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Standards Organizations Plan Collaboration

Author:

Source: Journal of AHIMA

Publication Date: June 2000


In March, the National Committee on Vital and Health Statistics (NCVHS) Subcommittee on Standards and Security reached an agreement with six standard-setting organizations. The six organizations include the Accredited Standards Committee X12, Dental Content Committee, Health Level Seven,....

Boosting Efficiency in Home Health Record Systems

Author: Abraham, Prinny

Source: Journal of AHIMA

Publication Date: April 2000


The growing pains of the past decade have led to medical record backlogs and record retrieval crises for many home healthcare agencies. These problems have pushed more than one agency director into enlisting the skills of an HIM professional to evaluate the medical record systems in pl....

Clarifying Selected CPT Modifiers

Author: Scichilone, Rita A

Source: Journal of AHIMA - Coding Notes

Publication Date: April 2000


Coding for professional services is complicated enough when coding professionals are charged with assisting the physician to select the best five-digit number for the services rendered. It becomes even more complex when circumstances of the case require the CPT code to be modified. Add....

Journal Q&A (4/00)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: April 02, 2000

Q: I was under the impression that a new prospective payment system (PPS) was to be implemented on October 1, 2000, for Medicare patients in rehabilitation hospitals. Where can I locate the proposed rules?
A: The Balanced Budget Act of 1997 mandated that a PPS be implemented for rehab h....

Code Sets: Improving the Quality of Coded Data

Author: Prophet, Sue

Source: HIPAA Conference 2000

Publication Date: March 14, 2000

2000 HIPAA Conference Presentation
Code Sets: Improving the Quality of Coded Data
The Healthcare Provider Perspective
Sue Prophet, RHIA, CCS
Director, Classification and Coding, AHIMA Current Problems with Use of Code Sets
Lack of acceptance of valid codes (e.g., V and E co....

Code Sets

Author: Brooks, Patricia E.

Source: HIPAA Conference 2000

Publication Date: March 14, 2000

2000 HIPAA Conference Presentation
Code Sets
Presented by Pat Brooks, RHIA
HCFA Standards for Electronic Transactions
HCFA-0149-P Published May 7, 1998 Final not yet published To be enacted 2 years after final notice (3 years for small plans)
Proposed Initial Standards for....

Transactions Standards

Author: Braithwaite, Bill

Source: HIPAA Conference 2000

Publication Date: March 14, 2000

2000 HIPAA Conference Presentation
Transactions Standards

Presented by Bill Braithwaite, MD, PhD, FACMI, Senior Advisor on Health Information Policy, US Dept. of HSS
Transaction Standards
NPRM published in 1998 (5/7/98 - 7/6/98) Adopts ASC X12N standards for transactions (e....

HIPAA Electronic Transactions

Author: Miller, Susan A

Source: HIPAA Conference 2000

Publication Date: March 14, 2000

2000 HIPAA Conference Presentation
HIPAA Electronic Transactions
Presented by Susan A. Miller, Esquire, Corporate Regulatory & Compliance Manager, IDX Systems Company HIPAA Summary
Title II, Subtitle F—Administrative Simplification of the Health Insurance Portability and Accoun....

Resolving Confidentiality Barriers in Research Data Collection

Author: Houser, Shannon H.; Engle, Molly; Schumacher, Joseph E; Caldwell, Ellen; Kohler, Connie L; Phelan, Sharon T; Raczynski, James M; Reynolds, Kim D

Source: Journal of AHIMA

Publication Date: March 2000


How can HIM professionals ensure data collection consistency without access to earlier records? When protecting patient anonymity posed a challenge in a research study, HIM professionals took a team approach to abstracting records that maintained quality without compromising confidentiality.

Steering Quality Improvement in Healthcare

Author: Schoenfelt, Suzanne

Source: Journal of AHIMA

Publication Date: February 2000


"Quality" is a multi-industry buzzword, but what does it really mean in today's healthcare climate? We asked the experts for their views on the state of quality improvement in healthcare and what lies in store for HIM professionals as QI evolves.
For decades, healthcare has concerned its....

Demystifying Nonphysician Practitioner Billing

Author: Lich, Denisha

Source: Journal of AHIMA

Publication Date: February 2000


To address today's financial challenges, healthcare facilities are increasing their use of nonphysician practitioners, such as nurse practitioners, clinical nurse specialists, and physician assistants, to provide patient care. As a result, providers need to pay close attention to the employmen....

Using CPT Modifier -25 for Professional Billing

Author: Yoder, Lois M.

Source: Journal of AHIMA

Publication Date: January 2000


You may want to consider a focused review of how your practice assigns CPT modifier -25, "a significant, separately identifiable Evaluation & Management (E&M) service by the same physician on the same day of the procedure or other service."1 The Health Care Financing Admini....

Crystal Ball for Coding

Author: Johns, Merida L.

Source: Journal of AHIMA

Publication Date: January 2000


What will the future of coding look like? A special AHIMA task force has several ideas. What will really happen depends on how coders choose to respond. Here's an overview of the task force's findings, plus suggestions on how readers can make the most of possible career opportunities.
It....

Off-Site Coding Success Story

Author: Kramer, Lynette; Meeks, Richard

Source: Journal of AHIMA

Publication Date: January 2000


If you asked HIM professionals about key success factors that substantially impact timely and accurate coding, three of the most common answers might be:
availability of the record immediately after the patient visit
availability of the complete record....

Global Language for Pharmaceutical Regulation

Author: Rulon, Vera

Source: Journal of AHIMA

Publication Date: January 2000


What will facilitate medical product regulation and related electronic data interchange worldwide? For some regulatory authorities, the answer is the Medical Dictionary for Drug Regulatory Affairs—also known as MedDRA.

MedDRA (the name is a trademark of the International Federat....

Trend Watch: Coding for Nonphysician Services

Author: Hill, Emily

Source: Journal of AHIMA

Publication Date: January 2000


From physician assistants to nurse practitioners, the number of healthcare professionals offering patient care services has increased dramatically in recent years. With this increase comes a challenge to coders—accurately reporting the services provided by these prof....

Coding Crosses into the Future

Author:

Source: AHIMA Advantage

Publication Date: December 1999


With all that's on your desk today, it's difficult to anticipate what changes are headed your way in the next year, let alone 10 years from now. But for a moment, as distant as it seems, consider what coding practice may look like on January 1, 2010.

It's a staggering question, one th....

Mobilizing to Do Adaptive Work

Author: Fletcher, Donna M.

Source: Journal of AHIMA

Publication Date: November 1999


Can our visionary leaders solve our problems? Sometimes. But more often, the reality is the power to solve problems lies with us. This is the fundamental assumption of the "adaptive work" concept presented in this article—along with some real-life examples of HIM adaptive work in action.....

Brief History of ICD-10-PCS

Author: Mullin, Robert L.

Source: Journal of AHIMA - Coding Notes

Publication Date: October 1999


The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) was developed as a replacement for the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) volume 3, Procedures. This version of ICD, in use since J....

Tools for Defining Data

Author: Shakir, Abdul-Malik

Source: Journal of AHIMA

Publication Date: September 1999


Similarly, data dictionaries, data sets, and data models have much in common, but many significant differences. Each can be used to define data, especially data that needs to get from point A to point B. This article describes each of these tools and the value they add to health information ma....

Compliance Efforts Get Some PEPP

Author: Bryant, Gloryanne H.

Source: Journal of AHIMA

Publication Date: September 1999


Earlier this year, the Office of the Inspector General (OIG) informed the Health Care Financing Administration (HCFA) that "the DRG system is vulnerable to abuse by providers who wish to increase reimbursement inappropriately through upcoding, particularly so within certain DRGs.&....

Getting Ready for APCs

Author: Scichilone, Rita A

Source: Journal of AHIMA

Publication Date: September 1999


While most healthcare practitioners support accurate coding, the challenge remains for HIM professionals: how to achieve coding accuracy in a system of imperfect data capture methods and changing reimbursement methodologies. Greater emphasis on coding specificity and completeness for reimburs....

PPS + New Technology = Growing Pains

Author: Blumenthal, Jane E

Source: Journal of AHIMA

Publication Date: September 1999


It's been a little more than a year since the prospective payment system (PPS) came into play in skilled nursing facilities. The post-acute PPS, initiated by the federal government under the 1997 Balanced Budget Act, was set in place to reduce the federal government's healthcare expend....

Automated Coding: The Next Step?

Author: Beinborn, Julie

Source: Journal of AHIMA

Publication Date: July 1999


Automated coding technology may be key to the evolution of the coding and billing processes. How do these systems work, and how will they change the role of the coder? The author offers a preview.
Technology is changing many aspects of healthcare, and coding is no exception.

R....

After Automated Coding, What?

Author:

Source: Journal of AHIMA

Publication Date: July 1999


As technology progressively automates more processes, what will HIM jobs look like in the future? In 1998, AHIMA published Evolving HIM Careers, which offers in-depth looks at seven new roles for HIM professionals, including the role of the clinical data specialist. Here are som....

Coders and Physician Liaisons: a Winning Combination

Author: Stavely, Starla

Source: Journal of AHIMA

Publication Date: July 1999


Never have so many HIM professionals had so much to worry about in the area of coding. Combine the need to keep an eye on case mix and a vigilant effort to prevent fraud and abuse, throw in a lack of physician documentation, increasingly stiff competition for the chart on nursing units, and co....

Where We've Been, Where We're Going

Author: Scichilone, Rita A

Source: Journal of AHIMA

Publication Date: July 1999



As conditions in the healthcare industry have become more challenging, many jobs have evolved. Not least among them in the HIM world is the role of the coder. In more ways than one, coding professionals are making their mark in the industry. And today, changes in coding requirements are pa....

Best Practices: What Works

Author: Carrier, Danielle

Source: Journal of AHIMA

Publication Date: July 1999




Medical record accuracy, record completion time, physician satisfaction—all of these are indicators of how well an HIM department is performing. The findings of a UHC benchmarking study may point the way to best practices that can be shared and adapted.

What....

Group Builds Consensus on Laboratory Test Policies

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 1999


The Balanced Budget Act of 1997 (BBA) mandated that the Health Care Financing Administration (HCFA) use a negotiated rulemaking process to develop national administrative and coverage policies for clinical diagnostic laboratory tests under Medicare Part B. The BBA stipulates that the p....

Sign of the Changing Times: CPT 1999

Author: Mallett, Sherri; Smith, Gail I.

Source: Journal of AHIMA

Publication Date: June 1999


This year brought with it 686 changes to CPT. While this is a moderate number in comparison to previous years, several of the changes have significant impact on code assignment. The purpose of this article is to highlight some of the areas of significant change. (See "1999 CPT Revisions" in t....

Imagine the Future of Coding

Author:

Source: AHIMA Advantage

Publication Date: June 1999


How will coding be different in the year 2010? Pondering the coding practices of tomorrow is the job of AHIMA's Coding Futures Task Force. And though there's no crystal ball involved, trends that will have a substantial impact on the future can be identified today.

Remember the word p....

Post-acute PPS: Changing the Way We Code

Author: Dougherty, Michelle

Source: Journal of AHIMA

Publication Date: June 1999


HIM professionals in post-acute care are reinventing their roles to accommodate the new coding demands of a prospective payment system. Here are some of the developments that are creating new interest in coding issues for post-acute settings.
Three major forces -- the prospective payment....

Managed Care in the Age of Accountability

Author: Tercero, Wendy

Source: Journal of AHIMA

Publication Date: April 1999


Additionally, as managed care grows, quality and cost will reach equilibrium, and today's economically driven model will have stabilized, turning into one that truly balances cost and quality. Healthcare organizations of the future will need to implement information systems that support decisi....

Clear Focus on Coding

Author: Moses, Rhona

Source: Journal of AHIMA

Publication Date: April 1999


For the past three years I have been manager of coding education and billing guidelines at Group Health Cooperative, a 600,000-member HMO. Group Health has 25 primary care clinics, four specialty centers, an ambulatory surgical center, and two hospitals. We have about 700 staff physic....

Benchmarking with National ICD-9-CM Coded Data

Author: Osborn, Carol E.

Source: Journal of AHIMA

Publication Date: March 1999


As HIM professionals, we want to be assured that we are providing the highest quality data for reimbursement and research purposes. We can review coded data internally, but this does not give us a clear picture of the total information that is being submitted to the Health Care Financing Admin....

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