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Make Sure Your ICD-10 Physician Training Measures Up

Written by Deena Kerr, MBA

The ICD-10 compliance date is squarely within the sights of the healthcare industry. With less than four months to go until we cross the transition threshold, consider what you've done — and what you can still do — to help your doctors succeed as they move from ICD-9 to ICD-10. Help physicians document for ICD-10 as soon as possible. Perhaps last-minute training is how you've prepared doctors in...

ICD-10 Readiness: Examining the Role of Technology in Preparing Physician Practices

Written by Bill Reid

It looks small – a coding change – but its impact will be far-reaching. Because ICD-10 readiness involves communication between parties, everyone has to change together. To make this change easier for everyone, the industry needs to ensure that the right tools are in the hands of the people who begin the process – the providers who begin the referral workflows...

Five ICD-10 Pillars of Success for Large Physician Practices

Written by Kelly Whittle, MS

Regardless of size, many physician practices are struggling with ICD-10 implementation. Over the last couple of months, much of the industry focus has been on smaller practices. This makes sense, given the financial and operational limitations of these practices. However, large practices (i.e., those with 25 or more physicians, as defined by the Centers for Medicare & Medicaid Services, or CMS) also face their own unique challenges, the...

Feature Stories

Here’s My PCS Pet Peeve. What’s Yours?

Do you have pet peeves? I have many, including those sun-catchers that folks hang on their rear-view mirrors, which on a sunny day blind the drivers behind them. So, what is my PCS pet peeve? Let us discuss the root operations of restriction and occlusion. By PCS definition, “restriction” refers to the partialclosing of an orifice or tubular body part that includes both ... Read more...

ICD-10’s Role in Furthering Population Health: Why Intensive Education and Training will Promote Better Care Decisions

On June 4, a new bill titled “Protecting Patients and Physicians Against Coding Act of 2015” (H.R. 2652) was introduced by U.S. Rep. Gary Palmer (R-AL) in the U.S. House of Representatives. With 35 co-sponsors as of June 10, the bill proposes a two-year ICD-10 grace period to allow physicians and healthcare providers to transition to the new coding set with no further implementation delays...Read more...

The Corporate Cultural Trap

There are so many ICD-10 bills popping up in Congress these days, you may be left wondering what you should do. Many of us might consider the approach of sticking our heads in the sand and hoping it all goes away. But the bottom line is that this marks a...Read more...

HBMA Conducts Revealing ICD-10 Readiness Survey

Earlier this month, the Healthcare Billing and Management Association (HBMA) surveyed members in an effort to assess their experiences regarding commercial payer, Medicaid, and HIPAA-exempt plan ICD-10 readiness. Fifty-four member companies...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

Combination Codes and ICD-10

June 22, 2014 / Cathie Wilde, RHIA, CCS

It’s one of the most important questions coders must ask while using ICD-10: Is there a single combination code that fully identifies the patient’s relevant conditions, or is it necessary to report two separate codes? This question is also important in ICD-9; however, the volume of combination codes in ICD-10 has increased, making it imperative for coders to be alert and aware of instances in which combination codes are applicable... Read more

ICD-10 Testing: Why Test – and Why Test Right Now?

December 9, 2014 / Betty Gomez

ICD-10 will impact nearly all of the processes in your practice or organization, and using that fact as the starting point for your ICD-10 testing will make the process smoother and more worthwhile for everyone involved. Although it may not be possible to coordinate or synchronize all aspects of the testing, the more comprehensive your testing plan is, the better prepared your organization will be on Oct. 1, 2015. In addition to helping you gauge your readiness for ICD-10... 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 Webcast

The Last Chance to Get It Right: ICD-10 Coding Management Essential 3-Part Workshop Series

The upcoming weeks, days, and minutes are becoming increasingly critical. The closer the ICD-10 implementation deadline approaches, the faster the time will fly by — and you don't want to be caught unprepared when that deadline arrives on October 1, 2015.

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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

Hospitals don't need to code inpatient procedures that do not impact the MS-DRG assignment. The reporting of "significant" procedures is embedded in the rules...

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