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Preparing Small Physician Practices for ICD-10

Written by Wendy Aiken, PMI-ACP

Over the course of the past three years, practice management vendors have been tasked with understanding all the nuances of ICD-10, updating their applications to meet these requirements and ensuring their clients were as prepared as possible for a successful transition. ....

A Radiology Perspective of ICD-10 Challenges

Written by Allison Morgan, MS, CPC, CPCO

Under ICD-10, submitting compliant and accurate claims and minimizing the negative impact to clients’ cash flow were concerns shared by all those in the coding and medical billing community. While the transition has been relatively smooth as it pertains to our internal operations, there have been unanticipated challenges on the payor side. One area that appeared to be significantly affected was radiology. ....

Five Tips to Ensure Compliance with ICD-10-PCS: Part One

Written by Cathie Wilde, RHIA, CCS

In a previous article, we reviewed several important ICD-10-CM guideline changes. This month, we’ll present the first piece in a two-part series that focuses on ICD-10-PCS: the system that everyone feared would slow productivity and cause the majority of problems related to documentation insufficiencies. ......

Feature Stories

AAPC to Join ICD-10 Coordination and Maintenance Committee

The American Medical Association (AMA) has asked that AAPC be added as a cooperating party in the U.S. Department of Health and Human Services (HHS) committee responsible for development and maintenance of ICD-10 codes, guidelines, and descriptions — the ICD-10 Coordination and Maintenance Committee. .......Read more...

Lewy Body Dementia and ICD-10

Lewy body dementia is the second-most common type of progressive dementia after Alzheimer’s disease, and it is captured with ICD-10-CM code G31.83, Dementia with Lewy Bodies. G31.83 is listed in section G31, titled "Other degenerative diseases of nervous system, not elsewhere classified,” and is included in category G31.8, titled "Other specified degenerative diseases of nervous system." ......Read more...

ICD-10 a Non-Event for Clearinghouses

ICD-10 has been a non-event for clearinghouses, which are continuing to report little impact on their day-to-day business operations. Availity, one such entity, has encountered a few minor issues over the past month, primarily related to data not being submitted correctly by providers or payers having slightly different interpretations of some of the Centers for Medicare & Medicaid Services (CMS) guidelines. ......Read more...

ICD-10 Implementation Brings Little to No Impact on Worker’s Compensation

As part of our efforts to track and help the industry respond to worker’s compensation challenges associated with the transition from ICD-9 to ICD-10, we will be penning a two-part series on the topic. This article is focused on the front end of post-implementation findings and benchmark recommendations to improve business processes. In December we will provide an update on ICD-10 benchmarks and stakeholder revenue cycle impact. ..... 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. Testing
  13. CMS
  14. AAPC
  15. Coding Tips
  16. Property & Casualty
  17. Root Operations
  18. Practice Management
  19. PCS Character Series
  20. ICD-11
  21. EHRs
  22. Clinical Labs
  23. 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...

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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CMS Setting Itself Up for Billions in ICD-10 Waste

Sept. 14, 2015 / Robert S. Gold, MD

Sometimes people do their homework with setting up a new system, and sometimes they don’t. Sometimes, even when those people do their homework, it may not be adequate, and billions of dollars of avoidable wasteful spending occurs. But too often “they” won’t listen.... 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...

The Diagnostic Mystery Movie of Robin Williams

Written by H. Steven Moffic, MD | Monday, 16 November 2015

For all he gave to us, I bet Robin Williams never imagined providing a justification for the importance of ICD-10 and the advances in our diagnostic classification of diseases. To see that, let’s start from the beginning, which is really the end. To the dismay of his fans and family, he committed suicide a little over a year ago. It left many diagnostic questions. Was his known history of some type of depression a crucial factor? Probably not, as that seemed to be in remission. Not his substance abuse, either, for that was apparently in remission, too. .... 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...

Efforts Underway to Increase ICD-10 Flexibility for Physician Practices

July 19, 2015 / Robert M. Tennant, MA

A joint announcement issued on July 6, 2015, by the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) tackled a number of ICD-10 issues in an effort in ease the burden for physician practices transitioning to ICD-10. While this effort addressed several important issues, at the same time it raised other important questions about the agency’s flexibility message and what practices need to do to avoid catastrophic cashflow disruption... Read more...

ICD-10 and Data Analytics: What’s in Store for HIM?

August 24, 2015 / Cathie Wilde, RHIA, CCS

In this age of electronic health records (EHRs) and big data collection, data analytics continues to pique curiosity. With the simple click of a button, organizations can analyze and cross tabulate essentially any data they collect, including productivity data as well as data that is financial or clinical in nature. The idea is to apply underlying principles of data science to improve processes or predict outcomes. Ideally, organizations can improve the quality of care while reducing cost, all by looking at what the data is telling them....... 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...

The Consistency of Inconsistency: ICD-10 Testing Requirements Vary with Payers

July 13, 2015 / Betty Lengyel-Gomez

Cooperative Exchange (CE), the National Clearinghouse Association recently surveyed its members regarding its recent ICD-10 testing experiences. The CE received informative and helpful feedback on members testing with different types of payers: Medicare; Medicaid; commercial health plans; Tricare; Property and Casualty (P&C); and group health payers. As you can imagine, each clearinghouse’s experience varied depending on the payers they engaged. First... 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

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...

ICD-10: What a Long, Strange Trip...

July 13, 2015 / Chuck Buck

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Thirty Days and Counting: You Can Make it Happen

August 31, 2015 / Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC

With only 30 days left until ICD-10 implementation, many in the healthcare industry are starting to get nervous. There are ways to ensure that you are prepared on time, but practices need to move fast. Here’s how you can make it happen. Everyone in your office, clinic, or facility will need some form of ICD-10-CM education. An educational plan will allow for a timeline, ensuring that everyone gets what they need at the right time. ...... 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...

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...

Home Health, Hospice Reporting Smooth Sailing Following ICD-10 Implementation

October 25, 2015 / Mark Spivey

Some sectors of the healthcare industry are experiencing more success than others in adjusting to the Oct. 1 implementation of ICD-10, but home health agencies and hospice facilities are enjoying a relatively seamless transition thus far, an industry sector leader reported this week. National Association for Home Care & Hospice (NAHC) Vice President William Dombi delivered the good news during the most recent broadcast of Talk Ten Tuesdays on ICD10monitor.com.... Read more...






ICD University Featured Resources

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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