Search results
Dennis Winkler Sidney Hebert 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,…
Greg Adams, FHFMA “Transparency” is a term typically reserved to apply to government entities or picture windows – not ICD-10. But Greg Adams, vice president of the consulting division of Panacea Healthcare Solutions, says it applies to that, too. “You may have heard about price transparency since there has been…
As I continue on my journey assisting hospital systems and medical practices transitioning to ICD-10, it has become evident that clinical documentation is at the core of this transition. But as I read so many articles about ICD-10 initiatives and clinical documentation improvement, I wonder if we really grasp the…
 Most of us have heard the saying “practice makes perfect.” Although 100-percent perfection is usually unattainable, the idea of applying one’s knowledge regularly to improve performance is something toward which all health information management (HIM) professionals strive. The same holds true for learning how to code using ICD-10. By now,…
As promoters of patient safety and guardians of data integrity, health information management (HIM) professionals have dedicated their careers to ensuring the high quality of information in all medical records, paper or electronic. They also have been crusading for the switch to ICD-10 for many years, in large part because…
With continued discussion about the coming adoption of the ICD-10 code set, we learn more and more about its great assets, which provide enhanced views into many different diseases. Yes, there are still some non-supporters of ICD-10, and it’s a real shame that they don’t see the value to our…
EDITOR’S NOTE: Healthcare consultant Stanley Nachimson, founder and principal of Nachimson Advisors, responds to an article recently published in the Journal of AHIMA, “Cost of Converting Small Physician Offices to ICD-10 Much Lower than Previously Reported.” While I welcome attempts to refine and improve the estimates produced by the recently…
It’s that time of year again: now that all of the major 2015 Federal Register Final Rules are published, many of us find ourselves scurrying to assess how these payment systems, Inpatient, Outpatient, and Physician, just to name a few, are going to affect our business. Although the Inpatient Prospective…
I have written several articles for ICD10monitor over the years as we as an industry grapple with ICD-10 compliance. Like many of you, I have become a bit ICD-10-weary, but I have found a new breath of energy in the topic of autism and ICD-10. Autism is a vague diagnosis…
Comedian Jerry Seinfeld shocked the nation recently when he announced he “might be on the autism spectrum” and subsequently created an uproar in the autism community. Many have viewed his statement as a play for attention and as an insult to those who are severely autistic. However, one must look…
According to the most recent statistics from the Centers for Disease Control and Prevention (CDC), there were 129.8 million visits to emergency departments across America last year. Almost 38 million were injury-related and 13.3 percent of those seeking treatment were admitted. To put that into perspective, during that same reporting…
Those of you who are listeners of our weekly Talk-Ten-Tuesday Internet broadcasts may have heard my “Follow the Money” segment and my comments on the financial implications regarding the implementation of ICD-10. Recently I gave some general statistics on the growth in value-based payments (VBP) and how both the federal…
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 the seventh character defines the qualifier – i.e., an additional attribute of the procedure,…
During the Nov. 5 MLN Connects™ national provider call on transitioning to ICD-10, Centers for Medicare & Medicaid Services (CMS) speakers covered a variety of topics, providing very useful information to audience members preparing for the Oct. 1, 2015 compliance date. A transcript of the call will be available at…
As an ICD-10 consulting professional and journalist, I have been fortunate to talk with many hospital CFOs and health information management (HIM) directors over the last year about their ICD-10 efforts. The contents of these discussions have mirrored the results of several recent industry surveys, indicating that there has been…
No other technology has the power to impact a healthcare practice’s financial health like its practice management system (PMS). The PMS is the epicenter of all activities related to revenue generation and cost containment, and it will be the key to a successful transition to ICD-10. But historically, there have…
EDITOR’S NOTE: This is the third article is the continuation of a series of articles on clinical documentation improvement by clinical service.    Musculoskeletal disease treatment and orthopedic surgery: Coding of these services will be challenging under ICD-10-CM/PCS. What are the necessary documentation changes? Let’s take a look at some examples.
On July 31, 2014, the Centers for Medicare & Medicaid Services (CMS) formally announced that the U.S. Department of Health and Human Services (HHS) had finalized Oct. 1, 2015 as the new compliance date for healthcare providers, health plans, and healthcare clearinghouses to ICD-10. At that time, all entities covered…
We all know that the official deadline for implementing ICD-10 has been moved to Oct. 1, 2015. Any healthcare organization that singles out that date as its primary focus, however, is placing itself at grave financial risk. While there are some portions of ICD-10 that simply cannot be implemented in…
The Healthcare Billing and Management Association (HBMA) resurveyed industry members this month in an effort to learn more about current progress toward the anticipated implementation of ICD-10 in October 2015 and ongoing impediments to readiness. Not unexpectedly, there was good news and bad news. Perhaps most importantly, the results allow…
EDITOR’S NOTE: Rhonda Buckholtz is scheduled to participate in a stakeholders’ national conference call being conducted by the Centers for Medicare & Medicaid Services today on the topic, “The ICD-10 Code Set Increased –Why?” Excerpts are in the following article. ICD-10 has achieved much recent notoriety for its external cause…
As we continue to move toward the new ICD-10 coding and reimbursement system, new challenges are facing healthcare providers above and beyond those associated with other high-profile federal mandates. New focuses demanding our attention and resources include the fearsome Ebola virus and Enterovirus D68 (EV-D68), which is more easily communicable…
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…
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…
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.
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.
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…
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…
We are hearing lots about ICD-10-CM/PCS (International Classification of Diseases, 10th revisions, Clinical Modification/Procedure Coding System) documentation needs.
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…
Recently I had the privilege of attending the National Association of Healthcare Quality’s Annual Educational Conference in Nashville, Tenn. Not surprisingly, I found myself sitting in on the presentation titled “Making Sense of your Data After ACA and ICD-10.” As a health information management (HIM) professional working in multiple settings,…
The recent Workgroup for Electronic Data Interchange (WEDI) survey results confirm what everyone watching this race to ICD-10 already knows. The proactive and mostly larger groups, facilities, and practices are proceeding full steam ahead for the Oct. 1, 2015 implementation date. The rest of the world is either taking a…
Most small-to-medium medical practices are struggling just to keep up with the changes taking place in healthcare today. As I work with larger hospital systems and small-to-large physician practices, I can see that the challenges associated with moving toward ICD-10 implementation are most daunting for the small physician practice. Large…
Recently I had the privilege of attending the National Association of Healthcare Quality’s Annual Educational Conference in Nashville, Tenn. Not surprisingly, I found myself sitting in on the presentation titled “Making Sense of your Data After ACA and ICD-10.” As a health information management (HIM) professional working in multiple settings,…
The ICD-10 Coordination and Maintenance (C&M) Committee is a public forum for the presentation of proposed modifications to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and ICD-10 Procedure Coding System (ICD-10-PCS). The committee is responsible for approving coding changes, developing errata, addenda and other modifications. At the…
EDITOR’S NOTE: Authors Wilson and Greene serve as the co-chairs of the Workgroup for Electronic Data Interchange (WEDI) Property & Casualty Subworkgroup. Even Captain Obvious knows that you need to “book reservations” early for external ICD-10 testing. A successful organizational transition to ICD-10 by the compliance date of Oct. 1,…
Many say that medicine is both art and science. It draws on the rich traditions of ancient Egyptians, Greeks, and Romans, who recognized the value of keen observation, expert listening skills, and disciplined documentation of findings. Modern-day physicians emerge from years of medical training, residency, and fellowship programs with expertly…
As always, AHIMA delivers a great convention filled with the latest and greatest industry knowledge and technology! Two of the greatest and most meaningful takeaways this year are related to Big Data and ICD-10, both of which tie nicely together.
Last month 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…
Editor’s Note: Former American Health Information Management (AHIMA) President and Chair Bonnie Cassidy was awarded the Distinguished Member Award by AHIMA during the association’s 86 conference in San Diego yesterday. Much will be written about Cassidy and her long list of achievements and honors. ICD10monitor caught up with her for…
WASHINGTON, D.C. – Vendors, health plans, and providers nationwide are continuing to make progress preparing for the planned Oct. 1, 2015 implementation of ICD-10, but lapses in testing and a stubborn trend of smaller providers struggling to keep up remain key areas of concern, according to the results of the…
You have probably read the stories and heard the jokes regarding the fact that ICD-10 has a code for everything. Some are humorous, such as the notion that there are codes for walking into a lamppost or being burned while on flaming water skis, or even my favorite, being injured…
I am excited to be attending the AHIMA 2014 Convention in San Diego next week to hear more buzz about what keeps HIM professionals up at night!
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…
What kind of fruit are you? Are you an apple, pear, or maybe a banana? Eating an apple may be good for you, but looking like an apple is not. Researchers reported in last Wednesday’s Journal of the American Medical Association that 54 percent of U.S. adults have abdominal obesity,…
Recent news of the Enterovirus 68 is spreading as fast as the virus! In the past few weeks thousands of children have been treated in hospitals across the country. The Centers for Disease Control and Prevention (CDC) is watching this situation closely and helping states test specimens. When the news…
The international classification system for diseases in the United States is used for all general epidemiological, public health surveillance, reimbursement, and many health management purposes and for quality and outcomes use.
Over the past 30 years, since institution of the DRG system for hospital reimbursement under the Medicare Inpatient Prospective Payment System (IPPS), hospitals would be marketed to by companies that had developed “the solution to all your problems” and would bring in experts to address maximizing Medicare reimbursement. Why? First…
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…
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.
EDITOR’S NOTE: This part one in a series of end-to-end testing results ICD-10 may have been delayed until 2015, but many payers are continuing with their original testing schedules. That means providers can’t wait either, because if they do, they risk missing out on opportunities that may not come around…
In the classic Aesop’s fable, the young shepherd boy cried wolf three times. The first two times, there was no wolf. The third time, there was a wolf, the townsfolk didn’t believe the boy, and he lost part of his flock. Today, the healthcare industry’s perspective of ICD-10 is very…
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…
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…
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…
EDITOR’S NOTE: This article is the continuation of a series of articles on clinical documentation improvement by clinical service —cardiology and cardiovascular surgery.    Cardiology and cardiovascular surgery services are frequently more impacted by the inpatient prospective payment methodology using ICD-10-CM/PCS. What are the documentation changes.
EDITOR’S NOTE: Authors Wilson and Greene serve as the co-chairs of the Workgroup for Electronic Data Interchange (WEDI) Property & Casualty Subworkgroup. 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…
Within the ICD-10-CM code set there are 21 chapters. The code range F01-F99 within Chapter 5 covers mental, behavioral and neurodevelopmental disorders.
Many people feel that physicians and payers are at opposite ends of the spectrum when it comes to reimbursement. I confess that I felt that way for many years, but of late, I have noticed greater and greater alignment of interests and goals. There is certainly is a great overlap…
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…
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…
There are 20 pediatric sub-specialties recognized by the American Board of Pediatrics today, and that doesn’t include surgical or radiological sub-specialties recognized and accredited by other board agencies. Specialists, who practice exclusively at one of 183 pediatric hospitals or 68 National Cancer Institute-designated cancer centers nationwide, have unique patient populations…
Transitioning to ICD-10 has been an ongoing challenge to providers due to resource demands and time and monetary restraints. Various providers have performed an initial assessment and until recently had been proceeding to do the following: Determine what is needed to be compliant on Oct. 1, 2014; and Determine how…
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 F, the fourth character defines the body part, body system, body…
July 31 brought good news to the healthcare community with the announcement from the U.S. Department of Health and Human Services (HHS) that Oct. 1, 2015 is the new implementation date for the much-awaited ICD-10 coding set.
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…
Estimated costs ranging from $1.1 to $6.8 billion for HIPAA-covered entities, sums associated with delaying the adoption of ICD-10 beyond October 2015, appear to have played a significant role in the formulation of the final rule that was posted yesterday in the Federal Register by the U.S. Department of Health…
We’ve got a date! Much of the healthcare industry was stunned on March 31, when Congress announced that due to passage of the Protecting Access to Medicare Act of 2014, ICD-10 could not be implemented before Oct. 1, 2015. Things looked dismal, as though all hope was lost for a…
As you prepare for the newly announced Oct. 1, 2015, ICD-10 compliance date, now is the time to evaluate and redefine your clinical documentation value chain. A value chain is a series of activities that are performed in order to deliver a valuable product or service for the organization.
The Workgroup for Electronic Data Interchange (WEDI) is inviting providers, health plans, vendors and clearinghouses to participate in this important survey to help monitor progress as the ICD-10 implementation date moves forward, according to a news release published on Monday. The final submission deadline is Aug. 21, 2014. Click here…
On a late Thursday afternoon, with the last minutes ticking down on Major League Baseball’s non-waiver trade deadline, the U.S. Department of Health and Human Services (HHS) posted a final rule regarding ICD-10 implementation in the Federal Register. While the outcome of today’s trades might end speculation regarding how the…
The U.S. Department of Health and Human Services (HHS) issued a rule today finalizing October 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10, the tenth revision of the International Classification of Diseases. This deadline allows providers, insurance…
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…
Not everything you read about ICD-10 is true. I know, it’s shocking. Sarcasm aside, I feel it is an important point to make since there is a lot of information floating out there about ICD-10 and it takes a level of discernment to ascertain what is the truth and what…
EDITOR’S NOTE: The American Health Information Management Association (AHIMA) recently announced the appointment of David S. Muntz, CHCIO, FCHIME, LCHIIME, FHIMSS, as its first advisor to the board of directors. Muntz began this volunteer, non-voting position at the July 10 board meeting. Muntz, the senior vice president and CIO of GetwellNetwork,…
It has been an ongoing struggle to keep physicians, hospitals, and others motivated in the ICD-10 implementation process. From my experiences with my own clients, I gauge that about 50 percent of providers are continuing to forge ahead with their implementation projects, while the other 50 percent have completely stopped…
As an integrated healthcare system, Kaiser Permanente is in a unique position when it comes to testing ICD-10. In order to become ICD-10-compliant, the company must test from the position of both a provider (caregiver) and a payer (insurance plan). During the coming months, Kaiser Permanente is targeting to test…
As expected, as usual – OK, as required by law – the Centers for Medicare & Medicaid Services (CMS) has published the proposed rules for all the various types of inpatient services and now is taking comments to incorporate into the final rule (which, also by law, should be available…
Chronic diseases are having a massive effect on our healthcare system and our society. According to testimony provided to the U.S. Senate Finance Committee last week, chronic disease care accounts for 93 percent of all Medicare spending. That figure is really something we cannot ignore, and the ICD-10-CM code set…
EDITOR’S NOTE: John Showalter, MD, chief medical information officer for the University of Mississippi Medical Center, told Talk Ten Tuesdays audience members last week that his facility will be prepared to roll out ICD-10 by October 2014. Talk-Ten-Tuesday followed up with Dr. Showalter.
ICD-10 testing isn’t going away — for the most part, it’s not even being delayed. That’s why many payers, including Medicaid, are taking advantage of the additional time before implementation to conduct more end-to-end testing. What does this mean for providers, payers, and clearinghouses? And how can these groups work…
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."  For 10 of the 16 ICD-10-PCS sections, the third character defines the root operation – the…
Several months have passed since we got the news about the latest postponement of implementation of the ICD-10 code set. For a large part of the industry, after the shock wore off, the next emotion was relief. Many welcomed the delay, which eroded the fears and anxiety that had been…
Sitting in the audience at the June 10 National Committee on Vital Health Statistics (NCVHS) quarterly Subcommittee on Standards meeting, I listened attentively to the wide range of presentations on the effect the ICD-10 delay has had (and will have) on the healthcare industry. As I listened to testimony, I…
There are wide-reaching benefits to clinical data and patient care within the core of the ICD-10-CM/PCS code set, and that is why supporting ICD-10 is the right thing to do. As a health information management (HIM) leader and professional for more than 35 years, I’m extremely passionate about the move…
“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was…
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…
Given the recent extension of the ICD-10 compliance date, many hospitals are stepping back and re-evaluating project plans and timelines to use this time to improve their transition readiness.
With the initial shock of the latest ICD-10 delay behind us, now is the time to leverage it as opportunity to ensure that coders are fully prepared for the transition. Coder training and readiness is a critical element of ICD-10 success. The additional time will give coders the ability to…
EDITOR’S NOTE: This article marks the beginning of a series of articles on clinical documentation improvement by clinical service. Changes associated with switching from ICD-9-CM to ICD-10-CM/PCS typically are reviewed in total and discussed service by service. When reviewing by individual services, the variances between the two classification systems will…
As soon as Congress announced the latest ICD-10 implementation delay, healthcare industry leaders from across the country rallied together to face the facts (not to mention their collective disbelief and disappointment) and figure out how to move forward. First there was the April 30 ICD-10 Summit organized by the Workgroup…
New York Yankees legend Yogi Berra once coined a phrase that seems to fit our present situation: “It’s déjà vu all over again!” The political fastball that none of us saw coming was whacked out of the proverbial ballpark a few weeks ago, with the implementation date of ICD-10 having…
EDITOR'S NOTE: The following article by Mandy Willis, originally published in the June 17, 2014 edition of the ICD10monitor eNews, is reprinted as the U.S. ramps up its response to the Ebola crisis here and in West Africa. Along with being a perpetual optimist, I’m also an information junkie, and…
Battered and bruised yet intact, like a dazed boxer entering a late round against an unrelenting challenger, the interim final rule for implementing ICD-10 by October 2015 limped into the federal Office of Management and Budget (OMB) last Friday.
Based on theory, it would seem that ICD-10-PCS root operations could be assigned correctly with relative ease; however, practical application sometimes intersects with coding scenarios that make one question the selection of the appropriate root operation. Hands-on ICD-10-PCS practice continually reinforces that only with the practical application of theory can…
At numerous meetings since the ICD-10 delay was announced, the chasm between large and small providers, entities, and practices has been evident. Obviously, some small groups are well ahead of the pack and some large groups are lagging, but the profound discrepancies keep reappearing. Stanley Nachimson recently commented on the…
EDITOR’S NOTE: Rhonda Buckholtz is testifying today before the National Committee of Vital Health Statistics. It appears that the coding industry is much more ready for ICD-10 than previously believed, and the cost to prepare is proving less expensive than was claimed by other sources, recent AAPC studies indicate.
The short answer to the question posed in the headline is this: it isn’t always easy, but definitely doable. The more important question is, how do you get physicians to learn once they show up? After all, attendance doesn’t always equal learning. This article will provide several tips to increase…
During the past few weeks I have spent time revising project plan timelines and milestones to give organizations more to prepare for ICD-10 – which in most cases is very much needed. All the physicians I have spoken to since the latest delay was announced are indicating that they are…