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EDITOR’S NOTE: This is the final installment in a three-part series on data analytics. As indicated in my article in the October 30, 2012, ICD-10 Monitor, providers must perform data analytics now so that they can drill down and identify documentation weaknesses.  Phase one includes running your data, and phase…
We all agree that testing is going to be a critical phase of the ICD-10 transition. The system upgrades, testing and adjudication of test data results with external partners will be complex. The development of your master testing plans will serve as a road map for testing and will define…
We all agree that testing is going to be a critical phase of the ICD-10 transition. The system upgrades, testing and adjudication of test data results with external partners will be complex. The development of your master testing plans will serve as a road map for testing and will define…
As we progress toward the Oct. 1, 2014 implementation deadline, some differences in opinion are arising regarding who bears the burden of knowledge relevant to ICD-10. Clearly, the coding industry is rapidly gaining the requisite education to transition to ICD-10, and numerous IT solutions are developed or under development, but…
Postoperative pain typically is considered a normal part of the recovery process following most forms of surgery. Such pain often can be controlled using typical measures such as pre-operative, non-steroidal, anti-inflammatory medications; local anesthetics injected into the operative wound prior to suturing; postoperative analgesics; and even intra-operative or post-operative injection…
Career Step, one of healthcare’s leading educational companies and the provider of The ICD-10 Solution, has signed an agreement to be a major sponsor of ICD10monitor. The agreement was announced jointly by Michael Hodgson, vice president of healthcare and corporate partnerships for Career Step, and Chuck Buck, publisher of ICD10monitor.…
Podcast Date: 12/11/2012 Which is your biggest concern related to I-10 Testing readiness? Number of Response(s) Response Ratio A. Provider readiness 137 53% B. Payer readiness 91 35% C. Vendor readiness 31 12% Total Results: 291 100%
The winter season begins on Dec. 21 (the winter solstice and the shortest day of the year, if you live north of the equator) and ends in March. Among several major religions, nationalities and ethnicities, winter brings with it holidays, which often include traditions of gift-giving, celebration, and, in most…
The winter season begins on Dec. 21 (the winter solstice and the shortest day of the year, if you live north of the equator) and ends in March. Among several major religions, nationalities and ethnicities, winter brings with it holidays, which often include traditions of gift-giving, celebration, and, in most…
If you are a physician, your eyes may glaze over instantaneously whenever you hear someone speak of ICD-10. Physicians, as well as most clinicians (speaking of myself), are generally not accustomed to change. Rightfully so for the last 30-plus years (and technically since 1979), hospitals have been reporting inpatient surgical…
Realizing the opportunities and avoiding the risks associated with the migration to ICD-10 will depend fundamentally on the individuals within each healthcare organization and their ability to thrive within this changing environment. What is required is an organization-wide approach that: Shows the impact of the ICD-10 migration across the organization;…
EDITOR’S NOTE: This is the last installment of a two-part series about ICD-10 readiness. In Part 1 of “Assessing ICD-10 Readiness,” I talked about the different perceptions in the industry regarding the varying degrees of readiness among providers. In part, this is because of the inherent issues involved with self-assessments.…
The online Urban Dictionary defines “chicken scratch”— also known as illegible medical record documentation in the healthcare industry—as follows: “Incredibly messy handwriting that is nearly impossible to read. Usually the only person who can read it is the person that wrote it. Sometimes not even they can read it after…
EDITOR’S NOTE: This is the second in a two-part series. There were very few changes to the ICD-10-CM Draft code set for 2013 – as was expected due to the partial code freeze that will be in effect through 2014. Changes in the 2013 ICD-10-CM Draft code set primarily consisted…
EDITOR’S NOTE: This is the final installment in a two-part series on clinical documentation improvement. Claim delays with slowed production means reduction in revenue. It is difficult to determine the amount of change that would be involved with the additional time necessary to document care, but will be based on…
Thanksgiving is an emotional holiday for many folks. People travel hundreds or even thousands of miles to be with people they only see maybe once a year (and then sometimes rediscover why once a year is way too often). You know that at the first Thanksgiving with the pilgrims, there…
Operative reports for breast procedures often confuse coding professionals because physicians use certain phrases—such as biopsy, lumpectomy, and excisional biopsy—interchangeably in their documentation. Just because physicians know what they mean does not mean that coding professionals will know unless they have an understanding of the procedure and the specificity of…
Podcast Date: 11/27/2012 Where is your organization related to I-10 Testing? Number of Response(s) Response Ratio A. Haven't addressed it yet 52 18% B. We are doing our assessment 73 25% C. It's in our implementation plan 112 38% D. We have begun testing 34 12% E. Not applicable 20…
EDITOR’S NOTE: This is the first in a two-part series. There were very few changes to the ICD-10-CM Draft code set for 2013 – as was expected due to the partial code freeze that will be in effect through 2014. Changes in the 2013 ICD-10-CM Draft code set primarily consisted…
EDITOR’S NOTE: This is the first installment in a two-part series on clinical documentation improvement. Because of the greater specificity of ICD-10-CM and ICD-10-PCS along with the opportunity to report the severity of a patient’s condition in more detail, it is anticipated most health plans will require a more detailed…
EDITOR’S NOTE: This is the second of a two-part series taking a close look at a collaborative approach to ICD-10 testing. The first of the two biggest issues the industry must deal with is that end-to-end testing, through which information flows from provider to payer and back again, will not…
As we anticipate the adoption of ICD-10-CM, there is a bit of uncertainty regarding non-covered entities as cited in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). One of the largest groups of these non-covered entities is the workers’ compensation insurers. Although they are not a covered entity…
Podcast Date: 11/13/2012 What will your practice do if your state workers' comp does not require acceptance of ICD-10 CM codes after Oct. 1 2014? Number of Response(s) Response Ratio A. Maintain dual billing systems for at least one year 108 55% B. Submit I-10-CM codes with electronic claims, let…
Now that the implementation date for ICD-10 is finalized, the next step many are tasked with is to figure out the training schedule for education. It is prudent to make the best use of the two-year timeline remaining; however, many continue to ask themselves….Is it too soon to start training…
EDITOR’S NOTE: This is the first in a two-part series. No one really knows which ICD-10-CM codes will be deemed “medically necessary” for which procedures – at least, not yet. However, we can make educated guesses.
The quality of a decision most often is a function of the information you rely on to make that decision. In the next two years, ICD-10 program managers will have to decide: What partners should I perform transaction testing with? How can I use my resources best to help ensure…
EDITOR’S NOTE: John Pitsikoulis, who lives in Downingtown, PA, which is outside of Philadelphia, rode through Sandy with minimal damage. A horrendous storm battered the Northeast recently, killing more than 100 people and causing tens of billions of dollars in damage. I always have been taught that material things, while…
If you are one of the thousands of 17 people who bother to read my contribution each month, you know I’m opinionated, somewhat caustic, and borderline rude I can be somewhat acerbic in my presentation. I have been advised by 42 air-headed pseudo-intellectuals one individual that I should take it…
As we move clinical documentation forward into the world of ICD-10 and value-based purchasing, the accurate coding and reporting of complications of care likely will become even more of an area of focus for healthcare facilities. This increased scrutiny only will underscore the ongoing struggle to balance the accurate reporting…
A galaxy of ICD-10 healthcare experts are lined up for their appearances on Talk-Ten-Tuesday, the live 30-minute Internet radio broadcast every Tuesday morning beginning at 10 a.m. Eastern. Coming up today will be the following thought leaders:
Last month on Talk Ten Tuesday, I thought it would be fun to do something a little different, so I performed an ICD-10 rap song I wrote called “Coder’s Paradise.” Except for my singing on the chorus (by the way… I thought I could sing. My mom says I can…
Last month on Talk Ten Tuesday, I thought it would be fun to do something a little different, so I performed an ICD-10 rap song I wrote called “Coder’s Paradise.” Except for my singing on the chorus (by the way… I thought I could sing. My mom says I can…
As facilities begin their ICD-10 preparations, one thing to keep in mind is coding audits. Coding is not a “once you learn the basics, you are set” type of job. To keep coding skills strong and healthy requires on-going exercise and stretching. You can never have too much education, training,…
I’m writing this article in my cold, dark home, having been without power for the past 48 hours due to Hurricane Sandy’s wrath and (in my opinion) my power company’s lack of understanding of the magnitude of the storm’s requirements and a lack of planning. It’s been a sleepless couple…
As we prepare for the implementation of ICD-10, there is much discussion in the industry about the need for better documentation because of the more detailed nature of the new codes. The ultimate educational goal in the next two years is to show physicians and other practitioners how more specific…
Podcast Date: 10/30/2012 What percent if your payers are incorporating HCCs into their payment structure? Number of Response(s) Response Ratio A. Minimal less than 10% 20 12% B. Moderate 11-25% 19 11% C. More than 25% 20 12% D. None 12 7% E. Not applicable 98 58% Total Results: 169…
EDITOR’S NOTE: This is the first in a two-part series on the collaborative approach to ICD-10 testing. The ICD-10 date has been set, organizations are mobilizing, and the airwaves are flush with numerous ICD-10 testing strategies to help the healthcare industry cope with the challenges of both internal and external…
As expected, commercial payers started working on ICD-10 readiness several years ago and are integrating very specific contract language addressing ICD-10 and the potential impact on payment differentials. It is imperative as part of your ICD-10 implementation planning to include a review of all your managed care and commercial payer…
Now that we have a new ICD-10 implementation date of October 1, 2014, it is time to get back on track. Industry experts agree that providers should be focusing on two tasks: Performing data analytics and finalizing education plans. As you may know, Talk-Ten-Tuesday airs every Tuesday at 10 a.m.…
For the last few days, folks on the East coast have been wondering whether and when Hurricane Sandy with its high winds and flooding will hit. No matter how well we prepare, it’s already causing havoc, producing anxiety and even a little fear at the disruptions it will cause. By…
Podcast Date: 10/23/2012 What type of Physician response are you getting to your queries? Number of Response(s) Response Ratio A. Agree with majority 156 53% B. Disagree with majority 3 1% C. Ask for clarification 35 12% D. No response most of the time 33 11% E. Not applicable to…
Have you ever pondered why residents and medical students do not understand how to document? Having been associated with resident physicians and medical students all of my career, I have been baffled trying to comprehend which part of “documentation in a medical record” they do not understand. Last evening, we…
Fiscal year 2013 began on October 1 for the inpatient prospective payment system (IPPS) along with its expanded versions of Medicare quality initiatives, including the Hospital Acquired Condition (HAC) Program. As you know, present on admission (POA) reporting figures into the determination of whether a condition is hospital-acquired or not.
Like all other healthcare providers, radiology providers must plan for ICD-10 system implementation by building organizational awareness and developing a communication plan. To help achieve that goal, the Centers for Medicare & Medicaid Services (CMS) have provided a “formal roadmap.”
E-supply chains are not unique to other industries, but it is a concept that is not considered aligned with patient care, when in fact the healthcare supply chain is measured by its ability to deliver value to the end customer: the patient! The E-supply change, or E Health, will require…
E-supply chains are not unique to other industries, but it is a concept that is not considered aligned with patient care, when in fact the healthcare supply chain is measured by its ability to deliver value to the end customer: the patient! The E-supply change, or E Health, will require…
EDITOR’S NOTE: This is the first of a two-part series about ICD-10 readiness. If you read enough about ICD-10, you’ll hear differing opinions about industry readiness. In some reports, a majority of entities are close to being on track and in others the entire industry is lagging dangerously behind. It…
Podcast Date: 10/16/2012 What is your Physician response rate? Number of Response(s) Response Ratio A. 70% or greater 92 31% B. 30-69% 99 34% C. Up to 29% 24 8% D.We don't have a CDIP 78 27% Total Results: 293 100%
My company is dedicated to all things ICD-10 all the time, so it’s important for us to stay abreast of what’s happening around the country, and we do that by occasionally polling health care organizations. For last month’s survey, we focused on small-to-medium-sized practices and asked two simple questions: “What…
My company is dedicated to all things ICD-10 all the time, so it’s important for us to stay abreast of what’s happening around the country, and we do that by occasionally polling health care organizations. For last month’s survey, we focused on small-to-medium-sized practices and asked two simple questions: “What…
There is a word that has long been held sacred by the chiropractic profession: The so-called vertebral “subluxation.” Throughout ICD-9, the term “subluxation” is used to describe a “partial dislocation,” which is not how it is defined by many chiropractors. Medicare defines it reasonably well on behalf of the chiropractic…
There is a word that has long been held sacred by the chiropractic profession: The so-called vertebral “subluxation.” Throughout ICD-9, the term “subluxation” is used to describe a “partial dislocation,” which is not how it is defined by many chiropractors. Medicare defines it reasonably well on behalf of the chiropractic…
Most healthcare organizations recognize that they have to know more about what their vendors, trading partners and providers are doing to get ready for ICD-10 – and what will affect their readiness. Information you must get from those entities includes their project plan statuses, which IT systems they use, and…
Developing an ICD-10 project plan for complying with the October 2014 deadline is one important first step many organizations have accomplished. While there are some great resources for organizations to utilize in order to manage key remediation components involving assessment and implementation, many organizations are relying on a “check-the-box” methodology…
Developing an ICD-10 project plan for complying with the October 2014 deadline is one important first step many organizations have accomplished. While there are some great resources for organizations to utilize in order to manage key remediation components involving assessment and implementation, many organizations are relying on a “check-the-box” methodology…
The clock is ticking leading up to October 2014, and there are now only 24 months left before the transition to ICD-10-CM/PCS. This seems like plenty of time, but if organizations haven’t started their preparations yet, they must do so now. Although the main thrust of any ICD-10 conversation revolves…
Podcast Date: 10/9/2012 Have you established and end-to-end testing plan for ICD10? Number of Response(s) Response Ratio A. Yes our plan is complete 13 5% B. We are working on our plan 125 46% C. We haven't started working on it yet 66 24% D.What is end-to-end testing? 44 16%…
As I discussed last month, engaging your physicians in the transition to ICD-10, despite your best efforts and months of planning, may continue to seem a daunting task – a notion fueled by the recent delay, peer skepticism and a lack of focus on a requirement that won’t be implemented…
As I discussed last month, engaging your physicians in the transition to ICD-10, despite your best efforts and months of planning, may continue to seem a daunting task – a notion fueled by the recent delay, peer skepticism and a lack of focus on a requirement that won’t be implemented…
I have been working on an e-learning program for ICD-10-PCS, which allowed me to review coding conventions and guidelines for Section 1 – Obstetrics. Because most of my focus since attending the American Health Information Management Association (AHIMA) ICD-10 Trainer Workshops has been on ICD-10-CM and the Medical and Surgical…
Let’s face it: During the ICD-10 “dark period” (the time from when the federal government in February announced that there was the potential for a delay to the recent August announcement of a final rule on the implementation date), provider organizations didn’t do a whole lot to advance their ICD-10…
In what might the first healthcare parody of the Carly Rae Jepsen’s mega hit, “Call Me Maybe,” Maria Bounos last week sang her version adding to the list on Internet parodies on the song that seems to have Americans humming these days. Bounos sang her version during the Wednesday edition…
In what might the first healthcare parody of the Carly Rae Jepsen’s mega hit, “Call Me Maybe,” Maria Bounos last week sang her version adding to the list on Internet parodies on the song that seems to have Americans humming these days. Bounos sang her version during the Wednesday edition…
As we all know, football season has started again, and it is time to get back in the game. But football is not the only thing we should be thinking about right now. It is time to jump-start your ICD-10 game plan as well. I am certain everyone in the…
A seventh character has been added to some chapters of ICD-10-CM. The meanings of the seventh character vary across chapters and categories, though. The language of each applicable ICD-10-CM category will identify the necessity to use a seventh character. The applicable seventh character is required for all codes within certain…
A seventh character has been added to some chapters of ICD-10-CM. The meanings of the seventh character vary across chapters and categories, though. The language of each applicable ICD-10-CM category will identify the necessity to use a seventh character. The applicable seventh character is required for all codes within certain…
 Tuesday, Sept. 22, 2015 10-10:30 a.m. ET; 7-7:30 a.m. PT   FEATURING Maria T. Bounos RN, MPM, CPC-H, PMC, CSPO; Gloryanne Bryant, AHIMA-Approved ICD-10-CM-PCS Trainer;  Betty Gomez; H. Steven Moffic, MD; Stanley Nachimson; and  Rhonda Taller, MHA      Like sailors watching a storm approaching on the horizon, healthcare professionals…
Podcast Date: 10/2/2012 Where do you think your facility falls with your readiness plan? Number of Response(s) Response Ratio A. Ahead of the game 31 10% B. Right on track 137 43% C. Slightly behind 96 30% D.Way behind 31 10% E.We haven't started yet 22 7% Total Results: 317…
The U.S. healthcare industry has had a sharp focus on ICD-10-CM, in turn publishing a great amount of guidance on the upgraded coding set and its projected impacts. However, the real game-changer is ICD-10-PCS. ICD-10-PCS is a new classification system that replaces the third volume of ICD-9-CM, which is used…
The U.S. healthcare industry has had a sharp focus on ICD-10-CM, in turn publishing a great amount of guidance on the upgraded coding set and its projected impacts. However, the real game-changer is ICD-10-PCS. ICD-10-PCS is a new classification system that replaces the third volume of ICD-9-CM, which is used…
EDITOR’S NOTE: This is the third installment in a three-part series about the author’s encounter with a physician and his staff regarding the clinical documentation of a patient who had suffered a hairline fracture of the left ankle. In this final installment, the author describes the granularity of ICD-10. Granularity…
EDITOR’S NOTE: This is the third installment in a three-part series about the author’s encounter with a physician and his staff regarding the clinical documentation of a patient who had suffered a hairline fracture of the left ankle. In this final installment, the author describes the granularity of ICD-10. Granularity…
When I began writing articles for ICD-10monitor, ICD-10 itself was looming on the horizon – on Oct. 1, 2013, to be specific. Now, as we all know, ICD-10 is being delayed until Oct. 1, 2014, which is still more than two years away. While two years is very little time,…
Now that the Centers for Medicare & Medicaid Services (CMS) has issued the final rule establishing Oct. 1, 2014 as the official date for implementation of ICD-10, physicians, hospitals, and health systems are recommitting to their preparatory efforts – which, perhaps, were dormant during the extended period of ambiguity. As…
EDITOR’S NOTE: On a recent Talk-Ten-Tuesday broadcast, Denny Flint, president of Complete Practice Resources, entertained the radio audience with an original rap song entitled, “Coder’s Paradigm —HIT IT.” In response to numerous requests, we have reprinted his lyrics. Since today’s topic focuses on education, I want to stress the importance…
Small hospitals and provider practices can thank the Centers for Medicare & Medicaid Services (CMS) for developing separate ICD-10 “implementation guides” for them to use. Each guide provides detailed information for planning and executing the ICD-10 transition, and CMS urges providers to use them as a reference “whether you're in…
It took just 30 minutes for four members of the ICD-9-CM Coordination and Maintenance Committee (the Committee) to provide ICD-10 updates at its Sept. 19, 2012, meeting—thanks, in large part, to the partial code freeze now in effect for ICD-9 and ICD-10 and the delayed implementation date for ICD-10 of…
It took just 30 minutes for four members of the ICD-9-CM Coordination and Maintenance Committee (the Committee) to provide ICD-10 updates at its Sept. 19, 2012, meeting—thanks, in large part, to the partial code freeze now in effect for ICD-9 and ICD-10 and the delayed implementation date for ICD-10 of…
Since 2009, many healthcare organizations have worked diligently to plan and execute the revamping of systems and processes for a successful transition to ICD-10. But a successful transition by the healthcare industry at large is far more important than the success of any individual stakeholder or organization. Through many previous…
Podcast Date: 9/25/2012 What modalities are you planning to use to educate all of your staff on ICD-10? Number of Response(s) Response Ratio A. On-line only 13 4% B. Print only 0 0% C. Seminar/ web-cast only 4 1% D. Live on-site only 9 3% E. Combination of the above…
The Centers for Medicare & Medicaid Services (CMS) has announced that Oct. 1, 2014 is the official, albeit delayed, implementation date for ICD-10-CM and ICD-10-PCS. Some healthcare providers didn’t stop their ICD-10 implementation plans back in February, when CMS first announced that there would be a delay – but whether…
The Centers for Medicare & Medicaid Services (CMS) has announced that Oct. 1, 2014 is the official, albeit delayed, implementation date for ICD-10-CM and ICD-10-PCS. Some healthcare providers didn’t stop their ICD-10 implementation plans back in February, when CMS first announced that there would be a delay – but whether…
EDITOR’S NOTE: This is the second in a three-part series about the author’s encounter with a physician and his staff regarding the clinical documentation of a patient who had suffered a hairline fracture of the left ankle. In this installment, Dr. Jones is challenging the office coder. “Listen, it was…
A one-year delay of the implementation of ICD-10-CM and ICD-10-PCS has been approved, pushing the implementation date from Oct. 1, 2013 to Oct. 1, 2014. This provides additional time to become familiar with the ICD-10-CM code set and the additional information and specificity included therein. Available ICD-10 codes will provide…
A one-year delay of the implementation of ICD-10-CM and ICD-10-PCS has been approved, pushing the implementation date from Oct. 1, 2013 to Oct. 1, 2014. This provides additional time to become familiar with the ICD-10-CM code set and the additional information and specificity included therein. Available ICD-10 codes will provide…
EDITOR’S NOTE: The following is a transcription of Dr. David Block’s segment on Talk-Ten-Tuesday. When I was in high school, I was a nerd, and not, how you say, successful with girls. My SATs were great, my GPA was great, and I knew everything worked. I’d see a girl of…
The average salary for a Certified Professional Coder (CPC®) was $47,796 — up nearly $900 from 2011, according to a survey being released today by AAPC. The 2012 AAPC Health Care Survey collected results from nearly 20,000 healthcare professionals, according to an AAPC news release. Another significant finding was that…
Our summer is now complete, as we actually know the implementation date for ICD-10, thanks to the Aug. 24 announcement and publishing of the U.S. Department of Health and Human Services (HHS) final rule establishing Oct. 1, 2014 as the compliance deadline for converting to the ICD-10-CM and ICD-10-PCS coding…
EDITOR’S NOTE: This is the first in a three-part series about the author’s encounter with a physician and his staff regarding the clinical documentation of a patient who had suffered a hairline fracture of the left ankle. The surgeon’s voicemail was straightforward and urgent: “Based on your audit findings and…
Qualedix QA and the North Carolina Healthcare Information and Communications Alliance (NCHICA) are piloting a trading partner certification program and an ICD-10 testing framework for end-to-end testing. This pilot represents a shared work effort involving test data creation, dual coding, testing and trading partner coordination, with clinically accurate ICD-10 test…
It’s clear that the coder staffing companies, recruiters and health information management (HIM) consulting companies are ready for ICD-10, but will you be? The medical records field is listed as a top 10 in-demand healthcare occupation, with faster-than-average projected growth of 18-26 percent through 2016. With the implementation of ICD-10,…
It’s clear that the coder staffing companies, recruiters and health information management (HIM) consulting companies are ready for ICD-10, but will you be? The medical records field is listed as a top 10 in-demand healthcare occupation, with faster-than-average projected growth of 18-26 percent through 2016. With the implementation of ICD-10,…
The comments have been reviewed, the speculation is over, and now we know that the ICD-10 implementation date is Oct. 1, 2014. So, what’s next? How do you proceed from here? What are the different considerations that need to be given regarding a one-year delay? At Blue Cross Blue Shield…
If you haven’t started already, it’s time to get your ICD-10 show on the road. October 2014 will be here before we know it, so physicians, clinical documentation specialists, coding professionals and administrators need to kick it into high gear, now. Here’s the challenge, though: no one can drive this…
ICD-10-PCS, designed for use in U.S. inpatient hospital settings, seems to have many of us scratching our heads as we try and understand how it will affect our current business practices, once implemented. Some providers are hopeful to avoid it altogether! However, ICD-10 will be here before we know it,…
For the last several weeks you’ve heard me railing against politicians, CMS and even the AMA for their parts in the interminable delays associated with ICD-10. Well, the time for rhetoric on both sides is over, me included. Rather than take the Andy Rooney approach and complaining about everything, it’s…
On Aug. 24, the Centers for Medicare & Medicaid Services (CMS) published a final rule setting the compliance deadline for converting to the ICD-10 system of diagnostic and procedural coding to Oct. 1, 2014, a change of plans from the original date of Oct. 1, 2013. The U.S. Department of…