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We all know that transitioning from the ICD-9 world to the ICD-10 world will increase complexity within our organizations. This increased complexity will become a major work driver as entities strive to achieve compliance. What we sometimes overlook in our preparatory efforts, however, are the inherent opportunities that the ICD-10…
Analysts from the Centers for Medicare & Medicaid Services (CMS) continue to review the public comments received on the proposed implementation delay of ICD-10 system. At this time, it’s unknown when the agency will issue a final rule, but preparations for the new system continue, and 2013 files for the…
The migration from ICD-9 to ICD-10, achieving a revenue-neutral position, or better, is important for providers and other involved parties. Understanding that the transition in itself should not impact reimbursement significantly, what are the most effective messages administrators can use to engage and motivate physicians to take an interest in…
For most people who live and breathe health IT policy in Washington, D.C., the week of Feb. 13 was an interesting one. In speaking to the American Medical Association Advocacy Conference that day, acting Centers for Medicare & Medicaid (CMS) Administrator Marilyn Tavenner said that CMS “would re-examine the time…
In a previous article titled ICD-10: the Axis of Classification, we had indicated that one method for preparing your key stakeholders for the transition to ICD-10 is to break ICD-10-CM down into its basic components: chapters and axes of classification. This article will continue that theme in reviewing changes we…
With implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) still coming and the final date yet to be determined, there is a lot of anxiety in the healthcare industry about this and questions regarding…
Jumping over ICD-10 and going instead to ICD-11 would be “like buying a bike but you don’t know how to ride one. If you don’t have the fundamentals on how to do that, I’m not sure how you could implement I-11.”
[The entire CMC board is meeting in the Executive Conference Room at CMC. There are 12 members around a glass conference table, all studying the CEO’s Letter of Resignation. We see an enraged Flange Ductworthy, the young, successful, and very vocal HVAC contractor, at his seat. Orell Worthy, MD, the…
The postponement of the ICD-10 implementation date has given us the gift of time—time to review additional workflow and processes. The mandated conversion from ICD-9 to ICD-10 will require changes to most facility information technology (IT) systems and will have significant impacts on business processes and the people within these…
More than ever, the burning question remains “Why ICD-10?” It feels like heartburn for most, but the increase in hesitation to adopt this new system appears to be directly related to the announcement of the impending October 2014 delay in the implementation date. The reason for ICD-10 is more than…
More than ever, the burning question remains “Why ICD-10?” It feels like heartburn for most, but the increase in hesitation to adopt this new system appears to be directly related to the announcement of the impending October 2014 delay in the implementation date. The reason for ICD-10 is more than…
If you’re one of the eight people who reads my article each month, you may have concluded one or more of the following: I’m cynical I’m anti-CMS I’m anti-ICD-10 I don’t know jack All of the above, and more. If you came to any of those conclusions, I would confess…
If you’re one of the eight people who reads my article each month, you may have concluded one or more of the following: I’m cynical I’m anti-CMS I’m anti-ICD-10 I don’t know jack All of the above, and more. If you came to any of those conclusions, I would confess…
“We’re panicky.” That statement was the start of an email query I received from an anxiety-ridden office manager at a solo practitioner neurology office in the deep South. This high importance-flagged query was concerned with how the provider, running a small, barely-staying-afloat office, would be able to foot the bill…
As we continue to wait on the final ICD-10 implementation rule to be issued by the Department of Health & Human Services (HHS), it is important for HIM directors to stay the course and continue their ICD-10 preparations. This delay provides them the opportunity to refocus their efforts and get…
Download Media File Ensure your organization’s ICD-10 readiness with powerful solutions from Wolters Kluwer Law & Business.Whether you require a search tool, e-codebooks, regulatory compliance resources, batch translation, reimbursement analysis, or a way to manage implementation across your entire enterprise, Wolters Kluwer Law & Business provides the comprehensive tools, resources…
Any possible delay of the implementation of the ICD-10-CM coding system is “unacceptable,” said Dan Rode, vice president, advocacy and policy, American Health Information Management Association (AHIMA), during his testimony at the June 20, 2012, meeting, of the National Committee on Vital and Health Statistics (NCVHS) Subcommittee on Standards.
(Scene: The office of LaDonna Emobilli, MBA, chief executive officer of CMC. There is a substantially sized 19th-century Renaissance Revival desk with a matching chair dominating the office, with a mismatched credenza to the side. There are two simple wooden chairs in front of the desk. There are the usual…
According to the Centers for Disease Control (CDC), in the U.S. about one in every 33 babies is born with a congenital anomaly (also called birth defects), and these babies are at a greater risk for illness and long-term disability than babies born without birth defects. Currently, congenital heart defects…
Physeal fractures, also referred to as growth plate fractures, are fractures that occur in the distal or proximal physis of the long bones, and they are of particular concern when they occur in children and adolescents who have not finished growing. Until full growth is attained, the growth plates are…
We just finished a statewide trip talking about ICD-10 with physicians of a large hospital system when we had an epiphany. I’m not talking about your run-of-the-mill light bulb going off. No, this was a real game-changer in terms of completely shifting our philosophy regarding educating physicians about ICD-10. And…
We just finished a statewide trip talking about ICD-10 with physicians of a large hospital system when we had an epiphany. I’m not talking about your run-of-the-mill light bulb going off. No, this was a real game-changer in terms of completely shifting our philosophy regarding educating physicians about ICD-10. And…
By now everyone in the healthcare industry dealing with matters of coding is aware of the impending shift from ICD-9 to ICD-10 within the next few years (per recent accounts, this will occur not on Oct. 1, 2013 as initially scheduled, but instead on Oct. 1, 2014). Effecting such an…
EDITOR’S NOTE: This is the second of a two-part article addressing the facts, adoption, implementation and the interconnectivity of ICD-10 and Meaningful Use. The Stage 1 Meaningful Use program is being touted as a success by the Centers for Medicare and Medicaid Services (CMS). “To date more than 43,000 providers…
Physicians and hospital administrators realize that optimizing workflows to accommodate urgent care and emergent services will require additional data collection needs under ICD-10. The seventh character under ICD-10 defines the “type of encounter”. As I mentioned in my earlier article, sensibly and tactfully preparing for ICD-10 can be achieved successfully…
In a previous article titled ICD-10: the Axis of Classification, we had indicated that one method for preparing your key stakeholders for the transition to ICD-10 was to break ICD-10-CM down into its basic components: chapters and axes of classification. This article will continue that theme in reviewing changes we…
When any type of change is introduced, there are some half-truths or misconceptions that often surface. For example, when it comes to long- and short-term implications, there are some financial myths surrounding the new ICD-10 compliance requirement. While some perceive ICD-10 as an expensive, administrative-intensive initiative, organizations can leverage the…
Last month I opined that the only real winners in the ICD-10 implementation project would include neither providers nor patients. That is, the government will get to flex its muscles, the payers will have more options for denials, researchers will have much better data, and so on, but providers really…
With the rebooting of ICD-10 programs subsequent to the recent U.S. Department of Health and Human Services announcement of a proposed new "go live" date, there seems to be a lot of activity involving procurement of ICD-10 mapping and crosswalk tools. Concurrently, we are seeing an evolution in philosophy relating…
With the rebooting of ICD-10 programs subsequent to the recent U.S. Department of Health and Human Services announcement of a proposed new "go live" date, there seems to be a lot of activity involving procurement of ICD-10 mapping and crosswalk tools. Concurrently, we are seeing an evolution in philosophy relating…
Maybe it’s because I live in New England – coupled with the timing of the recent announcement of the proposed rule regarding ICD-10 from the U.S. Department of Health and Human Services (HHS) – but I keep thinking about ICD-10 and comparing it to the Boston Marathon. Since I do…
When the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would delay the ICD-10 compliance date by one year, until Oct. 1, 2014, did the industry collectively let out a sigh of relief, or did it let out a sigh of distress? CMS considers a one-year…
At this point in time many would agree that ICD-10 implementation can be considered a money pit. Because of the cost increases, extensive training time and workflow process changes required of organizations, some would say that ICD-10 has become a wallet drainer. Change is good, and with ICD-10, change is…
At this point in time many would agree that ICD-10 implementation can be considered a money pit. Because of the cost increases, extensive training time and workflow process changes required of organizations, some would say that ICD-10 has become a wallet drainer. Change is good, and with ICD-10, change is…
When asked what they thought of the American Medical Association’s push for a two-year extension of the implementation of ICD-10, 77 percent of responding listeners to the weekly live Internet radio program Talk-Ten-Tuesday said the “AMA should stop and get on board with everyone else.”   While 10 percent of…
An interesting thing happens every time I am on the road speaking to physician groups about ICD-10. During the course of my lecture, I always demonstrate the difference between ICD-9 and ICD-10 by citing the number of codes in each for fracture of the patella. ICD-9? Two codes. ICD-10? Four…
An interesting thing happens every time I am on the road speaking to physician groups about ICD-10. During the course of my lecture, I always demonstrate the difference between ICD-9 and ICD-10 by citing the number of codes in each for fracture of the patella. ICD-9? Two codes. ICD-10? Four…
There are some significant differences between ICD-9 and ICD-10-CM for coding conditions related to pregnancy, childbirth and the puerperium. Coding for multiple gestation, for example, requires documentation related to the number of fetuses, the number of placentae and the number of amniotic sacs. This information is indicated in ICD-9-CM using…
On April 17, the proposed rule delaying the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014 was published by the U.S. Department of Health and Human Services (HHS). According to HHS, the change is just one part of a broader proposed rule that would adopt a standard…
The ICD-10-PCS root operation Table 4A0 classifies procedures and tests that involve measurement, which is defined in ICD-10-PCS as determining the level of a physiological or physical function at a certain point in time. An ICD-10-PCS code is derived by choosing a specific value for each of the seven characters…
The transition from ICD-9 to ICD-10 is big and complex - that's a fact, and it's nothing new. As the industry starts to realize how big and complex it is, though, we're starting to understand the impacts this transition will have on everything in our environment - and so some…
This is the fourth and final article in a series related to the key changes in the 2012 ICD-10-CM Official Guidelines for Coding and Reporting. I’ll be picking up below from last month and a continuation of a summary of chapter-specific coding guidelines, starting with chapter 19.
In a previous article titled ICD-10: The Axis of Classification, we had indicated that one method for preparing your key stakeholders for the transition to ICD-10 was to break ICD-10-CM down into its basic components: chapters and axes of classification. This article will continue that theme in reviewing changes we…
Submitted by Precyse The ICD-10-CM diagnostic classification is more specific and provides a better clinical picture to support optimal quality of care and reimbursement. And by now most coding professionals know that ICD-10-CM has far greater granularity and more current healthcare information and, as a result, the language has changed…
[Scene: the private meeting room at The Humble Dragon, the town's largest Asian buffet. Corey Sue LaChienne is facilitating a meeting of everybody at Crossroads Medical Center CMC in information technology. At the front table is Hamilton Beach, the CFO ("My hippie mom named me, hoping I would blend..."). Also…
Last week I attended the ICD-10 Summit in Baltimore. The atmosphere was energetic, with a myriad of speakers, attendees, and vendors ready to share their experience and expertise related to ICD-10 readiness and implementation. Sessions were well attended and in many cases standing room only, especially surrounding the topic of…
The momentum is back for ICD-10 risk assessments, following the Department of Health and Human Services’ (DHHS) announcement of a one-year delay in implementation date. Although we are still in the 30-day comment period, the industry is ready to begin and/or continue its assessment efforts. That’s my one big “take…
The momentum is back for ICD-10 risk assessments, following the Department of Health and Human Services’ (DHHS) announcement of a one-year delay in implementation date. Although we are still in the 30-day comment period, the industry is ready to begin and/or continue its assessment efforts. That’s my one big “take…
Daniel R. Levinson, Inspector General of the Office of Inspector General of the U.S. Department of Health and Human Services, is scheduled to appear on a live broadcast originating from the 16th annual Compliance Institute of the Health Care Compliance Association in Las Vegas, April 29 through May 2. The…
Three physicians, two nonphysician practitioners, a chief financial officer, a compliance officer, two practice managers, and me: These were the attendees of a very recent meeting. The purpose: an exit conference to talk about audit findings. I had recently conducted an audit of medical record (MR) documentation in comparison-and-contrast to…
BALTIMORE – On the first day of the 30-day comment period associated with the proposed rule to delay ICD-10 implementation by one year, Denise Buenning of the Centers for Medicare & Medicaid Services (CMS) told healthcare providers not to stop their implementation plans. “Do not cut or eliminate your I-10…
I have been working with ICD-10-CM for about two years, creating educational resources and tools. With each ICD-10-CM draft update and with each new educational resource or tool I work on, I learn something new. Most recently I have been reviewing ICD-10-CM Chapter 2: Neoplasms (C00-D49). Last month I provided…
As healthcare payers and providers prepare for ICD-10, a key area of focus involves navigating the switch from ICD-9 diagnosis and procedure codes to the new code set. Converting from one code set to the other is challenging because the sets are so dramatically different. There are few cases in…
On April 9, the Centers for Medicare & Medicaid Services (CMS) announced its proposed switch of the ICD-10 implementation date from Oct. 1, 2013 to Oct. 1, 2014. This delay was premised on three listed considerations: the challenges experienced in the transition to Version 5010, concerns about impact on provider…
If you’re a healthcare professional not living under the proverbial rock, you most likely already are aware that the U.S. Department of Health and Human Services (HHS) has provided some guidance on the much-anticipated revised ICD-10 implementation date. After creating substantial unrest and speculation in February (when HHS announced that…
The Department of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) understand the difficulties that providers are dealing with to comply with the complexity of required changes to implement the ICD-10-CM diagnosis and PCS coding systems across the healthcare industry. They have reviewed the…
Delay provides opportunity to refocus, prepare, train and get it right.   Wayne, Pa. and Alpharetta, Ga., April 9, 2012—Health and Human Services (HHS) Secretary Kathleen G. Sebelius today announced a proposed rule that would delay the compliance date for the International Classification of Diseases, 10th Edition diagnosis and procedure…
(BALTIMORE: 04/16/12---The ICD-9 code freeze, originally schedule to end Oct. 1, 2014, will be extended for one year if the implementation of the proposed one-year delay of ICD-10 goes into effect.
I had plenty of advance notice to get this article done by my deadline. But I had to catch up on calls I promised to make from the AAPC conference last week. Plus, I had all my normal day-to-day duties to attend to and also had to deal with some…
On Monday, April 9, the U.S. Department of Health and Human Services (HHS) issued proposed rule CMS-0040-P, in which it proposed a one-year delay for implementing ICD-10-CM/PCS. This proposal would extend the ICD-10 compliance date to Oct. 1, 2014 and also mandates a 30-day public-comment period prior to issuance of…
Some of the nation’s leading healthcare authorities and newsmakers will share their insight, perspective and expertise on the timely subject of ICD-10 — specifically, on the new compliance date for implementation — when Talk-Ten-Tuesday hosts Chuck Buck and Kim Charland broadcast live from the AHIMA I-10 Summit on Monday, April…
Reaction was swift and decisive among healthcare leaders following yesterday’s announcement from the Department of Health and Human Services (HHS) that its proposed rule would delay required compliance by one year—from October 1, 2013, to October 1, 2014.
Amid smoldering controversy generated by proponents and opponents, the U.S. Department of Health and Human Services posted a proposed rule today that would move the ICD-10 compliance date from October 2013 to October 2014. In doing so, HHS is soliciting comments for a 30-day comment period.
EDITOR’S NOTE: David Block, MD, PhD, is a featured panelist on Talk Ten Tuesday, the live weekly 30-minute podcast produced by ICD10monitor. Tuesday’s edition was broadcast live from the 20th national AAPC conference in Las Vegas. The following is a transcript of his segment that was heard throughout the convention…
If collaboration among providers, vendors and payers is deferred as a result of the delay of ICD-10 implementation, the light at the end of tunnel could be that of an oncoming train. That was the sentiment expressed by Annie Boynton, director of 5010/ICD-10 communication for UnitedHealthcare, speaking in Las Vegas…
This is the third in a series of articles related to the key changes in the 2012 ICD-10-CM Official Guidelines for Coding and Reporting. I’ll be picking up below where I left off last month, which is with a summary of chapter-specific coding guidelines.
As baseball spring training is already underway, it seems appropriate to quote a New York Yankees Hall of Famer who is widely regarded as one of the greatest catchers in baseball history. Yogi Berra once said “It’s hard to make predictions, especially about the future.” Yogi might be known as…
As baseball spring training is already underway, it seems appropriate to quote a New York Yankees Hall of Famer who is widely regarded as one of the greatest catchers in baseball history. Yogi Berra once said “It’s hard to make predictions, especially about the future.” Yogi might be known as…
Any suggestion that your organization can survive the transition to ICD-10 by insulating your systems and processes should be flatly rejected. The collective solution approaches of payers (commercial and government) and providers (institutional and professional) will drive the operational continuity of the healthcare industry and improve the value we deliver…
I have been working with ICD-10-CM for about two years, creating educational resources and tools. With each ICD-10-CM draft update and with each new educational resource or tool I work on, I learn something new. Most recently I have been reviewing ICD-10-CM Chapter 2: Neoplasms (C00-D49). Last month I provided…
The Centers for Medicare & Medicaid Services (CMS) has announced that the implementation of ICD-10-CM may be delayed beyond the scheduled Oct. 1, 2013 date. Inpatient Rehabilitation Facilities (IRFs) have been getting ready for the implementation of ICD-10-CM through education for hospital departments, physicians, clinicians and coders. Now is not…
The U.S. Department of Health and Human Services (HHS) announcement regarding the possible delay of the ICD-10 implementation date has caused great uncertainty in the industry. It’s truly overwhelming for most, as “Delay, or no delay?” is the question many have asked and grappled with during the last month. The…
The U.S. Department of Health and Human Services (HHS) announcement regarding the possible delay of the ICD-10 implementation date has caused great uncertainty in the industry. It’s truly overwhelming for most, as “Delay, or no delay?” is the question many have asked and grappled with during the last month. The…
Almost anyone who writes about ICD-10 shares the same problem each time they take “keyboard to screen” (no longer “pen to paper,” you see), and that is: What can I possibly write that hasn’t already been written? This problem is aggravated by the fact that, honestly, ICD-10 is really quite…
Almost anyone who writes about ICD-10 shares the same problem each time they take “keyboard to screen” (no longer “pen to paper,” you see), and that is: What can I possibly write that hasn’t already been written? This problem is aggravated by the fact that, honestly, ICD-10 is really quite…
A pathological or fragility fracture is defined as a fracture sustained due to trauma no more severe than a fall from standing height, with the break occurring under circumstances that would not cause a fracture in a normal, healthy bone. In ICD-10-CM there is one code to indicate a personal…
(Scene: A Tuesday evening. The curtain falls on a facilitated dialogue at Tickle Your Palate, a new restaurant and successful venture of local ENTs and their wives who were looking to do something romantic and professional. It’s closed for this private party of the CMC docs. The mediator and Corey…
In our previous article, titled “ICD-10: the Axis of Classification,” we had indicated that one method for preparing your key stakeholders for the transition to ICD-10 was to break ICD-10-CM down into its basic components: chapters and axes of classification. This article will continue that theme by reviewing changes we…
Physician documentation remains a crucial issue among physicians and payers alike, according to panelists appearing on “Live from AAPC” during the 20th national conference of the AAPC going on this week in Las Vegas.
As ICD-10 implementation and other pressures push healthcare providers to pursue outside auditing help, data security and encryption technologies must be part of the equation. Deployment of electronic medical record (EMR) systems, meaningful use, ICD-10 implementation and other regulatory changes add significant complexity to the operating environments in which healthcare…
While some providers in the healthcare industry breathe a sigh of relief in the wake of the news that ICD-10 implementation likely will be delayed beyond the original launch date of Oct. 1, 2013, others view the sudden lull as a golden opportunity to sprint ahead of the field in…
Some of the nation’s most respected healthcare thought leaders will share their insights during a series of live broadcasts originating during the AAPC 20 national conference in Las Vegas, April 2 through 4 being produced by ICD10monitor.com. The live broadcasts begin Monday, when the long-running Monitor Monday takes to the…
EDITOR’S NOTE: The following is the first in an occasional series of articles about what providers should be doing in the interim as CMS re-examines the timeline for the implementation of ICD-10.   “Data is the new bottom line for organizations. Management of data will determine success or failure in…
Don’t expect another extension for 5010 compliance, advises Denise Buenning, director of the administrative simplification group at CMS’ Office of E-Health Standards and Services. “Once this current period expires, there won’t be a predisposition to another extension,” said Buenning during an interview on yesterday’s Talk-Ten-Tuesday, ICD10monitor.com’s live weekly podcast. Buenning…
EDITOR’S NOTE: This is the fifth article in a series addressing the definitions and differences between the Medical and Surgical Root Operations of ICD-10-PCS. As usual, let’s review what we have covered so far. In the Medical and Surgical section (first character 0) there are 31 root operations using standardized…
The neoplasm chapter in ICD-10-CM has undergone some significant changes. Just as in ICD-9-CM, neoplasms are classified primarily by site and behavior (benign, carcinoma in-situ, malignant, uncertain behavior and unspecified). However, in ICD-10-CM there are additional classifications that are now grouped by morphology (histologic type). Therefore, selecting the most specific…
Even under the best of circumstances, change is hard. That’s why it is not surprising that there is mixed reaction to the announcement from U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius that the federal government may delay the implementation of ICD-10. The American Medical Association (AMA)…
Well, the battle lines are drawn. The implementation of ICD-10 was set for Oct. 1, 2013, but several professional organizations requested that it be deferred and Acting Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner announced that the agency will, in fact, modify its timeline for ICD-10 implementation.…
This is the second in a series of articles related to the key changes in the 2012 ICD-10-CM Official Guidelines for Coding and Reporting. I’ll be picking up below where I left off last month, which is with a summary of chapter-specific coding guidelines.
To the Editor: Many articles are being written about the potential ICD-10 deadline delay. As a “road warrior” addressing hundreds of physician organizations across the country, I want to share my observations. Of course, the “elephant in the room” is the looming presence of uncertainty and questions about what to…
CMS is announcing that it will not initiate enforcement action for an additional three months, through June 30, 2012, against any covered entity that is required to comply with the updated transactions standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Rather than focusing on the question of what the Centers for Medicare & Medicaid Services (CMS) will do and when will it do it, providers, vendors, and payers should consider another question: “What should we be doing to position ourselves so that we can hit the ground running when CMS…
Despite the possible implementation delay of ICD-10, your organization should continue to work on preparing for the new code sets. Even if your organization hasn’t completed a full ICD-10 assessment, you can check some things off your to-do list now. For example, you can review current encounter forms and electronic…
In a previous article titled ICD-10: the Axis of Classification, I discussed a particularly simple method for preparing your key stakeholders for the transition to ICD-10. The method consists of breaking ICD-10-CM down into its basic components: chapters and axes of classification. This article continues that theme in reviewing the…
ICD-10-CM category R83–R89 codes classify abnormal findings on examination of “other” body fluids, substances and tissues, without diagnosis. Laboratory testing is performed on many types of body fluids other than blood, because samples such as urine, semen and amniotic fluid can provide more definitive diagnostic information.
Waffling seems to be the norm these days… At a macro level, HHS/CMS is waffling on the already-pushed-out-once implementation date for ICD-10, causing a lot of confusion and unrest among participants in ICD-10 remediation programs. Concurrently, and not necessarily in relation to recent governmental machinations, we’ve been seeing some waffling…