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September 26, 2016
Spinal Fusion Procedures in ICD-10: Keys to Proper Selection of Qualifiers and Devices
By Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Of all the challenges associated with the transition to ICD-10-PCS, coding spinal fusion procedures is by far the most difficult to tackle, in this author’s opinion. Even after training, many coders still struggle with the complexities of coding these procedures. This article focuses on the importance of thoroughly reviewing operative…
September 26, 2016
Are New Coding Guidelines Letting Physicians off the Hook?
By Sandra L. Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
Over the many weeks since the release of the updates to the ICD-10-CM Official Coding Guidelines for the 2017 fiscal year, I have had the opportunity to engage in multiple conversations about the most controversial guideline, which addresses the use of clinical indicators for code assignment. Some of those conversations…
SPECIAL GUEST Larry Field DO, MBA, CHCQM, CPC, CHC, LHRM, ICD10 CM/PCS Trained; Baldrige Quality Trained Treasurer- American College of Physician AdvisorsALSO FEATURING Sue Bowman, MJ, RHIA, CCS, FAHIMA; Rudy Braccili, Jr., MBA, CPAM, CRCE; Sandra L Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer; and Laurie M. Johnson, MS,…
Media
September 19, 2016
Preparing Your Organization for the 2017 IPPS Changes
By Michelle M. Wieczorek RN RHIT CPHQ
The 2017 Inpatient Prospective Payment System (IPPS) guidelines contain several fundamental changes, and certainly some challenges insofar as clinical documentation improvement (CDI) and coding practices are concerned.As an advocate for integration of coding guidelines into our CDI practice, the 2017 IPPS certainly offers an opportunity for tighter collaboration between the…
As it does every year, the Centers for Disease Control and Prevention (CDC) recently released its list of the leading causes of death in the United States. With the transition to ICD-10 and new codes facing provider organizations looming on Oct. 1, 2016, what should coders be aware of regarding this list? A…
September 19, 2016
No, Doctor – It’s not Just About Money
By Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
If you would allow me to vent a little today, then please indulge me. If you are not in the particular mood for what some might call a rant, well, you should read anyway, because this promises to be an entertaining and thought-provoking example. The topic is a common criticism…
September 19, 2016
2017 ICD-10-CM Coding Guidelines – Will They Make a Difference?
By Sandra L. Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
I often hear auditors and coding leaders say that their physicians are pretty good at listing rationale for their diagnoses of sepsis, acute respiratory failure, and encephalopathy. However, commercial insurance continues to deny their claims.They are very frustrated – and wondering if the new ICD-10-CM guideline will help. What they…
September 13, 2016
Developing Story: ICD-10 Coordination and Maintenance Committee Meeting: Live Report
By Chuck Buck
FEATURING Rudy Braccili, Jr., MBA, CRCE; Sandra L Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer; David Glaser, Esq.; Laurie M. Johnson, MS, RHIA, FAHIMA, FAHIMA; and Stanley Nachimson
Media
September 12, 2016
ICD-10 Coordination and Maintenance Committee Meeting Marks Coding Milestone
By Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
EDITOR’S NOTE: Laurie Johnson will be reporting live from the ICD-10 Coordination and Maintenance Committee meeting getting underway today. Her report will be carried during this week’s edition of Talk Ten Tuesdays, the Internet radio broadcast produced by ICD10monitor.When are Type II myocardial infarctions (MIs) not really MIs?Intensely debated during the…
September 12, 2016
Clinical Indicators for Code Assignment – Deeper than Just Coding
By Sandra L. Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
The new guideline instructing coders not to use clinical indicators for code assignment has generated considerable interest. I have received many emails from colleagues, and even some from physicians, voicing concerns or sharing enthusiasm for coding and documentation integrity.No matter what your stance is on this guideline, it is clear…
Physician practices have had nearly a year to acclimate themselves to the ICD-10 coding that took effect in October 2015. Thanks to a grace period known as ICD-10 “relaxed rules,” which were established jointly by the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA), the…
August 30, 2016
Clinical Validation versus DRG Validation: ICD-10 Hot Topic Continues to Simmer
By Chuck Buck
FEATURING Betty B. Bibbins, MD, BSN, CHC, CI-CDI, CPEHR, CPHIT; Rhonda Buckholtz, CPC, CPMA, CPC-I, CRC, CDEO, CHPSE, CENTC, COBGC, CPEDC, CGSC; Laurie M. Johnson, MS, RHIA, FAHIMA, FAHIMA; and Michelle Wieczorek, RN RHIT CPHQ
Media
August 29, 2016
Battling Burnout from Within: How Healthcare is Fighting an Ennui Epidemic
By Mark Spivey
EDITOR’S NOTE: This is the second piece in a series of articles on the issue of burnout among healthcare professionals – a problem leading medical experts say is not only increasing in prevalence, but also intensity. During the coming month, several of these experts will be making appearances on Talk-Ten-Tuesdays, the…
August 29, 2016
Survey: Most Respondents Assign Codes Based on Physician Documentation
By Kim Charland, BA, RHIT, CCS
ICD10monitor and RACmonitor have been covering the controversy that the release of the 2017 ICD-10 Official Coding and Reporting Guidelines has drummed up yet again.Two excellent articles this past week were “Coding Conundrum: Clinical Indicators for Code Assignment” by Sandra Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer; and “Developing:…
August 29, 2016
AHA: “Unjustified” Payment Cut in Hospital IPPS Final Rule for FY 2017
By Janis Oppelt
In the final rule for the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) PPS for the 2017 fiscal year, the Centers for Medicare & Medicaid Services (CMS) continues to move the Medicare program toward paying providers based on the quality, rather than the quantity, of care…
The new year for diagnosis codes begins Oct. 1, 2016. That date also marks the end to the moratorium on new codes that has been in place since Oct. 1, 2011. For the upcoming year, there are 1,974 code additions, 311 deletions, and 425 revisions. In addition to many new, more…
SPECIAL GUEST James S, Kennedy, MD, CCS, CDIPALSO FEATURING Rudy Braccili, Jr., MBA, CRCE; Sandy Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer; Laurie M. Johnson, MS, RHIA, FAHIMA, FAHIMA; and H. Steven Moffic, MD
Media
August 22, 2016
Coding Conundrum: Clinical Indicators for Code Assignment
By Sandra L. Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
With the 2017 ICD-10-CM and PCS coding update on the horizon, we in the healthcare industry have a lot to talk about.One of the most important and possibly controversial updates affects Section I of the ICD-10-CM Official Guidelines for Coding and Reporting. This new guideline, titled Code assignment and Clinical…
Renewed interest in ICD-10 education has been prompted by the announcement last Thursday from the Centers for Medicare & Medicaid Services (CMS) indicating that the Medicare ICD-10 flexibilities agreement will end and will not be extended beyond Oct. 1, 2016.CMS also stated that Medicare would not “phase in” the requirement…
August 22, 2016
Ten Things about Oct. 1 that Coders and CDI Specialists Need to Know Now!
By Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
The 2017 Inpatient Prospective Payment System (IPPS) final rule brings with it a number of changes that are likely to have an even bigger impact on documentation, coding, and revenue than ICD-10 itself. An unprecedented number of dramatic changes will go into effect on Oct. 1.I knew that things were…
August 22, 2016
Battling Burnout from Within: How Healthcare is Fighting an Ennui Epidemic: Part II
By Mark Spivey
EDITOR’S NOTE: This is the second in a series of articles on the issue of burnout among physicians – a problem leading medical experts say is not only increasing in prevalence, but also intensity. During the coming month, several of these experts will be making appearances on Talk-Ten-Tuesdays, the weekly Internet…
August 22, 2016
End of Medicare ICD-10 Grace Period Prompts Call for More Education
By Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
Renewed interest in ICD-10 education has been prompted by the announcement last Thursday from the Centers for Medicare & Medicaid Services (CMS) indicating that the Medicare ICD-10 flexibilities agreement will end and will not be extended beyond Oct. 1, 2016.CMS also stated that Medicare would not “phase in” the requirement…
SPECIAL GUEST Sue Bowman, MJ, RHIA, CCS, FAHIMA ALSO FEATURING Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer; Allen Frady, RN, BSN, CCS, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer; Laurie M. Johnson, MS, RHIA, FAHIMA, FAHIMA; and Rhonda Taller, MHA
Media
August 15, 2016
Battling Burnout from Within: How Healthcare is Fighting an Ennui Epidemic: Part I
By Mark Spivey
EDITOR’S NOTE: This is the first in a series of articles on the issue of burnout among physicians – a problem leading medical experts say is not only increasing in prevalence, but also intensity. During the coming month, several of these experts will be making appearances on Talk Ten Tuesdays, the…
August 15, 2016
ICD-10 Guidelines: The Catch 22 of Reporting Dicey Diagnoses
By Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
One item that has not yet received much attention is a guideline addressing the ability of a facility to report or not to report a diagnosis provided by a physician.What is a facility to do when a physician documents a diagnosis that may be unsupported by the clinical circumstances reflected…
We all know how important clinical documentation is to patient care, and from a compliance standpoint, it is also crucial to auditing – but for those dealing with the financial side of healthcare, the importance may translate into reimbursement losses. Let us look at a clinical scenario.Say an 80-year-old male…
August 15, 2016
Good News and Bad in IPPS Final Rule
By Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
The Centers for Medicare & Medicaid Services (CMS) released the Inpatient Prospective Payment System (IPPS) final rule for the 2017 fiscal year on Aug. 2, one day after its federally mandated deadline. This final rule will be effective for inpatient discharges taking place on and after Oct. 1, 2016.There were…
SPECIAL GUEST H. Steven Moffic, MDALSO FEATURING Chris Bundy, MD, MPH; Larry Field, DO, MBA, CHCQM, CPC, CHC, LHRM ICD-10CM/PCS-Trained, Baldrige Quality Trained; Laurie M. Johnson, MS, RHIA, FAHIMA, FAHIMA; and Melissa Walton-Shirley, MD
Media
August 8, 2016
ICD-10-CM Official Coding and Reporting Guidelines; Noteworthy Changes and Revisions for 2017
By Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer
Well, the long-anticipated ICD-10-CM Official Coding and Reporting Guidelines for the 2017 fiscal year have been released, and there are definitely some key areas on which to focus. The Guidelines still are to be organized into sections. Section I includes the structure and conventions of the classification and general guidelines…
August 8, 2016
Navigating the 2017 ICD-10-PCS Code Update
By Sandra L. Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer
When I think back on all of the road trips I went on with my family when I was a child, I don’t remember how many miles we drove. We once traveled from Arizona to West Virginia – quite a long trek across the country. But what I do remember…
August 8, 2016
It’s Official: CMS Does not Support Third Definition of Sepsis
By Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
Last spring I wrote about the new third definition of sepsis with a fair amount of enthusiasm and excitement. From my perspective, this new definition was the answer to the ever-present criticism of sepsis criteria – namely, the notion that people who meet the criteria often are not septic. The…
August 8, 2016
Medical Assistants Add Value for Physician Offices
By Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS, AHIMA-approved ICD-10-CM/PCS Trainer
Physicians can benefit from the talents of their medical assistants, and possibly in areas other than ICD-10.Medical assistants (MAs) are typically members of physician office teams. If certified, these individuals have completed a structured education program with courses in anatomy, medical terminology, coding, and disease processes. They are among the…
SPECIAL GUEST Barbara Hinkle-Azzara, RHIA, HRSALSO FEATURING Rose T. Dunn, MBA, RHIA, CPA, FACHE; Ronald Hirsch, MD, FACP, CHCQM Laurie Johnson, MS, RHIA, FAHIMA; and Stanley Nachimson
Media
Given the massive number of new ICD-10 codes and the Oct. 1, 2016 compliance date, HRS and ICD10monitor are producing a special-edition Internet broadcast that will focus on the imperative of pre-bill auditing.The free broadcast will air live at 1:00 p.m. on Thursday, Aug. 4. The 60-minute live event is being sponsored…
August 1, 2016
What is the Ultimate Test in Determining Whether a Query is Leading?
By Cesar M Limjoco, MD
In order to determine what makes a query leading versus non-leading, I would like to use a coding question I received recently. It goes like this… “Our doctors here frequently document ‘acute respiratory distress.’ They are using J80 for this, which codes to ‘acute respiratory distress syndrome’ (ARDS).”I responded by noting that…
August 1, 2016
Respondents Report Using ICD-10-PCS Codes for Outpatient Visits
By Kathy Pride, CPC, RHIT, CCS-P, AHIMA-Approved ICD-10-CM/PCS Trainer
Though ICD-10-PCS (procedure) codes are only required for billing purposes on inpatient claims, ICD10monitor wanted to know how many of you are using them for your outpatient claims.For billing purposes, facilities are only required to code and submit CPT® codes for outpatient services; however, pre-ICD-10 implementation, many facilities captured both…
August 1, 2016
When to Start and Stop: It’s About Time
By Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS, AHIMA-approved ICD-10-CM/PCS Trainer
One of the most vexing issues coding professionals face when coding for infusions and drug administration is the absence of start and stop times.According to the Centers for Medicare & Medicaid Services (CMS) Transmittal 902, hospitals are to report codes that indicate the actual time in which an infusion is…
FEATURING Rhonda Buckholtz, CPC, CPMA, CPC-I, CRC, CDEO, CHPSE, CENTC; Rose T. Dunn, MBA, RHIA, CPA, FACHE; Holly Louie, RN, CHBME; Laurie M. Johnson, MS, RHIA, FAHIMA FAHIMA; and Joseph C. Nichols, MD
Media
July 25, 2016
Reducing Your Risk and Staying the Course
By Rhonda Buckholtz, CPC, CPMA, CPC-I, CRC, CDEO, CHPSE, COPC, CPEDC, CGSC
One thing always remains the same in healthcare: change. With the implementation of ICD-10 we found out how disruptive some of these changes can actually be, and it appears that this was only a precursor to even more change in healthcare, with the implementation of new quality payment initiatives.During the…
The long-awaited update to the CT lung screening national coverage determination (NCD) was finally released this month. As you may recall, current smokers who were otherwise eligible were omitted from the NCD-covered codes released last year. That is the really good news. The really bad news is that at least…
EDITOR’S NOTE: This is the final installment of a two-part series that examines episodes of care as healthcare payment model. Part I was published on July 19, 2016. The financing of healthcare is rapidly changing in this country. The Centers for Medicare and Medicaid Services (CMS) has introduced a wide array…
July 25, 2016
Where There’s Smoke, There’s Fire: Relevant ICD-10 Codes
By Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
Excessive heat warnings and heat advisories have been published recently for much of the Great Plains, Mississippi Valley, Midwest, Ohio Valley, Mid-Atlantic states, and Southern U.S., according to the National Weather Service. The United States has also experienced dry weather this summer, and some areas are in exceptional drought, such as…
FEATURING Kathy Pride, RHIT, CPC, CCS-P, CPMA, Sandra L. Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer; Jonathan LaFleur, BSN, RN, CCS; Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10 CM/PCS Trainer; Cesar M. Limjoco, MD; and Joseph C. Nichols, MD
Media
The changing clinical indicators for sepsis have ignited a firestorm of debate at all levels of the healthcare industry. This month’s column provides a quick review of the changes and identifies three primary impacts to clinical coding as the new guidelines phase in.Comparing sepsis indicatorsThe existing clinical indicators we have…
EDITOR’S NOTE: This is the first in a two-part series that examines episodes of care as healthcare payment model. Part II will be published on July 26, 2016.The financing of healthcare is rapidly changing in this country. The Centers for Medicare and Medicaid Services (CMS) has introduced a wide array…
July 18, 2016
Live Long and Prosper Under ICD-10-CM
By Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
EDITOR’S NOTE: Star Trek Beyond will be released on July 22, 2016. The fourth installment in the rebooted sci-fi series is to begin production on Sept. 26, 2016.If you are unfamiliar with the Star Trek brand, it began with a TV series in 1966 with William Shatner as Captain Kirk…
Last fall’s implementation of ICD-10 throughout the nation’s healthcare industry did not produce the dire financial impacts many had feared, according to new data recently unveiled by Crowe Horwath LLP.“The conversion … was expected to have far-reaching effects. Anticipated impacts included delays in billing and coding, the potential for increased…
GUEST CO-HOST Mary Beth Pace, RN, BSN, MBA, ACM, CMAC Trinity Health SPECIAL GUEST Sue Bowman, MJ, RHIA, CCS, FAHIMA ALSO FEATURING Rudy Braccili, Jr., MBA, CPAM, CRCE; Bonnie S. Cassidy, MPA, RHIA, FAHIMA, FHIMSS; Laurie A. McBrierty, MLT, ASCP; and Stanley Nachimson
Media
EDITOR’S NOTE: Hard on the heels of one of the deadliest Middle East bombings in more than a decade in which 175 people were killed in Baghdad on one of the final days of the Islamic holy month of Ramadan, came last week’s wave of domestic violence. So with violent demonstrations here at…
July 11, 2016
Coding Clinic Continues with Incremental Clarifications
By Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
Coding Clinic is not issuing corrections stating that linkages should not be assumed for diabetes. Rather, it is confirming that this is a new era of associated relationships for diabetes. The Coding Clinic published for the second quarter of 2016 indicated that the term “with” means both “associated with” and “due…
July 11, 2016
Lesson Learned Implementing ICD-10: The Need for Collaboration
By Bonnie S. Cassidy, MPA, RHIA, FAHIMA, FHIMSS
ICD-10 implementation success to date has been a result of collaboration and leveraging technology and education. Just as we experienced with planning for the successful implementation of ICD-10, we have learned that it takes a team of healthcare colleagues working together and sharing expertise across the continuum of patient care…
July 11, 2016
Many New ICD-10-PCS Codes – Preparation and Follow-through is Key
By Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer
With the release of the new ICD-10-PCS codes for the 2017 fiscal year effective October 2016, we certainly are hearing lots of discussion and opinions. There are 3,827 new hospital inpatient procedure codes, and 97 percent will update the cardiovascular and lower joint body systems, per the Centers for Medicare…
GUEST CO-HOST Mary Beth Pace, RN, BSN, MBA, ACM, CMAC Trinity HealthSPECIAL GUEST Sue Bowman, MJ, RHIA, CCS, FAHIMAALSO FEATURING Rudy Braccili, Jr., MBA, CPAM, CRCE; Bonnie S. Cassidy, MPA, RHIA, FAHIMA, FHIMSS; Laurie A. McBrierty, MLT, ASCP; and Stanley Nachimson
Media
June 27, 2016
DEVELOPING: CDC Releases 2017 ICD-10-CM Codes
By Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
EDITOR'S NOTE: The Centers for Disease Control and Prevention (CDC) which administers the diagnosis codes released the 2017 ICD-10-CM codes on June 24, 2016. This information can be found at https://www.cms.gov/Medicare/Coding/ICD10/2017-ICD-10-CM-and-GEMs.html Since the release of the 2017 ICD-10-PCS codes, the healthcare vendor community has been waiting with bated breath for the 2017 ICD-10-CM…
EDITOR’S NOTE: The late Robert S. Gold, MD tackled the issue of sepsis even before the advent of the 1992 SIRS criteria. He made certain that healthcare professionals should be aware that capturing the true clinical picture should be first and foremost on the agenda. This is the second in…
Hematopoietic stem cells (HSCs) are produced in bone marrow. These stem cells are responsible for the constant renewal of blood, with the production of billions of blood cells every day.What is amazing about an HSC is the fact that it can differentiate itself into a variety of cells. An HSC…
In the past year, the spectacle of clashing interests, priorities, and agendas of the public and private sectors of America’s healthcare system played out in the electronic pages of ICD10monitor’s e-newsletter, which chronicled the turmoil leading to the adoption of the International Classification of Diseases, Version 10 (ICD-10).There it was…
SPECIAL TWO-PART SERIES GUEST CO-HOST Dennis R. Jones Nyack Hospital, Nyack, New York FEATURING Sue Bowman, MJ, RHIA, CCS, FAHIMA; Jon Elion, MD, FACC; Laurie Johnson, MS, RHIA, FAHIMA; and Joseph C. Nichols, MD; and Melissa Walton-Shirley, MD
Media
GUEST CO-HOST Dennis R. Jones Nyack Hospital, Nyack, N.Y. FEATURING Betty Bibbins, MD, BSN, CHC, C-CDI, CPEHR, CPHIT; Holly Louie, RN, CHBME; H. Steve Moffic, MD; Stephen Spain, MD, FAAFP; and Nick van Terheyden, MD
Media
June 20, 2016
Good, Bad Trends in ICD-10 Coding Accuracy: Early 2016 Data Revealed
By Eileen Dano Tkacik
A recent data set gathered from 300 coders at 50 health systems was revealing with regard to ICD-10 coding accuracy thus far following the October 2015 implementation. The data exposed both good news and bad news for health information management (HIM) directors and coding managers.The good news is that coding…
EDITOR’S NOTE: Last week’s nightclub shooting in Orlando once again generated a call for mental health screening to help keep firearms and assault weapons out of the hands of the mentally ill. In the aftermath of the shooting, ICD10monitor Publisher Chuck Buck checked in with nationally renowned psychiatrist H. Steven…
June 20, 2016
Men Not Proactive in Matters of Personal Health
By Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
June 19 was Father’s Day, and the conclusion of Men’s Health Week, which was celebrated June 13 through June 19. It appears that men are not proactive in taking care of their health, as evidenced by the Agency for Healthcare Research and Quality (AHRQ) data. The following statistics have been…
Life expectancy for American males is remaining stagnant and the overall U.S. death rate recently rose for the first time in a decade, according to concerning data released by the Centers for Disease Control and Prevention (CDC) in April and June.The life expectancy data, which compared rates recorded in 2013…
June 13–19, Men’s National Health Week, is set aside to shine a light on the topic of men’s health. While there is obviously an overlap between conditions that impact men and women, there are a number of conditions that are specific to men and specific to women.To try to understand…
In advance of the upcoming national observance of Father’s Day and in recognition of Men’s Health Week, which got underway yesterday and continues through Father’s Day, ICD10monitor is producing a two-part series on men’s health.The series will air today on Talk Ten Tuesdays, the live Internet radio broadcast produced by ICD10monitor. The…
EDITOR’S NOTE: The following is a transcription from an interview with Melissa Walton Shirley, MD, a consulting cardiologist with the St. Thomas Heart Group in Nashville, Tenn., by ICD10monitor publisher Chuck Buck.If I could have one present that I can give the men in my life for Father’s Day, it…
EDITOR’S NOTE: The late Robert S. Gold, MD tackled the issue of sepsis even before the advent of the 1992 SIRS criteria. He made certain that healthcare professionals should be aware that capturing the true clinical picture should be first and foremost on the agenda. This is the second in…
SPECIAL GUEST Angela Kennedy, EdDGUEST CO-HOST Gloryanne Bryant, Dan Catalano, MD, FACOG; Laurie Johnson; and Laurie McBrierty
Media
EDITOR’S NOTE: The following are the transcribed remarks by Mark Laudenberger during the May 24 edition of Talk Ten Tuesdays broadcast that honored the late Robert S. Gold, MD. Good morning, everyone – it is an extreme honor to be able to speak today on the life of Dr. Robert Gold.…
The proposed Inpatient Prospective Payment System (IPPS) rule changes proposed for the 2017 fiscal year were released on April 18. In reviewing the changes outlined in the 1,585-page rule, it became clear that there were a few practice areas that will be particularly impacted, and this article will focus on…
June 6, 2016
Achieving CDI Success from Key Performance Indicator Management Strategies Part II
By Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
EDITOR’S NOTE: This is the final installment in a two-part series examining how to manage a CDI program using Key Performance Indicator management strategies.If your set goals are not achievable, you may need to go back and look at the process. How can we eliminate things like duplicative work, administrative…
June 6, 2016
Catching a Breath with Cystic Fibrosis
By Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
EDITOR’S NOTE: This article has been written in recognition that May was National Cystic Fibrosis Awareness Month. More than 33,000 people in the United States are affected with cystic fibrosis, with 1,000 new cases of the genetic disease diagnosed each year, according to the Cystic Fibrosis Foundation.Surprisingly, at least half of…
EDITOR’S NOTE: The late Robert S. Gold, MD tackled the issue of sepsis even before the advent of the 1992 SIRS criteria. He made certain that healthcare professionals should be aware that capturing the true clinical picture should be first and foremost on the agenda. This is the second in…
SPECIAL GUEST Carmen D. Zorrilla, MD Professor, Obstetrics and Gynecology UPR School of Medicine San Juan, Puerto RicoALSO FEATURING Dennis Jones; H. Steven Moffic, MD; Denise Buenning, MSM; and Eileen Dano Tkacik
Media
SPECIAL GUEST Cesar M. Limjoco, MD Vice President of Clinical Services DCBA, Inc.ALSO FEATURING Daria Bonner, CHCA, CCP, RMC; Samantha Gold, CCS; Laurie Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10 CM/PCS Trainer; and Mark Laudenberger, RHIA, MS
Media
May 23, 2016
ICD-10: Pre-Bill Clinical Documentation Integrity Review
By Bonnie S. Cassidy, MPA, RHIA, FAHIMA, FHIMSS
Over the last few years, many provider organizations have encouraged collaboration among the revenue cycle team, clinical documentation improvement (CDI), case management, utilization management (UM), and coding staffs. There are many different and unique goals that each one of these lines of business have, yet they also have the mutual…
EDITOR’S NOTE: The late Robert S. Gold, MD tackled the issue of sepsis even before the advent of the 1992 SIRS criteria. He made certain that healthcare professionals should be aware that capturing the true clinical picture should be first and foremost on the agenda. This is the first in…
Given the added specificity inherent in ICD-10, it’s no surprise that medical necessity denials for physician practices and medical groups are expected to increase throughout 2016. In addition to greater levels of code granularity, three key industry drivers are expected to impact ICD-10 coding compliance among physician practices in the…
May 23, 2016
Achieving CDI Success from Key Performance Indicator Management Strategies Part I
By Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
EDITOR’S NOTE: This is the first in a two-part series examining how to manage a CDI program using Key Performance Indicator management strategies.Managing a clinical documentation improvement (CDI) program is about much more than just coordinating time-off requests, allocating budget items, coordinating meetings and trainings, facilitating the occasional audit, or…
Before I begin, I would like to take a moment and acknowledge Dr. Robert Gold, who passed away last week. Dr. Gold was a pioneer and leader in our field of clinical documentation improvement (CDI) and coding. He was first my mentor, then my colleague, and then my friend. I…
May 16, 2016
Industry’s First ICD-10 Coding Summit Expected to Attract Over 1,000 Attendees
By Stephanie Thompson, ICD10monitor National Correspondent
Laurie McBriertyDee LangHolly LouieGeorge V. Vancore, Jr. Preliminary reports indicate that more than 1,200 healthcare professionals have registered to attend the upcoming special edition broadcast of the industry’s first coding summit scheduled for Thursday, May 19. The live broadcast will feature George V. Vancore, Jr., senior manager and systems integrator and business…
May 16, 2016
Accurate ICD-10-CM Coding for ADHD Assists with Research and Data Collection
By Kim Carr, RHIT, CCS, CDIP, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer
EDITOR’S NOTE: Attention deficit hyperactivity disorder (ADHD) continues to make news. “Science Daily” reported recently that a new study from Aarhus University documented that there is some truth to the claim made by parents of children with ADHA that their children have more trouble falling to asleep than other children.…
May 16, 2016
Ransomware: An Emerging National Threat
By Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
The recent ransomware attack on MedStar Health, located in the Washington, D.C./Baltimore area and comprised of 10 area hospitals, is another indication of the current vulnerability of our nation’s medical records. In fact, cyber-invasions represent the fastest-growing threat to clinical information security, according to the FBI. Ransomware affects organizations through the…
Bonnie Cassidy, MPA, RHIA, FAHIMA, FHIMSS Laurie McBrierty, MLT, ASCP Dennis Jones Jim Daley Rudy Braccili Jr. MBA, CPAM, CRCE Seth Avery, JD, CPA
Media
AppRev announced this week that it has compiled and released the results of its historic ICD-10 implementation study.The study compared the last three months under ICD-9 (July-August 2015) with the first three months under ICD-10 (October-December 2015). The goal of the study was to allow hospitals and providers to view…
May 9, 2016
Toxicity in the HIM World a Cultural Problem
By Allen R. Frady, RN, BSN, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer
Allow me to preference this by saying I love coders. Many of my best work relationships are with coders. I am a coder, and have been since 1998. Coding gave me my career path into consulting. I owe much of what I have learned to all of those years poring…
The ICD-10 migration was by most accounts highly successful, despite its enormity of scope and effort. Since there will likely be other large changes coming down the road, the Workgroup for Electronic Data Interchange (WEDI) felt it would be important to understand why this transition went so well and to…
May 9, 2016
Getting ICD-10 Right: 2017 Claims Data Will Determine 2019 Payments
By Rhonda Buckholtz, CPC, CPMA, CPC-I, CRC, CDEO, CHPSE, COPC, CPEDC, CGSC
Last week at the Health Care Payment Learning and Action Network Spring Summit, there was some great information shared with representatives of the industry.For those who don’t know about the HCP LAN, they say in order to help achieve better care, smarter spending, and healthier people, the U.S. Department of…
SPECIAL CO-HOST Tina Greene Senior Regulatory Affairs Consultant Mitchell International ALSO FEATURING Rhonda Buckholtz, CPC, CPMA, CPC-I, CRC, CHPSE, CENTC, COBGC, CPEDC, CGSC; Kimberly Janet Carr, RHIT, CCS, CDIP, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer Rose T. Dunn, MBA, RHIA, CPA, FACHE, AHIMA ICD-10-CM/PCS Approved Trainer; Laurie Johnson, RHIA, FAHIMA, AHIMA-Approved ICD-10-CM/PCS…
Media
May 2, 2016
Industry’s First ICD-10 Coding Summit Will Have Expanded Coverage
By Stephanie Thompson, ICD10monitor National Correspondent
Laurie McBriertyDee LangHolly LouieGeorge V. Vancore, Jr.,The upcoming special edition broadcast of the industry’s first ICD-10 coding summit has been expanded to include George V. Vancore, Jr., senior manager and systems integrator and business architect for Florida Blue, the trade name for Blue Cross and Blue Shield of Florida. “We are particularly pleased…
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Bonnie S. Cassidy, MPA, RHIA, FAHIMA, FHIMSSCesar M Limjoco, MDChuck BuckDeborah Grider, CPC, CPC-H, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP, Certified Clinical Documentation Improvement PractitionerDenise M. Nash, MD, CCS, CIMErica E. Remer, MD, FACEP, CCDSEvan M. Gwilliam, DC, MBA, BS, CPC, CCPC, CCCPC, NCICS, CPC-I MCS-P, CPMAGlenn Krauss, RHIA, BBA, CCS, CCS-P, CPUR, CCDS, C-CDI, PCS, FCS, C-CDAMGloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-Approved ICD-10-CM/PCS TrainerHolly Louie, RN, BSN, CHBMEJoseph C. Nichols, MDKim Carr, RHIT, CCS, CDIP, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer
