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Interpretive Guidelines for Life Safety

Author: U.S. Centers for Medicare & Medicaid Services

Source: Government (U.S.)

Publication Date: October 02, 1986

State Operations Manual
Appendix I - Interpretive Guidelines for Life Safety

Interpretive Guidelines for Physical Therapists in Independent Practice

Author: U.S. Centers for Medicare & Medicaid Services

Source: Government (U.S.)

Publication Date: February 02, 1987

State Operations Manual. Appendix F
Interpretive Guidelines, Physical Therapists in Independent Practice

Disorders of the Breast

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: May 1996

Carcinoma

Breast cancer is the most common form of cancer in women. Risk factors include a personal or family history of breast cancer, delayed childbearing, and personal history of benign breast disease.
A tumor may be identified by mammogram or self-examination. Many tumors are d....

Myocardial Infarctions: Frequently Asked Questions

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 1996

Myocardial Infarctions

Many coders still have questions regarding the correct coding and sequencing of myocardial infarctions (MI), particularly in relation to the use of the fifth digits, transfers, underlying diagnosis, and performance of procedures. The following information is provide....

Quest for Quality and Comparability in the National Healthcare Database: Announcing A Payer’s Guide to Health Care Data Quality and Integrity

Author: AHIMA Coding Policy and Strategy Committee

Source: Journal of AHIMA - Coding Notes

Publication Date: September 1996


As the computer-based patient record slowly becomes a reality, the need has never been greater for a national cooperative effort to recognize and apply uniform terminology and coding guidelines for both the clinical community and fiscal intermediaries. AHIMA’s Coding Policy and Strategy Commit....

ICD-9-CM Revisions -- Effective October 1, 1996

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: October 1996


The revisions to ICD-9-CM became effective with discharges occurring on or after October 1, 1996. Highlights of the changes are summarized below. Since not every revision is described in this article, it is important to review the official authorized addendum published in a special edition of....

Evolution of HEDIS: 3.0 and Beyond

Author: Rulon, Vera; Sica, JoAnn

Source: Journal of AHIMA

Publication Date: June 1997


History of HEDIS
Employer Issues Leading to HEDIS
The Health Plan Employer Data and Information Set (HEDIS) is a set of standard performance measures designed to provide purchasers and consumers with the information they need to compare the performance of managed healthcare plans.....

Managing Clinical Data: A Cancer Registries Update

Author: Watkins, Sue

Source: Journal of AHIMA

Publication Date: July 1997


Introduction
The American Cancer Society estimates that about 1.38 million new cancer cases will be diagnosed, and about 560,000 Americans will die of cancer, in 1997.1 These estimates do not include carcinoma in situ or basal and squamous cell skin cancer. To monitor trends in cancer i....

Overview of Trauma Registries in the United States

Author: Garthe, Elizabeth

Source: Journal of AHIMA

Publication Date: July 1997

Overview of Trauma Registries

How many trauma registries are there in the US? This is a tough question to answer. According to a survey conducted by members of the Emergency Nurses' Association (ENA), the number of clients reported by trauma registry software companies exceed 1850 organi....

Hypertensive Disorders of Pregnancy

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: September 1997


Hypertension complicates at least 10 percent of all pregnancies. The hypertensive disorder of pregnancy most likely to result in significant adverse clinical outcomes is preeclampsia.

Preeclampsia
Preeclampsia is unique to pregnancy and is characterized by elevated blood press....

Physician Office Billing Compliance Program

Author: Eisenhauer, Sue

Source: Journal of AHIMA

Publication Date: October 1997


Physician offices try to adhere to the coding and billing guidelines as defined by Medicare. However, claims to commercial insurance carriers frequently are not handled as precisely. The passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) has brought to our atte....

ICD-9-CM Revisions (effective 10/1/97)

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: November 1997


The revisions to ICD-9-CM became effective with discharges occurring on or after October 1, 1997. Highlights of the changes are summarized below. Since every revision is not described in this article, it is important to review the Official Authorized Addendum. The complete addendum is publish....

Coding Compliance: Practical Strategies for Success

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: January 1998


"Fraud," "abuse," "upcoding," "unbundling," and "compliance" have all become buzzwords in the news media. Eliminating healthcare fraud and abuse has become a top priority for the federal government. Government investigations are on the rise and providers everywhere tremble at the thought of b....

Stevens-Johnson Syndrome

Author: Prophet, Sue

Source: Journal of AHIMA - Coding Notes

Publication Date: March 1998


The term "erythema multiforme" was first used by von Hebra in 1866 to describe a disease characterized by symmetrically distributed, pleomorphic, evolving cutaneous lesions, located primarily on the extremities, and by a proclivity for recurrence. In 1922, Stevens and Johnson....

Managed Care: The Dominant Paradigm in US Healthcare

Author: Welch, Julie J.

Source: Journal of AHIMA

Publication Date: April 1998


What does "managed care" really represent -- and what effect has managed care had on the healthcare market? The author describes how managed care came to be a critical market force, offers a snapshot of its proliferation, and examines its effects on the traditional payment system.
It's....

Testing ICD-10-PCS

Author: Brooks, Patricia E.

Source: Journal of AHIMA

Publication Date: May 1998



HCFA conducted a formal test of ICD-10-PCS (procedure coding system) in order to determine if it would be a practical replacement for the current ICD-9-CM, Procedures. This coding system was developed after an open competition contract was awarded to 3M/HIS. In order to avoid any con....

No Uncertain Terms

Author: Zender, Anne

Source: Journal of AHIMA

Publication Date: May 1998


HIM professionals think of classification systems such as ICD-9-CM as tools for everyday use. But these familiar systems are evolving and changing rapidly—as Donna Pickett, RRA, is well aware.

Pickett is medical systems administrator for the Office of Data Standards, ....

Development of the ICD-10 Procedure Coding System (ICD-10-PCS)

Author: Averill, Richard F.; Mullin, Robert L.; Steinbeck, Barbara A.; Goldfield, Norbert I; Grant, Thelma M.

Source: Journal of AHIMA

Publication Date: May 1998


The ICD-10 Procedure Coding System (ICD-10-PCS) has been developed as a replacement for Volume 3 of ICD-9-CM. This article will describe the development and structure of ICD-10-PCS‹as well as describe the modifications that have been made to the system as a result of extensive review and test....

Nursing Data, Classification Systems, and Quality Indicators: What Every HIM Professional Needs to Know

Author: Henry, Suzanne Bakken; Warren, Judith J.; Zielstorff, Rita D.

Source: Journal of AHIMA

Publication Date: May 1998

by Suzanne Bakken Henry, RN, DNSc, FAAN, Judith J. Warren, RN, PhD, FAAN, and Rita D. Zielstorff, RN, MS, FAAN

The nursing profession has developed a number of classification systems. What can HIM professionals learn from the processes and results? This article presents an overview of the....

Maximizing Data Quality of the Minimum Data Set

Author: Zender, Anne

Source: Journal of AHIMA

Publication Date: June 1998


HIM professionals who work in long term care settings are well acquainted with the Minimum Data Set 2.0 (MDS). Since 1990, it has been part of the standardized assessments that nursing homes participating in the Medicare and Medicaid programs must complete. Starting this summer, updated submis....

Comparative Data--Its Impact and Opportunities

Author: Bellile, Susan K.

Source: Journal of AHIMA

Publication Date: June 1998


A battle for control of medical management is now being waged among hospitals, managed care plans, insurers, employers, physician groups, and researchers—a battle in which data is the weapon of choice. Cumulative and comparative healthcare information is being used to eva....

What is Gulf War Syndrome (Part II)

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: September 1998


Presidential Advisory Committee on Gulf War Veterans' Illnesses

President Clinton established the Presidential Advisory Committee on Gulf War Veterans' Illnesses in May 1995 to ensure an independent, open, and comprehensive examination of health concerns related to Gulf War service....

Journal Q&A (10/98)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: October 02, 1998


Q: I work in a skilled nursing facility and want to know if it is mandatory for all states to use Resource Utilization Groups III (RUGS III). If so, when was the deadline?

A: The Balanced Budget Act of 1997 mandates the implementation of a per diem prospective payment sy....

FY1999 Inpatient PPS Changes: ICD-9-CM Revisions

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: October 1998


All of the inpatient DRG and other inpatient Prospective Payment System (PPS) changes described below became effective with discharges occurring on or after October 1, 1998. Complete details of these changes can be found in the Federal Register.1
Transfers to Postacute Settings

....

Performance Improvement for Documentation

Author: Labak, Carol

Source: Journal of AHIMA

Publication Date: October 1998


We've all seen it before: that look of bewilderment on a physician's face when a discussion about documentation arises. While this is not the first incidence of this discussion between the physician and the health information manager, neither is it the first time the HIM professional ....

Benchmarking Project Harvests Ideas for Network

Author: Zender, Anne

Source: Journal of AHIMA

Publication Date: November 1998


It started as a simple benchmarking project. But when Patricia Rhodes, RRA, Carol Keller, MPA, and their team finished, the project had taken them across the country, opened up lines of communication with staff members at nine other facilities, and helped them improve their....

Rheumatoid Arthritis

Author: Prophet, Sue

Source: Journal of AHIMA - Coding Notes

Publication Date: November 1998


Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, and other organs in the body. An autoimmune disease is one in which the body tissues are mistakenly attacked by the body's own immune system. Patients have antibodies in....

1999 CPT Revisions

Author: Willard, Dianne

Source: Journal of AHIMA

Publication Date: January 1999


This article will summarize some of the major additions and revisions in the 1999 Current Procedural Terminology (CPT). A complete review of all the code and guideline changes -- including the rationale for these changes -- can be found in the November 1998 issue of the CPT Assistant newslette....

AHIMA's Response to HCFA on the Notice of Proposed Rule-Making on the Proposed Prospective Payment System for Hospital Outpatient Services

Author: Kloss, Linda L

Source: AHIMA testimony and comments

Publication Date: January 06, 1999


Text:

The American Health Information Management Association (AHIMA) is pleased to have the opportunity to submit comments on the proposed prospective payment system for hospital outpatient services.

Description of the Ambulatory Payment Classification (APC) Groups
W....

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