technologies." The statement clearly indicated that the congressmen will continue to work closely with the Centers for Medicare & Medicaid Services (CMS) to, as the statement put it, "ensure that the deadline can successfully be met by stakeholders... Read more...

Cooperative Exchange Rolling Out Key ICD-10 Payer Testing Results Tool

January 5, 2015 / Tim McMullen, JD, CAE

There’s been an industrywide concern among healthcare providers during recent months about the lack of knowledge on what to expect in testing from payers. To help facilitate ICD-10 testing during the remaining transition period, the Cooperative Exchange (CE) will gather information on payers regarding their testing parameters. This is a value-add for Cooperative Exchange clearinghouse clients and all providers and clearinghouses... Read more

ICD-10: Let’s Focus on the Money

December 15, 2014 / D’Arcy Gue and Thomas Grove

ICD-10 is supposed to be about better disease management and more accurate medical diagnoses and treatment reports. But for many in the healthcare world, ICD-10 is all about money. The federal government wants ICD-10 in order to help our healthcare system save money. ICD-10’s promises of more precise and complete data for research, fraud and abuse investigations, and payment determinations is expected to cut costs significantly. For providers, it’s a lot simpler. Many smaller providers don’t want ICD-10 at all, because converting from the antiquated ICD-9 coding system costs money... 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

CMS Acknowledgement Testing Week Highlights Lingering ICD-10 Issues

December 8, 2014 / Mark Spivey

Despite a decline in participation and some lingering issues still affecting providers, Centers for Medicare & Medicaid Services Provider Billing Group Director Diane Kovach told Talk-Ten-Tuesday listeners last week that she was pleased with the results from the second of four scheduled acknowledgement testing weeks being planned and coordinated by the agency. “Overall,” Kovach said, “the testing went really well.” Only two things were being scrutinized during the testing week that recently ended prior to the Thanksgiving holiday: the ability of providers to submit claims containing ICD-10 codes to CMS... Read more

2015: What’s in a Year?

January 5, 2015 / Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC

A new year can bring about many changes, and you never really know how all those changes can pan out. One thing is for sure in looking back, however: many of us were surprised by the ICD-10 delay. What side of the fence you stood on surely determined your thoughts of whether it was welcomed or not. Whether you were for or against a delay, however, we learned a lot in a short period of time. Here are four top things we have learned from the delay – and if you haven’t started... 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 6 – Device

December 8, 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." ..... Read more

ICD-11: A Code Set for the Future

April 6, 2015 / Michael Stearns, CPC, CFPC, MD

CD-11 has been in development since 2007 but will not be ready for use in the United States, by some estimates, until the year 2023 or later. ICD-11 is an important undertaking, as its precursor, ICD-10, is the most widely used code set in the world. The World Health Organization (WHO) has elected to modernize ICD so that it will be suitable for use “with electronic health applications and information systems... Read more...

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ICD-10 Dual Coding: It’s About Time

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ICD-10-PCS Solutions for Non-Operating Room Procedures: 11-Part Series

ICD-10-PCS Solutions for Non-Operating Room Procedures: 11-Part Series

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