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

Reaching Agreement on Accurate Coding and DRG Assignment

Written by Joel Moorhead, MD, PhD, CPC

Got denials? This article is about building relationships between hospitals and payers. Hospitals in our country are currently taking one or more of the following three steps in some form, with the goal of reaching agreements with insurance companies and other payers. .......

Shocking Revelation About Septic Shock

Written by Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer

It has been almost a week since I published a rant about my many complaints with regard to ICD-10 or the state of affairs concerning audits and “clinical validation.” .......

Improving Performance Outcomes and the Financial Health of Your Organization

Written by Michele Wieczorek, RN RHIT CPHQ and Cheryl Ericson, MS, RN, CCDS, CDIP

While it is now officially calendar year 2017, we are a full quarter into the 2017 federal fiscal year. That said, it is not too late to think about what you as a leader of a clinical documentation improvement (CDI) or coding department can resolve to do to improve your performance outcomes in a variety of key areas. .....


New Year, New Policies, New Challenges

Jan. 1 always brings fresh starts, both personal and professional. Many of us focus on how we can make improvements for the new year. Whether it is fitness, motivational, financial, or transformational, they all require the same thing: dedication and consistency....Read more...

False Assumptions: Linking Hypertensive Heart and Kidney Disease

Well, it has started happening. As I feared, there are coders who want to link any and all hypertensive patients who also happen to have chronic heart failure (CHF) and/or renal failure all together. ...Read more...

Expensive Conditions Require Focus on Data and CDI

The Healthcare Cost and Utilization Project (HCUP) released a report in May 2016, National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013, outlining which medical conditions were the most expensive to treat. ...Read more...

AHIMA Revises Standards of Ethical Coding

The American Health Information Management Association (AHIMA) House of Delegates approved the newest version of its Standards of Ethical Coding on Dec. 12, 2016. ...Read more...


Has the Time Come for Query Focus Groups?

One of the hardest jobs for coders is to translate physician terminology into ICD-10 coding terminology. This has been especially challenging with codes related to mental and behavioral health. In some cases during the year following ICD-10 implementation, there was no way to convert DSM-5 terminology used by psychiatrists and psychologists to ICD-10-CM. Lack of understanding of the differences between the code sets led to misinterpretation and frustration among coders and mental health professionals. ...Read more...

  1. Dual Coding
  2. CDI
  3. Physician Education
  4. Payers
  5. Mental Health
  6. CHIRO
  7. HBMA
  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
  22. EHRs
  23. Clinical Labs
  24. Hospice

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...

The Ever-Changing Landscape of Sepsis

Written by Laurie McBrierty | Monday, 11 April 2016

It may seem that rules come and go, changing with the prevalent estimation of the current thinking. But are we really slaves to the winds of interpretation? For example, consider the first, second, and third definitions of sepsis – did they really change what it truly means? ....Read more...

Problematic Diagnoses

Written by Denise M. Nash, MD, CCS, CIM | Monday, 14 March 2016

As I was listening to a recent broadcast of Monitor Mondays, I was a bit taken aback when I thought I heard the phrase “the physician writes down the diagnosis, and it should be accepted as the diagnosis.” .... Read more...

Health Plans Report ICD-10 Success

Mark Spivey | Thursday, 17 December 2015

Health plans nationwide are touting widespread success in the implementation of ICD-10, according to comments made by three health plan representatives during the most recent edition of Talk Ten Tuesdays, the weekly Internet broadcast hosted by ICD10monitor.com. ... Read more...

Is Self-Love Real Love?

Written by Chuck Buck | Monday, 15 February 2016

EDITOR’S NOTE: The confluence of two national events last week inspired the following interview with H. Steven Moffic, MD, Talk Ten Tuesdays’ celebrated resident psychiatrist: Valentine's Day on Sunday, Feb. 14 and last Tuesday’s New Hampshire presidential primary, which resulted in a GOP victory for presidential hopeful Donald Trump. A number of comments about Trump’s alleged narcissism have been made in the media, but could there be a code to denote his behavior? That’s one thing we wanted to find out. ... Read more...

ICD-10 Coding and Documenting for Spinal Disc Problems

Evan M. Gwilliam, DC, MBA, BS, CPC, NCICS, CCPC, CCCPC, CPC-I MCS-P, CPMA | Monday, 11 January 2016

Selecting the correct ICD-10 code for disc disorders can take a little bit of research. There are many options found in the M50 and M51 categories, which are: ... Read more...

Latest Results: HBMA’s ICD-10 Benchmark Survey: Three Rev Cycle Companies Shuttered

Monday, 07 March 2016 / Written by Holly Louie, RN, CHBME

In February, the Healthcare Billing and Management Association (HBMA) surveyed its members seeking information on current claims statuses as well as their experiences with ICD-10 implementation. Many responses were as predicted, some were consistent with other industry reporting, some confirmed what we already knew, and there were some surprises. This was not a statistically valid survey. However, we believe the survey is a valid snapshot of the revenue cycle industry. Thirty-eight billing companies responded; on average, that represents 13 to more than 15 million claims per year. Consistent with past discussions with key industry stakeholders, not all companies were able to answer all questions at the time of the survey. Regarding coding questions in particular, not all revenue cycle companies provide coding services.... Read more...

ICD Codes May Be Past Their Shelf Life

Written by Craig Kasten | Monday, 01 February 2016

In business as well as in life, it’s always interesting to look back on what was critically important a year ago to see if those things are as big a deal now as they were then. Back in January 2015, one of the hot topics in healthcare was the transition from International Classification of Diseases, Version 9 (ICD-9) to ICD-10. Providers and payers both worried whether they would be able to meet the looming Oct. 1, 2015 deadline, and various organizations continued pleas to delay it for the third time right up until the due date........ 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 Declares ICD-10 Implementation “Non-Event”

Written by Mark Spivey | Thursday, 17 December 2015

The organization representing the healthcare clearinghouse industry has declared the much-anticipated implementation of ICD-10 a “non-event,” according to a statement issued this week. The assessment was based on the Cooperative Exchange’s view that “good ICD-10 planning, education, testing, and industry collaboration” resulted in a smooth transition for most healthcare providers nationwide..... Read more

Fine-Tuning for Financial Success During the ICD-10 Transition: Preparations to Prevent Cash Flow Disruption

July 19, 2015 / Ken Bradley

When something needs fine-tuning, it’s either near the end of preparation (“Hey, let’s fine-tune the presentation before tomorrow’s meeting”) or in pretty good shape overall (“Fortunately, that squeak is no big deal; your car just needs fine-tuning”). For most providers, both scenarios are likely an accurate reflection of their ICD-10 status. After months of hard work, the finish line is in view—a fact that elicits relief alongside a healthy dose of stress as everyone asks, “Will we be ready on October 1? What are our weak points?” And lastly, the... Read more

Coding Clinic Solves Documentation Issues, Changes Paradigm for Diabetes and Heart Failure Coding

Written by Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer | Monday, 11 April 2016

As many of you may know by now, the often-discussed question of what to do about physicians’ use of new clinical practice terms that do not correspond to ICD-10 codes was recently addressed in the Coding Clinic for the first quarter of 2016. ..... Read more...

New Technology Equals Additional Reimbursement

Written by Laurie M. Johnson, MS, RHIA, FAHIMA | Monday, 15 February 2016

Today, February 16, the Centers for Medicare & Medicaid Services (CMS) is holding a New Technology Town Hall Meeting at the CMS Headquarters in Baltimore. The New Technology meeting is being held to allow the agency to review applications for New Technology designation in the Medicare Severity-Diagnosis Related Groups (MS-DRGs) reimbursement methodology for the Inpatient Prospective Payment System (IPPS). This desig.. Read more...

Dear Doctor: We Don’t Care if You Don’t Get Paid Promptly

Written by Holly Louie, RN, CHBME | Monday, 22 February 2016

EDITOR’S NOTE: The following is a personal reflection by the author and does not necessarily reflect the views of the Healthcare Billing and Management Association of which she is president. The story I am going to relate in this article could borrow a line from the classic 1989 comedy “When Harry Met Sally.” In the film, Sally is sobbing, noting that she is about to turn 40. When Harry asks when, Sally responds, “someday!”...Read more...

Eight Areas of Focus for Better ICD-10 Documentation

Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer | Monday, 14 December 2015

If you don’t read anything else this holiday season, read this. Documentation improvement is at the heart of any successful ICD-10 coding program, and in this article I will highlight eight key areas of focus about ICD-10 and clinical documentation improvement (CDI). .... Read more

ICD-10’s Impact to the Worker’s Compensation Industry

Written by Sherry Wilson and Tina Greene | Monday, 28 March 2016

A general assumption had been that states would be aligning their worker’s compensation regulations with the rest of those of the healthcare industry in order to adopt the ICD-10 regulations. As of Oct. 1, 2015, there were only 21 states that had aligned with the Centers for Medicare & Medicaid Services (CMS) ICD-10 .... 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...

ICD-10 is Risky Business

August 17, 2015 / Holly Louie, RN, BSN

The risks associated with the changeover to ICD-10 on Oct. 1 have been numerous and varied. Will there be increased allegations of false claims? Did the recent Centers for Medicare & Medicaid Services (CMS) clarification regarding “families” of codes alleviate concerns? Will the change really create a surge in improper payments? Potential legal ramifications aside, will there be increases in issues that concern patients? Will improved clinical documentation result in optimal coding? .... Read more...

Clinical Labs Likely to Face Challenges Under ICD-10

August 24, 2015 / Robin Zweifel, BS, MT (ASCP)

When ICD-10 implementation becomes a reality on Oct. 1, 2015, clinical laboratories will continue to experience challenges related to the submission of test requisitions, no matter how prepared they are internally. Administrative problems that exist under ICD-9 will not go away; in fact, they could worsen under ICD-10 if the ordering providers are not ready for the change..... Read more...

ICD-10 Impact on a Hospice: A Case Study

Suzi K. Johnson, MPH, RN | Monday, 07 December 2015

Here are some lessons learned over the last year as we have prepared for an organization-wide approach to implementing ICD-10 across a very large health system in San Diego. ... Read more...






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