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During the past several years I have had the opportunity to work with leaders from several hundred hospitals and health systems, as well as the physicians on their medical staffs, and have come to understand the impact of a number of external realities on our profession. These realities are resulting…
As healthcare providers across the nation prepare for the upcoming conversion to ICD-10, projected financial impacts should be factored into planning efforts. As you prepare for the conversion, the magnitude of the coming changes that will affect your employees, your patients, and your bottom line should not be underestimated. There…
Wearing parkas, Ugg boots, earmuffs, and mittens, a contingent of delegates from the American Health Information Management Association (AHIMA) braved one of the snowiest Saint Patrick’s Days in recent memory in Washington, D.C. yesterday, descending on Capitol Hill as part of the association’s 12th annual Hill Day.   While local…
Eliciting more questions than volunteers, listener responses to yesterday’s edition of Talk-Ten Tuesday revealed that although providers are willing to participate in the Centers for Medicare & Medicaid Services (CMS) limited end-to-testing this coming July, uncertainty abounds.   During Tuesday’s broadcast, venerable healthcare authority Stanley Nachimson, once an official at…
Angela Kennedy, PhD, RHIA; president of AHIMA; and Lynne Thomas Gordon, MBA,RHIA, CAE, FACHE, FAHIMA; CEO, AHIMA kicked off the 2014 Leadership and Advocacy Symposium amid a highly unusual March 17 snow storm which did not stop the constituents from meeting with their representatives and senators on March 18.
An annual membership event for the American Health Information Management Association (AHIMA) and its component state associations is to come and advocate for healthcare in Washington, D.C. The California Health Information Association (CHIA) brought its board to the capital city and joined forces with AHIMA leadership, other state health information…
Coder staffing has hit the proverbial brick wall. With thousands of coders consumed by ICD-10 training and thousands more actively involved in dual coding, clinical documentation improvement efforts, and end-to-end ICD-10 testing, hospitals and outsourced coding firms are focusing intently on coder supply, capacity, and development. Everyone is searching for…
EDITOR’S NOTE: In this article, Robert S. Gold, MD, explains problems associated with ICD-10 and answers questions he is frequently asked. Going from a healthcare coding system with 14,000 diagnosis codes to one with 73,000 diagnosis codes is undoubtedly a challenge. But why is our ICD-10 different from that of…
One of the primary benefits of the recent front-end testing of ICD-10 claims was the psychological one, said Tim McMullen, executive director of the Cooperative Exchange, an association representing clearinghouses. He also noted that it showed providers how easy or hard it was to code in ICD-10, and it gave…
On March 3-7, the Centers for Medicare & Medicaid Services (CMS) conducted a highly anticipated and critically needed ICD-10 National Testing Week via all the Medicare Administrative Contractors (MAC). Providers, clearinghouses, and others participated in the first-ever ICD-10 claims acknowledgement testing. This was a major milestone on the ICD-10 implementation…
Julius Caesar William Shakespeare CLICK TO EXPAND Tomorrow, March 15th, is the "Ides of March," a phrase that became memorialized when the Bard, William Shakespeare, wrote "The Tragedy of Julius Caesar." In the play, as in ancient history, a soothsayer comes up to Caesar as he is walking (ultimately to…
Last month I focused on training practitioners in documenting appropriately for ICD-10 and ensuring that training is focused on the right specialty. I mentioned the template rebuilding necessary to support ICD-10 documentation requirements. Many of my hospital systems and physician practices are now beginning the template and workflow revisions. We…
Cooperative Exchange members have more than 5,000 direct payer connections. Imagine the amount of testing that will be going on in the next few months and all the different testing plans. Well, actually you don’t have to imagine – you will be able to find out for yourself! To help…
Now that I am back from Orlando and have had a weekend to spend at home (then a few very long days to dig out of what seemed like a bottomless inbox), I have finally had a chance to reflect fully on my time at the recent HIMSS conference. When…
Halfway through my morning drive to the office, it slowly dawns on me: this is the day! Wednesday, Oct. 1, 2014. Today it starts. ICD-10 is here! I wonder what I will find when I get to the office. Will everyone be in an uproar? Reflecting on my preparation, I…
Under growing pressure from the healthcare industry to make certain that Medicare will be prepared for ICD-10, the Centers for Medicare & Medicaid Services (CMS) is soliciting volunteers to participate in a limited form of end-to-end testing starting in July. The deadline for participation commitments by providers and clearinghouses is…
As we hurtle toward the October 1, 2014, ICD-10 implementation date, it seems more and more focus is on the outlandish, rather than the key documentation issues for physicians and coders. My grave concern is that the current “insanity” is such an unfortunate distraction at such a critical time. In…
As we draw closer to the Oct. 1 implementation of ICD-10, concern about impacts to payment is increasing. On the inpatient side, hospitals are already well aware of the financial relevance of ICD-9 codes, yet the financial impact of ICD-10 is even easier to grasp. On the ambulatory side, the…
We are at the 11th hour of ICD-10 industry transformation, and yet we still are talking about what I-10 codes are, how to do an assessment, how much does they cost to implement, and how to implement them. The healthcare industry will continue to see facilities and providers, etc. work…
“Didn’t ICD-10 get rid of unspecified codes? Isn’t ICD-10 more specific than ICD-9” These are two questions I’ve heard over and over during the period leading up to ICD-10 implementation. And as we near the big day of Oct. 1, 2014, these questions still are popping up in one form…
EDITOR’S NOTE: The following is a transcribed version from Denny Flint’s segment on Talk-Ten-Tuesday, Feb. 25, 2014. What’s the view from the road, Chuck? What’s the view from the road? I’ll tell you the view from the road. It’s the same view as this time last month, and this time…
Guarded hope that the transition to ICD-10 is progressing and confidence that the Centers for Medicare & Medicaid Services will not delay the implementation and enforcement date of October 1, 2014 prevailed during yesterday’s broadcast of Talk-Ten-Tuesday from the 2014 HIMSS conference. Proof of that cautious optimism came from AHIMA’s…
Ana Croxton is worried about gridlock. And has good reason to be since she works in Atlanta, the city that was brought to its knees three weeks ago when two inches of snow and ice blanketed highways and freeways. She’s not worried about the kind that happens on the highway during…
EDITOR’S NOTE: Tom Ormondroyd, vice president and general manager of Precyse Learning Solutions, will offer a series of upfront and personal accounts of his observations and experiences at HIMSS 14, taking place this week in Orlando, Fla. This is the second of his daily dispatches. Food, along with a few…
American Health Information Management Association (AHIMA) Vice President Meryl Bloomrosen, who recently testified before the National Committee on Vital and Health Statistics (NCVHS), will headline a panel of subject matter experts appearing on a special Wednesday edition of Talk-Ten-Tuesday coming up today at 10 a.m. EST.
Are physician offices and those owned by health systems more vulnerable to missing the ICD-10 compliance deadline of October 1, 2014? That issue was raised by Thomas Ormondroyd of Precyse during yesterday’s Talk-Ten-Tuesday broadcast. Ormondroyd worries because at this HIMSS conference, taking place now through Friday in Orlando, Fla., attendees…
Rumors were circulating about the exhibit floor and in meeting rooms yesterday that there would a meeting today with the practice management vendors to assess their readiness. A recurring complaint heard often during our Talk-Ten-Tuesday broadcasts comes from providers who report that ICD-10 vendors will not ready in time with…
As we move toward the ICD-10 deadline of Oct. 1, 2014, educating physicians and non-physician practitioners regarding documentation requirements is an important step. Right now I and many of my colleagues in the industry have begun training physicians how to document with ICD-10.
Citing a report predicting that preparation costs could hit physician practices far harder than previously imagined, the American Medical Association is urging U.S. Department of Health and Human Services Secretary Kathleen Sebelius to reconsider the mandate that ICD-10 be implemented nationwide by Oct. 1.
Before the October 1 ICD-10 implementation date, hospital leaders need to answer a lot of questions about their facility’s healthcare analytics. By now, most have answered the questions related to how ICD-10 will affect coding, billing and reimbursement—but these are just a part of the big picture that must be…
“Isn’t ICD-10 more specific than ICD-9?” “Didn’t ICD-10 get rid of unspecified codes? “ These are two questions I’ve heard over and over during the period leading up to ICD-10 implementation. And as we near the big day of Oct. 1, 2014, these questions still are popping up in one…
EDITOR’S NOTE: Tom Ormondroyd, vice president and general manager of Precyse Learning Solutions, will offer a series of upfront and personal accounts of his observations and experiences at HIMSS 14, taking place this week in Orlando, Fla. This is the first of his daily dispatches. On Sunday, the first official…
Citing a report predicting that preparation costs could hit physician practices far harder than previously imagined, the American Medical Association is urging U.S. Department of Health and Human Services Secretary Kathleen Sebelius to reconsider the mandate that ICD-10 be implemented nationwide by Oct. 1.
“Tick tock, goes the clock…” starts the old nursery rhyme, and in the case of ICD-10, the clock shows that there are just seven month left until the implementation date of October 1. Several guests on Talk-Ten-Tuesday’s February 24 live broadcast from the 2014 HIMSS conference hammered home the urgency…
At the end of a long day – the first official day of the HIMSS14 Annual Conference and Exhibition – Centers for Medicare & Medicaid Services representatives charged with coordinating the adoption of ICD-10 huddled for a private meeting with healthcare association leaders. Front and center for CMS was the…
Succumbing to industry pressure, the Centers for Medicare & Medicaid Services (CMS) today announced that the agency would offer end-to-end testing to what it described as a “small sample group” of providers this summer. Details are expected to follow.   The issue of whether CMS would conduct end-to-end testing has…
We hear the term “testing” on a daily basis and see hundreds of articles on how important testing is, and yet these warnings often go largely ignored. This results in installing defective software and business processes into production. Why does this happen, time and time again? For the most part,…
“Big data” – we have all heard the term, as it points to the degree of ICD-10 specificity that will provide more comprehensive and complete data for outcome analysis and decision-making. As the industry is preparing for the clinical documentation and coding changes inherent in ICD-10, how are we preparing…
As we go through 2014, every month has a number of holidays, each of which applies to at least some of us. So it occurred to me that I could use holidays as inspiration for articles leading up to the greatest secular holiday of the year: Oct. 2, 2014! The…
The Medical Group Management Association’s (MGMA’s) Robert Tennant is among a cadre of 24 healthcare professionals who will be reporting for ICD10monitor’s Talk-Ten-Tuesday from the Healthcare Information and Management Systems Society (HIMSS) annual conference and exhibit in Orlando, Fla. later this month.
Is this really the home stretch? Since the new year began last month, I’ve heard many clients, colleagues, and other acquaintances mention that ICD-10 programs are in the “home stretch.” But I’m not sure I agree. Dictionary.com declares the term as follows: home·stretch (noun) The straight part of a racetrack …
American Health Information Management Association (AHIMA) Executive Vice President of Operations and Chief Operating Officer Deborah K. Green will head a team of subject matter experts signed on to report live from the Healthcare Information and Management Systems Society's (HIMSS) annual conference and exhibit in Orlando, Fla. later this month.
In preparation for ICD-10, there have been innumerable articles published and presentations delivered on lack of physician engagement, how to engage physicians, clinical documentation improvement needs, lack of specificity needed for coding – the list goes on. It seems we are working so hard helping physicians prepare that we have…
January 2014 marked one of the coldest months on record for many states. Below-zero temperatures, mountains of snow, and blustering winds shut down airports and closed classroom doors. Similarly, ICD-10 is predicted to be healthcare’s “storm of the century.” And lost surgical service revenue may pack the nastiest punch. Major…
Observations from Paul Weygandt, MD Industry-wide, there is substantial interest in specialty-specific ICD-10 education for physicians. Recognizing that physicians will not, and reasonably cannot, take a broad approach to learning ICD-10 as do coders and clinical documentation specialists, education is increasingly being focused on those specific areas relevant to a…
With only eight months to go, now is the time to ensure that your hospital or practice maintains a positive cash flow after ICD-10 goes live. A critical initiative will be to understand payers’ expectations regarding the processing of ICD-10 claims. To start, create a spreadsheet that includes all the…
Be part of one of the largest healthcare events in the United States when ICD10monitor brings you three days of broadcast coverage from Orlando, site of this year’s HIMSS. Subject matter experts representing leading healthcare vendors, clearinghouses, and consultants will be calling in live from Orlando to report the latest…
The year ahead is shaping up to be something of a prize fight. You could call it battle of the regulated sectors of the healthcare industry.
One of the biggest challenges we face as we prepare for ICD-10 is getting providers engaged. Too many of my colleagues view this transition as an administrative function or a coding initiative. They lack an appreciation for, and understanding of, how this code set implementation is going to affect their…
As adults, we learn theories in many different ways; however, until we apply those theories or glean “What’s in it for me?” it’s difficult to truly learn much. The opportunity to take knowledge and apply it in practice is a great one, especially when we are talking about ICD-10. I…
Physicians excel at thinking analytically – that is, using a step-by-step clinical decision-making process to arrive at an accurate diagnosis. This logical way of thinking will be a huge asset when it comes to ICD-10. Physicians must ask critical questions of themselves and their staff to determine their “ICD-10 prognosis.”…
Depending on the size of your practice or facility, ICD-10 budgeting requirements and reporting will vary. But one fact still remains: all practices must budget for ICD-10-CM implementation. Most physician-based practices utilize a cash-based accounting system, while larger facilities and hospital-owned clinics utilize accrual-based accounting. Either accounting system will require…
An eponym is defined as the person for whom something is named. In the world of Western science and medicine, eponyms are commonly used to name everything from conditions, drugs, and devices to procedures and techniques. This is a relic from the past, when medicine lacked tools to investigate underlying…
Depending on the publisher, there are about 30 pages of guidelines in the ICD-10-CM code set. The bulk of these guidelines, from section 1.C, are chapter-specific.
In spite of what you may have heard, clearinghouses are indeed ready to facilitate the end-to-end testing of ICD-10 claims between providers and payers. In fact, they have been ready for two years—since implementation of the 5010, according to Gloria Chung, chief operating officer at Office Ally, LLC—one of the…
When preparing for the final steps of ICD-10 implementation, it is suggested that every organization set up a “war room” or “command center” to be available during the transition phase. This technique has been used for years by project management groups and implementation teams in many fields to increase communication…
What if you could tell health plans how they are really doing so they can improve their performance? That’s the intent of a new survey provided by the Cooperative Exchange, a nationally recognized resource and representative of the clearinghouse industry. This confidential online survey provides a means for healthcare electronic…
Just a year ago, the idea of actually being ready for ICD-10 implementation by October 1, 2014, seemed a distant dream, full of confusion and panic. Since then, a lot of people have done a lot of work to get the ball rolling in the right direction, and the guests…
We are in the middle of the rollout of health insurance exchanges of the Patient Protection and Affordable Care Act (PPACA), and there are a few significant lessons the healthcare industry, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) should…
Editor’s Note: Laurie M. Johnson of Peak Health Solutions presented a segment outlining 10 ICD-10 New Year’s resolutions during the Jan. 7 edition of Talk-Ten-Tuesday, the weekly Internet broadcast on www.ICD10monitor.com. The following is a rough transcript of that presentation. January is a month where we all make New Year’s…
Happy New Year! This is a year of significant change. Of course, I am talking about the ICD-10 transition, which will be the most significant change I have seen in the 32 years of my healthcare career. I know many of you are getting very nervous – especially those of…
Physician documentation is of the utmost importance in the healthcare industry, both today and once ICD-10-CM/PCS goes into effect on Oct. 1, 2014. Insufficient physician documentation will continue to be problematic under ICD-10-CM/PCS unless hospitals address the problem now.
EDITOR’S NOTE: Holly Louie is the newest member of the ICD10monitor editorial board. With the final countdown to ICD-10-CM implementation underway, more and more providers are looking for solutions to help them master the looming coding changes. Vendors are investing tremendous resources and marketing various solutions to meet these needs.…
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…
The Workgroup for Electronic Data Interchange (WEDI), in partnership with the 2013 WEDI Report Founding Sponsors, released the 2013 WEDI Report. The culmination of a 7-month public-private effort with more than 200 subject matter expert volunteers, this report will serve as a new roadmap for healthcare IT over the next…
EDITOR’S NOTE: This is the ninth in a series of articles on fast-tracking ICD-10 implementation. This month marks the beginning of the “Countdown to ICD-10.” We have only 10 months left to get ready. Many of my clients have been asking, “What are the top four areas of implementation that…
One of the biggest questions doctors have these days is “which codes will I actually use when ICD-10 kicks in on Oct. 1, 2014?” This is the great mystery. Fortunately, we have access to the same code set that payers will be using as they determine which codes they would…
Every major religion seems to have some sort of festival in the December-January time frame, and as far as I can determine, all of them are positive, upbeat, and “sharing” in nature. If you celebrate such a holiday at this time of year, best wishes to you and yours. One…
An implementation plan without contingency planning is most likely an incomplete plan, according to Joseph C. Nichols, MD. Nichols, in a soon-to-be-released white paper, writes that contingency planning must “be an integral part of the implementation plan in order for it to reduce the risk of failure.” Expressing deep concern…
Many individuals working within the healthcare arena will recognize the above phrase, as it is extracted from the legacy of surgical training. While perhaps overstating a surgical resident’s ability to assimilate information, the principle does, in fact, describe the process of learning within many surgical and medical specialties. As an…
The looming implementation of ICD-10 is doing a great job exposing the gaps that currently exist in our healthcare delivery stream. One such gap can be found in the flow of diagnostic information from a physician to ancillary providers such as labs, imaging centers, and home health providers, just to…
In a survey conducted by the Cooperative Exchange this fall, a large number of clearinghouses report they are well positioned for implementation of ICSD-10 on October 1, 2014. The Cooperative Exchange (CE), established in 2002 to promote and advance electronic data exchange for the healthcare industry by improving efficiency, advocacy,…
Implementing integrated clinical documentation improvement (CDI) and computer-assisted coding (CAC) technology platforms can help hospitals achieve more positive results than would be realized using CAC alone. The most significant impact CDI technology has on the CAC component of an integrated platform is creating high-quality documentation, and documentation has a direct…
Nobody enters a race to finish second, and no team fields just their defense. During recent months there has been a clear business rationale for focusing on essentially defensive strategies for wrapping the ICD-10 transition in revenue neutrality. But as planning for 2014 falls into place, an argument has been…
Below is a case study that identifies some of the subtle differences between the descriptions of ICD-9-CM and ICD-10 codes. Note that the ICD-10 codes provide a higher level of specificity to the code assignment. Postoperative diagnosis: Colloid cyst of the third ventricle Operation: Bi-frontoparietal craniotomy, transcallosal removal of colloid…
Editor’s Note: For another installment of profiles of thought leaders in the healthcare industry, ICD10monitor’s publisher recently interviewed healthcare executive-turned-healthcare consultant Lyman G. Sornberger. Having stunned the healthcare industry with his abrupt departure from the famed Cleveland Clinic Health System (CCHS) in November 2012 for what he told the Cleveland…
EDITOR’S NOTE: This is the first article from Rhonda Buckholtz, vice president of ICD-10 education and training at AAPC, who has joined the ICD10monitor editorial board. We talk about documentation and how it needs to change under ICD-10, but really, the implementation of new codes should not be why documentation…
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 set to the other, we are providing tips for coding…
Few providers are aware of the risk adjustment model that is quietly emerging under the Patient Protection and Affordable Care Act (also known as the ACA). That model is known as the Hierarchical Condition Categories (HCCs), and it has been the basis for reimbursement for Medicare Advantage plans (Medicare Part…
The emergency department (ED) is a hospital’s front door to the public. It’s also an open back window for revenue loss. ED volumes continue to rise while reimbursements drop. And according to recent executive surveys, there is no end in sight. Long wait times, primary care shortages, and an underinsured…
In January 2011, Cedars-Sinai Health System engaged a consulting firm to help build an initial project management plan for its global ICD-10 implementation. The plan started as a risk assessment and recommended governance structure. As we started developing a more detailed plan and moved into execution, the need for multidisciplinary…
As I write this, it’s mid-afternoon on Veterans Day. It’s also one of those rare moments when I actually reminisce about my time in the U.S. Air force – more than eight years, actually – and whether I made a difference. Oh, I’m no martyr. I know my time in…
I have a confession: I’ve had a sour attitude about ICD-10 lately. I know I’m not the only one, but I’m usually the champion and cheerleader for the new coding set. It seems like there’s a large amount of negativity surrounding the transition to ICD-10, and the loudest voices seem…
The recent decision by the Centers for Medicare & Medicaid Services (CMS) to set aside the week of March 3-7, 2014 as ICD-10 Testing Week is raising concerns among healthcare industry experts. Amid a flurry of rumors that CMS stakeholders were reconsidering the need for end-to-end testing, the agency issued…
For many, the ICD-10 journey can be compared to running a marathon – and with less than one year until implementation in the United States, all providers should be well into their preparation plans and nearing the finish line. In other words, providers should be in their final stages of…
EDITOR’S NOTE: This is the first in a continuing series of profiles of healthcare thought leaders. Angela Kennedy, EdD, MBA, MED, RHIA, CPHQ, president/chair, AHIMA Board of Directors. Kennedy is also chair of the health informatics and information management department at Louisiana Tech University.  She served two terms as president…
EDITOR’S NOTE: This is the eighth in a series of articles on fast-tracking ICD-10 implementation. As I started developing training plans for hospital facilities and physician practices, I realized it would not be an easy process. It may sound simple, but it isn’t. There is so much to consider: who…
Cooperative Exchange, the national association representing organizations in the healthcare information technology and transaction industry, held its membership meeting last month in San Diego during the MGMA National Conference on October 8. The number one topic of discussion: Transitioning from ICD-9 to ICD-10 on October 1, 2014, and the clearinghouse…
The debt ceiling crisis of 2013 temporarily brought the U.S. government to a halt and pushed both political parties into an arduous, lengthy budget showdown. Just like the U.S. government, hospitals annually struggle to rob Peter to pay Paul. Cost reductions and expenditure cuts are commonplace for healthcare providers.
Basic combat training in the U.S. Military is a 10-week training course that transforms civilians into soldiers. Likewise, basic coder training for ICD-10 turns ICD-9 coders into ICD-10 experts. Or does it? Just like in the military, it’s hands-on experience and day-to-day exposure that turns basic training into ICD-10 expertise.…
Codes in the ICD-10-CM code set are more detailed than the codes included in ICD-9-CM. To assign these detailed codes, physician documentation will need to include more specific and detailed information. There are ICD-10 codes for unspecified conditions, and coders have indicated they could avoid the query process and assign…
I must admit, I’m not much of a hipster and I don’t know what a hashtag really is. I’ve tweeted once in my life, and it was for a very uncool purpose (I was at a conference and they had a gimmick where attendees could tweet songs they wanted to…
We are less than a year away from ICD-10 GO LIVE and we have either not quite started, done a little, are in the throes of moving our plan along, continuing to firm up our documentation, or are getting ready to move into dual coding. That is certainly going from…
ICD-10 is the lollapalooza of healthcare. It’s the curtain going up on a Broadway premiere. It’s the opening seconds of the worldwide telecast of The Oscars. It is the solid clank of the metal safety harness pressed hard against your legs on the Cyclone roller coaster on Coney Island, when…
Greetings, everyone. In this article, first I want to address some “show” business; then I want to talk about the deadline no one seems to know about. Since the AAPC National convention in May, I’ve been to national trade show after show. Most recently it was the Medical Group Management…
A few weeks ago, while teaching an ICD-10 seminar for chiropractic doctors, one physician asked me if ICD-10 solved the sprain/strain issue that exists under ICD-9. Frankly, I was not familiar with the problem, so I did a little digging.
We’re now into our final year of preparation for ICD-10 implementation, and it seemed like a long time coming. Most of us have had a detailed implementation plan with a timeline and deliverables in place for some time now. For those of you working in health information management (HIM) and/or…
Unfortunately, many healthcare leaders do not believe they have time for ICD-10 education with all of the significant operational changes now occurring in the healthcare industry. That’s the view expressed by Greg Adams, president of consulting services at Panacea Healthcare Solutions. Adams was addressing the impact of ICD-10 on education…
While ICD-10 has been touted as “revenue neutral” by CMS, HIM professionals at this week’s 85th annual convention of the American Health Information Management Association (AHIMA) know different.