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I listened in via the Web on the Wednesday U.S. House of Representatives Energy and Commerce Committee Health Subcommittee hearing on examining ICD-10 implementation. The subcommittee chairman, Joseph Pitts of Pennsylvania, opened the meeting with a brief overview of ICD-10. Testimony was presented by Carmella Bocchino, executive vice president of…
I was eagerly awaiting Wednesday’s hearing to see what information would be presented to the U.S. House of Representatives Energy and Commerce Committee’s Subcommittee on Health. In opening statements, U.S. Rep. Joseph Pitts (R-Penn.), the chairman of the subcommittee, expressed his support for the Oct 1, 2015 date for implementation…
Talk Ten Tuesdays will broadcast a special legislative update on the outcome of the implementation of ICD-10 following testimony during a hearing being conducted by the U.S. House of Representatives Energy and Commerce Committee's subcommittee on health.
The Government Accountability Office (GAO) reported Friday that a majority of stakeholders believe that ICD-10 educational and outreach activities by the Centers for Medicare & Medicaid Services (CMS) have been helpful in preparing for the Oct. 1, 2015 compliance deadline, but work remains for states to complete testing of the…
February 9, 2015

Correction

By
In the February 3, 2015 edition of ICD10monitor enews it was incorrectly reported that American Medical Association was currently working with the House Rules Committee Chair Pete Sessions (R-Tex.) and House Energy and Commerce Committee Chair Fred Upton (R-Mich.) to add language to a 2015 fiscal year appropriations bill for…
The age of multitasking, overscheduling, and 24-7 technology connectivity has given way to increased use of the phrase “quality time.” As in, “my family and I are turning off our phones tonight and spending some quality time together.” Or “this weekend, we’re going camping for some quality time with friends…
We’re getting closer to the probable implementation date for ICD-10, and we all know about the fear of the unknown that’s so prevalent in the healthcare industry.
Back in November, I wrote about clinical documentation improvement (CDI) in the medical practice and the importance of this critical step in adopting ICD-10. It will not only improve diagnosis coding, but also compliance for procedures and services reported by the practitioner.
EDITOR’S NOTE: This is the first in a series of articles from Mollie Niznik a senior in the Health Information Management (HIM) program at The College of St. Scholastica in Duluth, MN. Writes Niznik, “I look forward to my future in the HIM field after graduation in May.” As a…
It’s difficult to argue with the logic that you can’t build a modern skyscraper (or, really, any structure of significance) on a crumbling foundation. Unfortunately, that logic does not apply to the modernization of America’s healthcare system, much of which continues to use an antiquated coding system called ICD-9 that…
About 10 months have passed since ICD-10 implementation was delayed for another year, but the possibility for yet another delay still looms. ICD-10 implementation was delayed because it was tied to the “one-year doc fix,” otherwise known as the Protecting Access to Medicare Act of 2014 (PAMA). This legislation, which…
Now that the New Year is here, we’re certainly counting down the months to the scheduled October 2015 implementation of ICD-10. Your ICD-10 implementation plan must include education and training. This is key to your success with the new code set. It takes education, learning and building of knowledge, training,…
Editor’s Note: This is the fourth article in the continuation of a series of articles on clinical documentation improvement by clinical service. We have turned the calendar to a new year, and as such, we will look at a new service: pulmonology and respiratory surgery, both of which may present…
As I’ve read and listened to so many passionate arguments for and against ICD-10, it has always seemed that there is more to the story than some think. How can a simple coding change, albeit a whopper, create such angst, animosity, argument, and adversarial positions? Why are so many physicians…
Ministry Health Care is a network of 15 hospitals in the American Midwest that places special attention on servicing the needs of lower-income families and their local communities. Their hospitals service more than 90,000 outpatients annually, with more than 455,000 total visits, and those providers have received awards from independent…
In April 2014, ZirMed began its end-to-end testing efforts with commercial payers such as Blue Cross Blue Shield of Florida. We continued testing with several government and commercial payers throughout 2014. As ZirMed continues to engage in testing with payers, we identify more and more front-end edits to enable miscoded…
Call 2014 the Year of the Hack. There were cybersecurity breaches at major retail chains such as Home Depot and Target, resulting in the release of personal information and credit card data belonging to tens of millions of people. There were internationally renowned celebrities who had their iCloud accounts illegally…
“ICD-10 implementation has not been as hard as they thought it would be, and … overall it has improved processes and documentation in their practices.” Similar comments were echoed by many of the more than 2,000 respondents who participated in a recent AAPC ICD-10 Testing Survey.
The change in classification of cardiomyopathies — diseases that can affect the function of the heart and, if progressive, may lead to heart failure — from one that is disease-based to one that is infested with echocardiogram findings, is a step backward in time and contrary to the intent of…
Monica Greene remembers with perfect clarity the response one friend had when she broke the news to him a little more than 20 years ago: she was a woman trapped in a man’s body. “Couldn’t you just lie for the rest of your life?” Greene recalled the friend saying –…
As a company with deep roots as a government contractor focused on national security, Leidos Health supports and advocates for the Oct. 1, 2015 compliance date to transition to ICD-10-CM/PCS. Recent events have driven company representatives to speak out about a potential impact that many may be overlooking. The purpose…
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…
Centers for Medicare & Medicaid Services (CMS) Chief Marilyn Tavenner is stepping down, according to news reports. Tavenner made the announcement to in a letter to colleagues today, but said she will remain at her post until February. On her watch, the at-times embattled administrator dealt with ICD-10 being delayed…
Note: ICD-10 and Gender Identity Disorder featured today on Talk Ten Tuesdays, 10 ET - Register here. Gender identity dysphoria, formerly known as gender identity disorder, hit the mainstream media recently due to the tragic suicide of Leelah Alcorn of Kings Mill, Ohio. The 17-year-oldended her life in part to…
It’s 2015, and ICD-10 is coming…again. Some of us have made good use of an extra year to prepare, but for many smaller hospitals and physician practices, it appears that the procrastination caused by the last delay (from 2013 to 2014) is being repeated. However, 2015 will not be a…
During the first quarter of 2014, Congress enacted a one-year delay in the implementation of the ICD-10 code sets, extending the implementation date from Oct. 1, 2014 to Oct. 1, 2015. This delay initially was met with uncertainty, and various organizations (providers and payers) deployed different strategies – alternately pausing,…
While the ICD-10 transition will require a well-orchestrated effort from multiple stakeholders, it is the medical coder who must learn and apply the brand-new language of ICD-10. A strong team of coding professionals who have been educated, trained, and prepared will make or break your transition into this new reality.…
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…
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…
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.
Gender identity disorder (GID), also known as gender dysphoria, will be the focus during the season premiere of Talk Ten Tuesdays on Jan. 13 at 10 a.m. EST, according to executive producer and program host Chuck Buck. The broadcast will feature nationally prominent psychiatrist H. Steven Moffic, MD, a frequent…
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…
The Healthcare Administrative Technology Association (HATA) is off to a tremendous start as a leader and key voice for the healthcare administrative technology industry. Launched in July 2014, this association provides a forum for members to form a collective representative voice advocating on behalf of an industry that represents nearly…
Despite a significant lobbying effort mounted by a small but very vocal minority within the healthcare industry, the implementation of ICD-10 is expected to proceed without further delay. The failed push marked a third attempt to delay the Oct. 1, 2015 ICD-10 implementation deadline well into 2017. Members of Congress…
It has been a very challenging 2014. There have been many starts and stops associated with the implementation of ICD-10, as much confusion arose when it was delayed yet again in the spring of this year. How can you prepare and get ready for such an important transition when the…
EDITOR’S NOTE: This article originally appeared in the ICD10monitor e-news on Dec. 18, 2012. Just as sure as the menorah is on display at the deli and Santa Claus can be seen stuffing himself down that cheesy cardboard chimney at the hardware store, one day soon you will notice when…
Risk adjustment is an actuarial tool used to predict healthcare costs and adjust payments to healthcare plans to cover expected relative costs for providing coverage to enrollees. Risk adjustment ensures that health insurance plans have adequate funding to provide care to people who are likely to have high healthcare costs…
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…
ICD-10 could live to see another day. The House Appropriations Committee posted the $1.1 trillion spending bill Tuesday night. According to the American Health Information Management Association (AHIMA) there is no language tucked into the bill that would delay the implementation of ICD-10.
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…
As attention turns toward end-of-year activities such as the holidays, giving back, and spending time with family, physicians may find themselves on the receiving end of a few freak holiday accidents. The new and sometimes jaw-dropping granularity of ICD-10 codes represents a daunting new level of detail that will become…
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 2, and 4,the sixth character defines the device– i.e., the graft,…
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…
As I reflect on the many comments from physicians, coders, educators, auditors, and various organizations, a message of frustration keeps creeping into the conversation. Physicians aren’t cooperating. Physicians don’t want to hear about ICD-10. I can’t get my doctors interested. As I reflect on the reasons that might exist for…
EDITOR’S NOTE: Dr. Wilbur Lo reports on coding ASD in ICD-10 as part of ICD10monitor’s coverage of the advantages of coding and documenting ASD in ICD-10. According to the National Institute of Mental Health, Autism Spectrum Disorder (ASD) is characterized by a wide range of symptoms and levels of impairment…
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…