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New PPS Proposed for LTC Hospitals
Author: Dougherty, Michelle
Source: Journal of AHIMA
Publication Date: July 2002
In the past 10 years, the number of new long-term care hospitals (LTCHs) in the United States has tripled. Because of this growth, LTCHs are the newest post-acute settings to face a change in the reimbursement system.
While there are only about 270 LTCHs in the United States, t....
Early Word on HIPAA Claims Attachments
Author: Dougherty, Michelle
Source: Journal of AHIMA
Publication Date: October 2001
If we could look into a crystal ball and see into the future, it would be much easier to prepare for HIPAA, particularly the electronic transaction standards. Because of the rarity of crystal balls these days, we must rely on other predictors at our disposal, such as the white paper issued by t....
New Home Care PPS Brings Major Changes
Author: Dougherty, Michelle
Source: Journal of AHIMA
Publication Date: October 2000
The home care industry will undergo a significant shift in reimbursement methodology when HCFA implements a new prospective payment system (PPS) for Medicare claims on October 1, 2000. Under the new system, a Medicare beneficiary receiving covered home care services will be reimbursed for a 6....
Standard Terminology Helps Advance EHR
Author: Dougherty, Michelle
Source: Journal of AHIMA
Publication Date: November 2003
On July 1, 2003, Secretary of the Department of Health and Human Services Tommy Thompson announced a new agreement between the National Library of Medicine (NLM) and the College of American Pathologists (CAP) to license SNOMED-CT. This five-year agreement is seen as a significant advancement f....
Advancing Technology Connects Transcription and Coding: The Developing Role of NLP, NLU, and CAC in HIM
Author: Dooling, Julie A
Source: Journal of AHIMA
Publication Date: July 2012
For many years transcription and coding departments have been two separate and independent structures within health information management (HIM).
While these areas have always been interdependent regarding their need to share documentation, their technology platforms have op....
Transcription and Data Capture in the EHR
Author: Dooling, Julie A
Source: Journal of AHIMA
Publication Date: June 2011
Transcription has always played an important role in HIM, but today it is taking on a new role in supporting the meaningful use program. Organizations are looking to leverage their transcription technology to capture structured data within their electronic health records (EHRs), a requirement....
Organization Track - Definitions, Assumptions and Issues: Use Case Specification
Author: Dolin, Robert H
Source: AHIMA Convention | AHIMA Clinical Vocabulary Mapping Meeting
Publication Date: October 15, 2005
Code Sets: Improving the Quality of Coded Data
Author: Dixon-Lee, Claire
Source: HIPAA Conference 2000
Publication Date: March 14, 2000
2000 HIPAA Conference Presentation
Code Sets: Improving the Quality of Coded Data
Presented by Claire Dixon-Lee, PhD, RHIA Future of Code Sets
Data Content Standardization Data Elements including formats and definitions Code Sets and values
Maximum defined data set Computer-....
Importance of Coding in Hospital Benchmarking and Performance Evaluation
Author: Dismuke, Clara
Source: IFHRO Congress | AHIMA Convention
Publication Date: October 15, 2004
Introduction
The Diagnosis Related Group (DRG) system was created in the US and has spread widely around the world. Currently, approximately 36 countries use some version of the system for either information collection, financing, or reimbursement for inpatient care.1 This widespread ad....
ICD-10 Moves Healthcare One Step Closer to Improved Documentation
Author: Diop, Karen
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: November 2015
Change has become a constant in healthcare. With the introduction of electronic health record (EHR) systems, core measures, the “meaningful use” EHR Incentive Program, value-based purchasing, and the ICD-10-CM/PCS code sets, the healthcare industry has been bombarded by wave after wave in....
CMS Readies for 5010, ICD-10
Author: Dimick, Chris
Source: ICD-TEN Top Emerging News | AHIMA newsletter article
Publication Date: May 02, 2011
Reminisce back to the simpler days of 2009. The ICD-10 deadline, set for 2013, seemed far enough in the distance to be manageable, and aside from transitioning to HIPAA Version 5010, no other government initiatives seemed to stand in the way of preventing on-time compliance.
But then cam....
Presenters Discuss ICD-10 Documentation Needs
Author: Dimick, Chris
Source: ICD-TEN Top Emerging News | AHIMA newsletter article
Publication Date: July 02, 2011
The warnings have rung loud since the ICD-10-CM/PCS deadline was set. The more specific ICD-10 code set will require more specific physician documentation – documentation that is currently missing from medical records.
Looking to explore these warnings, Texas State University faculty and....
Growing ICD-10: Seedling Transition Programs Take Root
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: June 2011
There are two basic approaches to the ICD-10 transition: (1) a late, mad scramble to get systems converted before the deadline; or (2) an intentional cultivation that uses the transition to improve business processes, documentation, and clinical care. Three organizations offer a picture of the....
Clinical Documentation Specialists
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: July 2007
Clinical documentation improvement programs are growing, moving some HIM professionals to the clinic floor.
With sharp eyes, clinical documentation specialist Sharnetha White calmly combs through a patient’s chart. She isn’t fazed by the organized chaos that surround....
ICD-10 Postcards: Canadians, Australians Share Experiences with ICD-10 Implementation
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: March 2008
When people face a big change, they often call a friend for advice. It’s natural to seek out those who have experienced a similar transition.
Many questions surround the implementation of ICD-10 in the US. Besides the big question of when the classification system will be requir....
Certified I10-Ready
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: October 2011
To build up competencies in the new code set, AHIMA-credentialed professionals must add ICD-10-CM/PCS continuing education to their credential maintenance through 2013.
The impending coding classification system change from ICD-9 to ICD-10 is the talk of health information....
Art of Keeping Current: Coding Supervisors Must Meet Today’s Deadlines, Prepare for Tomorrow’s Changes
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: July 2008
Change is the constant in coding. And while it is a coding supervisor’s job to stay current and implement these changes, sometimes just getting the day-to-day coding work accomplished is a challenge.
Staying ahead of the changes can be difficult, but it is important that manage....
Clear Road Ahead: No Dead-End Jobs in This Coding Department
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: August 2011
A coding department reorganizes its career paths from the bottom up, creating a culture of professional development.
Six years ago, a limited promotional structure, high turnover, and low recruitment had knocked a dent in the morale of Denver Health's coding department.
Simplification at Last? HHS Rolls out Operating Rules for HIPAA Transaction Standards
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: February 2012
The HIPAA transaction standards-meant to streamline financial and administrative transactions-have instead devolved into a kind of free-for-all. Now the first operating rules are in hand to standardize use of the standards and gain the efficiencies originally intended.
When it....
Getting the Best from Your ICD-10 Vendor
Author: Dimick, Chris
Source: Journal of AHIMA - website
Publication Date: May 2011
May 10, 2011
Payers and providers must work their way through the transition to ICD-10-CM/PCS only once, and by the end, few will likely choose to do it again. System vendors and consultants, however, will have been through many, many implementations before it’s all over.
Achieving Coding Consistency
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: July 2010
Even small departments may never experience complete harmony in their assignment of codes, but they have good motivation for achieving as much consistency as they can. Training, communication, monitoring, and coding reviews help reach that goal, HIM experts say.
Coding manager Julie....
Top Documentation Issues for ICD-10
Author: Dimick, Chris
Source: Journal of AHIMA - website
Publication Date: April 2011
Apr 18, 2011
ICD-10-CM/PCS offers organizations better data about their patient populations and the services they provide them. The code set’s greater specificity allows coding professionals to more accurately reflect the details of physician documentation.
However, an....
Year of the Audit
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: March 2010
The healthcare forecast for 2010 includes a strong chance of audit. HIM professionals in many organizations will be busy responding to a shower of external record requests and internal compliance checks.
Stormy systems of audit programs, compliance initiatives, and fraud preventi....
US Organizations Look Ahead
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: March 2008
Transitioning to ICD-10-CM may seem like a distant problem. But SSM Integrated Health Technologies began its preparations about three years ago. Its reason is simple: “Something of this magnitude, you don’t want to be scurrying,” says Anne Stuckel, SSM’s manager of clini....
Strategies to Prepare for ICD-10 Transition
Author: Dimick, Chris
Source: ICD-TEN Top Emerging News | AHIMA newsletter article
Publication Date: June 02, 2011
Tick tock. Health information management professionals know that sound well, as each beat of the clock brings closer the ICD-10-CM/PCS implementation deadline of October 1, 2013.
Despite significant competing IT priorities and pressure to reduce costs, most healthcare providers and payer....
Field Guide: Seeing the Trees through the Forest in 2012
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: January 2012
A forest of issues crowds the 2012 HIM landscape. AHIMA practice experts offer a guide for the year ahead.
The seedlings of change planted in 2009 by the announcement of the ICD-10 transition and the American Recovery and Reinvestment Act have sprouted into a towering forest of....
Anticipating the EHR: a Coding Department Gets ahead of the Curve with Workflow Analysis
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: July 2007
With the hospital’s emergency department converting to a completely electronic record, the coding department at Cleveland Clinic had a choice. Staff could sit tight, wait for the implementation to roll out, and then be rocked in its wake.
Or they could set out to meet the s....
Three Short Years: Organizations Lagging in 5010 and ICD-10 Progress
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: September 2010
The calendar is marching steadily toward October 2013, when all healthcare organizations must begin submitting claims using the ICD-10-CM and ICD-10-PCS code sets. Much needs to be done in making the transition, and healthcare organizations should have taken major steps in their preparation al....
Shadowing Physicians for Documentation Improvement
Author: Dimick, Chris
Source: Journal of AHIMA - website
Publication Date: September 2009
posted by Chris Dimick
Sep 01, 2009 08:05 am
Strike when the ink is wet.
That is the motto of the clinical documentation improvement specialists (CDSs) at Shands Hospital, based in Jacksonville, FL. They routinely “shadow” physicians as part of their clinical....
Sweeping Revisions for Cancer Registries: Like Coders, Cancer Registrars Adapting to Major Changes
Author: Dimick, Chris
Source: Journal of AHIMA - website
Publication Date: July 2010
Jul 01, 2010 07:02 am
Coding professionals are not alone as they prepare for the sweeping changes that come with the ICD-10-CM/PCS implementation. They only need to look down the hospital hall to find another department grappling with a major shakeup in how it classifies clinical do....
Leading Clinical Documentation Improvement: Three Successful HIM-led Programs
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: July 2008
Clinical documentation improvement programs are increasingly common, but who leads them varies. Here’s a look at three successful programs led by HIM departments.
Tammy Love knew they were coming. She needed to take action.
It was April 2006, and Love, RHIA, CCS, knew....
HIM Breakup: Changing Times Pull HIM and Coding Apart
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: March 2009
Benefits can follow when coding packs its bags and moves to the revenue cycle. But all realignments have their opportunities and risks.
HIM and coding are breaking up.
Once a common couple, the two departments are beginning to split at some facilities, moving on to differen....
Quality Check: An Overview of Quality Measures and Their Uses
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: September 2010
Meaningful use and pay-for-performance are shining a spotlight on quality measures. There are hundreds of measures in use, but most fall within three broad categories.
Just performing a healthcare service may not be enough to receive payment anymore. Increasingly, payers are ty....
Top-10 for ICD-10: Essential Tasks for the First Phase of the Journey
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: June 2011
It's a long journey to ICD-10 implementation. Organizations that need directions-or a jumpstart-can use a new checklist to map out 10 milestones for the first leg of the journey.
Healthcare facility staff unsure how to start the conversion to ICD-10 now have a ready-reference road ma....
Mortality Coding Marks 10 Years of ICD-10
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: July 2009
Morbidity coders rarely see a mortality code. But for 10 years the National Center for Health Statistics has been busy compiling mortality data coded in ICD-10.
There are a thousand ways to die in this life, and the National Center for Health Statistics tracks every one of the....
Computers, Coding, and Change
Author: Dimick, Chris
Source: Journal of AHIMA
Publication Date: January 2008
Computer-assisted coding won’t eliminate the profession, but it will change it dramatically.
Mythily Srinivasan thought she was out of a job. Out with human coders, in with computer-generated coding. At first that seemed to be her facility’s master plan.
Ensure Equitable Reimbursement through an Accurate Charge Description Master
Author: Dietz, Mark S.
Source: AHIMA Convention
Publication Date: October 21, 2005
Introduction
The charge description master (CDM) plays an important role in the revenue cycle process of a healthcare facility. The importance of the CDM has accelerated as providers try to obtain equitable reimbursement and continually focus on this area, which will obtain the gr....
ICD-10 Implementation: Objects on the Horizon Are Closer Than You Think
Author: Dickhudt, Daryl; Steinichen, Paul; Battani, Jordan; Computer Sciences Corporation
Source: External web site
Publication Date: April 15, 2010
Role of Coding and Documentation in the Quality Payment Program
Author: DeVault, Kathryn; Easterling, Sharon; Huey, Kim
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: January 2017
In the current era of healthcare transformation, the continuing importance of documentation and coding cannot be overstated. With the multitude of acronyms being added to the healthcare vocabulary, one may wonder where documentation and coding fits in. It’s important to remember that....
FY 2012 Changes to the Hospital IPPS
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: November 2011
The final rule for the FY 2012 Hospital Inpatient Prospective Payment System was released August 1, 2011. Changes in the rule went into effect with October 1, 2011, inpatient discharges.
MS-DRG Documentation and Coding Adjustment
The Centers for Medicare and Medicaid Services....
ICD-10-PCS Root Operation Groups, Part 3
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: September 2010
Root Operations That Alter the Diameter/Route of a Tubular Body Part and That Define Other Repairs
The medical and surgical procedure section of ICD-10-PCS contains most, but not all, procedures typically coded and reported in the hospital inpatient setting. This article is the th....
The Musculoskeletal System and ICD-10-CM/PCS
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: September 2011
The ICD-10-CM/PCS transition will provide coding professionals with the opportunity to enhance their coding skills. However, it will also require most coders brush up on their anatomy and physiology knowledge. Now is the perfect time to gain a better understanding of the differences between IC....
2015 ICD-10-CM Coding Guideline Changes
Author: DeVault, Kathryn
Source: CodeWrite | AHIMA newsletter article
Publication Date: March 2015
Although they were minimal, the 2015 ICD-10-CM Coding Guidelines contained some updates that should be reviewed, as they provide additional clarification for coding in ICD-10-CM. A complete set of the 2015 guidelines can be found on the CMS website. Several of the guideline changes and upd....
ICD-10-PCS From the Heart: Cardiovascular Procedures
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: September 2015
The complexity of ICD-10-PCS, as well as the need for a better understanding of anatomy and physiology and the technique of surgical procedures, has been well documented. The coding of cardiovascular procedures in ICD-10-PCS, in particular, requires focus.
Consider these p....
MACRA Quality Payment Program: Its Importance and Impact
Author: DeVault, Kathryn
Source: CodeWrite | AHIMA newsletter article
Publication Date: March 2017
With 2017 well underway, there will be continued conversation about the Medicare Access and CHIP Reauthorization Act (MACRA) program, which began in 2015 and will continue beyond 2021. MACRA is a quality payment program (QPP) which replaced the Sustainable Growth Rate (SGR) methodology and....
Six Months and Counting: Are You Ready for ICD-10-CM/PCS Implementation?
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: April 2015
With just six months until the implementation of ICD-10-CM and ICD-10-PCS, now is the time for HIM professionals to re-evaluate the state of their facility’s implementation plan and make any necessary adjustments to ensure a successful transition. Previous delays may have slowed down....
Best Practices for Coding Productivity: Assessing Productivity in ICD-9 to Prepare for ICD-10
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: July 2012
As organizations begin to prepare for ICD-10 implementation, the question of coder productivity is usually close to the top of everyone's list. Addressing productivity in ICD-9-CM will provide a baseline of information crucial for the transition to ICD-10-CM/PCS.
The AHIMA e-HIM Cod....
2010 CPT Coding Update
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: February 2010
Changes to CPT codes for 2010 include 219 additions, 141 revisions, and 63 deletions. This article highlights some of the more notable changes; a comprehensive list can be found in appendix B of the 2010 CPT coding book. The changes took effect January 1.
Resequencing
The most n....
FY 2010 Changes to the Hospital IPPS
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: November 2009
The final rule for the FY 2010 Hospital Inpatient Prospective Payment System was released on July 31, 2009. Changes in the rule went into effect with inpatient discharges of October 1, 2009, and are reflected in Grouper Version 27.0.
The changes to MS-DRGs and the complication and co....
The Respiratory System and ICD-10-CM/PCS
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: January 2012
The transition to ICD-10-CM/PCS will provide coding professionals with the opportunity to enhance and improve their coding skills. However, it will also require coders brush up on their anatomy and physiology knowledge. This is the perfect time to gain a better understanding of the differences....
Rooting Out ICD-10 Procedure Codes, Part 5
Author: DeVault, Kathryn
Source: ICD-TEN Top Emerging News | AHIMA newsletter article
Publication Date: July 02, 2010
Editor’s note: This is the fifth of a nine part series discussing the nine root operation groupings.
There are 31 root operations in the medical and surgical procedure section of ICD-10-PCS. These root operations are arranged into nine groups that share similar attributes. This artic....
Coding Root Operations with ICD-10-PCS: Understanding Drainage, Extirpation, and Fragmentation
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: June 2013
Editor’s note: This is the third in a series of 10 articles discussing the 31 root operations of ICD-10-PCS.
The implementation of ICD-10-PCS will challenge the skills of coders-it contains many unique features and provides an opportunity to truly reflect the complexity of....
Coding Root Operations with ICD-10-PCS: Understanding Bypass, Inspection, and Map
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: November 2013
Editor's note: This is the seventh in a series of 10 articles discussing the 31 root operations of ICD-10-PCS.
In this article, the Journal of AHIMA continues the 10 part Coding Notes series focusing on the 31 root operations of ICD-10-PCS. This article will take a more in de....
FY 2011 Changes to the Hospital IPPS
Author: DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: November 2010
The final rule for the FY 2011 Hospital Inpatient Prospective Payment System was released July 30, 2010. Changes in the rule went into effect with October 1, 2010, inpatient discharges.
The changes to MS-DRGs and the complication and comorbidity (CC) and major complication and comorb....
Denial Management--The Secret to Correct Coding
Author: Derricks, Joette; Cogley, Janis
Source: AHIMA Convention
Publication Date: October 21, 2005
Introduction
For most healthcare providers, Medicare is the largest payer. According to the Centers for Medicare & Medicaid Services (CMS), it rejects 26 percent of the services it processes, with 40 percent of these never rebilled. This results in 11 percent of all Medicare claims ne....
Audit the Auditors: Are Your Documentation, Coding and Billing Audit Findings Valid?
Author: Derricks, Joette
Source: AHIMA Convention
Publication Date: October 15, 2004
Recently, the General Accounting Office (GAO) released the 2003 Revised Government Auditing Standards , also referred to as the "Yellow Book."1 These standards outline proper audit protocols governing auditors' competence, integrity, objectivity, and independence in planning, conducting,....
Clinical Validation: the Next Level of CDI (December 2016 update)
Author: Denton, Debra Beisel; Endicott, Melanie; Ericson, Cheryl E; Love, Tammy R.; McDonald, Lori; Willis, Daphne
Source: AHIMA practice brief
Publication Date: December 2016
One of the more challenging tasks for both coding and clinical documentation improvement (CDI) professionals is clinical validation. This is a relatively new responsibility that has evolved as CDI programs mature and CDI and coding professionals advance their knowledge and collaboration on clin....
Clinical Validation: The Next Level of CDI
Author: Denton, Debra Beisel; Endicott, Melanie; Ericson, Cheryl E; Love, Tammy R.; McDonald, Lori; Willis, Daphne
Source: AHIMA practice brief | Journal of AHIMA
Publication Date: July 2016
This practice brief has been updated. See the latest version here. This version is made available for historical purposes only.
ICD-10: Turning Regulatory Compliance Into Strategic Advantage
Author: Deloitte Center for Health Solutions
Source: External web site
Publication Date: August 15, 2008
HHA Prospective Payment System Changes
Author: Deakle, Mary S; DeVault, Kathryn
Source: Journal of AHIMA - Coding Notes
Publication Date: March 2013
Several changes to the prospective payment system went into effect at the start of 2013, including coding changes affecting the M1024 Rule.
Reimbursement for home healthcare agencies (HHA) was converted to a prospective payment system by the Centers for Medicare and Medicaid....
Help Wanted: Five Steps to Take Before You Hire
Author: Davis, Nadinia A.; Gentul, Marion K.
Source: Journal of AHIMA
Publication Date: March 2002
Are you hiring? This excerpt from AHIMAs new publication, Effective Management of Coding Services, offers basic guidelines that coding managers can use to assess their facilities needs when recruiting applicants to fill a vacancy in the HIM department.
Step One: Perform a Ne....
Lessons Learned from the Bill Error Correction Process
Author: Davis, Nadinia A.
Source: AHIMA Convention
Publication Date: October 02, 2011
ABSTRACT
Front-end errors in registration and charge entry prevent billing problems that drive up the DNFB. These errors can lead to denials for incorrect billing or untimely filing. Bill error correction is typically housed in Patient Financial Services, in which case HIM staff are invol....
Do You Want Fries With That? Decoding All the 'Extras' in Physician Visits
Author: Davies, Sharon
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: September 2016
Place an order at almost any fast food chain and you can expect to hear the cashier ask, “Do you want fries with that?” From fries to soft drinks to apple pie desserts, extras abound at any given restaurant. When working on the coding for physician visits, it’s important to keep all the p....
How to Make the Most of your "Coding" Compliance Review: Before during and after moving forward with the results
Author: Daube, Julie L
Source: AHIMA Convention
Publication Date: September 27, 2010
Baseline Audits & Compliance Program: Getting Started
In these ever changing times in HIM, the one thing we are hearing over and over is the word "audit". For some of us it sends shivers down our spines thinking about all the government agencies and commercial....
Society for Clinical Coding Comes Around as CoP
Author: D'Amato, Cheryl; Hoag, Patience J.; Crocker, Elsa; Neville, Deborah; Carpenter-Barbee, Cheryl; Bartell, Laurie
Source: Journal of AHIMA - Coding Notes
Publication Date: June 2002
Remember the glorious Knights of the Round Table who made Camelot famous? King Arthur created a meeting place with special significance, a roundtable at which every seat had equal worth. AHIMA has embraced the spirit of this concept in a program known as coding roundtables, which are designed....
Final Rule for FY 2008 IPPS: MS-DRGs and POA Top List in a Year of Major Change
Author: D'Amato, Cheryl; Garrett, Gail S.; Johnson, Laurie M.
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: November 2007
The final rule for the fiscal year 2008 inpatient prospective payment system (IPPS) went into effect October 1, 2007. The rule includes ICD-9-CM code changes, implementation of the new Medicare severity-adjusted (MS) DRG system, and a number of quality-related changes that affect how Medic....
How Gaps in Data Quality Impact Reimbursement
Author: D'Amato, Cheryl
Source: AHIMA Convention
Publication Date: October 10, 2001
Introduction
Improving the quality and flow of data for outpatient services will impact how facilities fare financially under Medicare's outpatient prospective payment system (OPPS). This paper will provide practical advice on how to effectively evaluate and reengineer coding....
Health Information Management Improving the Revenue Cycle: Practical Applications for Acute Care Facilities
Author: Curtis, Elizabeth; Osborn, Carol E.; Maxim, Dorothy
Source: AHIMA Convention
Publication Date: October 21, 2005
Introduction
The broad ownership of the revenue cycle within a healthcare organization complicates management. In any healthcare setting, the revenue cycle consists of a complex set of processes that involve multiple departments coordinating reviews of multiple monitors to ensure a health....
Coding Connections in Revenue Cycle Management
Author: Cummins, Ruth; Waddell, Julie
Source: Journal of AHIMA - Coding Notes
Publication Date: July 2005
Recently, there has been a significant amount of talk in the healthcare industry about revenue cycle improvement. So what is all of the excitement about? It is about the bottom line. Specifically, how we can improve our bottom line through more effective and efficient revenue cycle management.....
Strategies for Implementing Computer-Assisted Coding Technology
Author: Cummins, Ruth; Kocsis, Christina; Ryan, John
Source: AHIMA Convention
Publication Date: October 31, 2006
Introduction
Nationwide, computer-assisted coding (CAC) tools are being tested, trialed and implemented. Early results indicate a significant impact on coding productivity and quality. Why, however, has the prevalence of such coding engines been so slow to enter the market? Are they diffi....
Preparing for Automated Coding
Author: Cummins, Ruth
Source: AHIMA Convention
Publication Date: October 15, 2004
Introduction
On an ongoing basis, the coding staff and HIM management teams in healthcare facilities anticipate and prepare for changes in codes, coding guidelines, payment systems, and coding regulations. Additionally, the proposed upgrade of the coding classification system to ICD-10 is....
Using Data to Survive RAC Attacks: Analyzing Audit Data Helps Mitigate Future RAC Risk
Author: Crump, Dawn
Source: Journal of AHIMA
Publication Date: January 2014
Medicare's Recovery Audit Contractor (RAC) program began as a three-year, three-state pilot program in 2005 and went nationwide in 2009. The American Hospital Association (AHA) began tracking data collection in January 2010 and since then, according to AHA, the RAC program has recouped $2.....
Remote Coding Solutions: Ensuring Bottom-line Results with Remote Control (A Case Study)
Author: Crossley, Linda
Source: AHIMA Convention
Publication Date: October 15, 2004
Introduction
Recognizing the key role that coding plays in maintaining the financial viability of healthcare organizations, health information management industry leaders are looking for ways to optimize available coding resources, as well as to increase student enrollment in academic pr....
How to Improve Your Revenue Cycle Processes in a Clinic or Physician Practice
Author: Crocker, Janice
Source: AHIMA Convention
Publication Date: October 31, 2006
How to Improve Your Revenue Cycle Processes in a Clinic or Physician Practice
Janice Crocker, MSA, RHIA, CCS, CHP
Introduction
Reimbursement for medical practices has been impacted by various trends and healthcare industry changes over the last five to ten years. Medicare and Medica....
Building Data Quality into Clinical Trials
Author: Crerand, William J.; Lamb, Jana; Rulon, Vera; Karal, Bilun; Mardekian, Jack
Source: Journal of AHIMA
Publication Date: November 2002
Data management's mission is to construct databases that are complete and high quality to meet a study's analytic objectives and comply with regulatory standards. In this article, we'll provide an overview of basic procedures and approaches used in the pharmaceutical industry to "build quality....
Everyday Ethics: AHIMA Code of Ethics Guides Daily Work, Complex Situations
Author: Crawford, Mark
Source: Journal of AHIMA
Publication Date: April 2011
Ethics can look easy on paper, but the working world offers some complex situations. Three scenarios illustrate how the AHIMA Code of Ethics provides a guide for examining ethical issues.
Anyone who is a member of AHIMA or holds its credentials agrees to abide by its code of ethics.....
Truth about Computer-Assisted Coding: A Consultant, HIM Professional, and Vendor Weigh in on the Real CAC Impact
Author: Crawford, Mark
Source: Journal of AHIMA
Publication Date: July 2013
HIM professionals have been looking for some truth and straight talk on computer-assisted coding (CAC). The technology has been billed as everything from the savior of coding-based bottom lines due to ICD-10-CM/PCS (ICD-10) to the automated destroyer of human coding jobs. As the technology....
E/M Coding for Nonphysician Practitioner Services
Author: Cox, William G.
Source: Journal of AHIMA - Coding Notes
Publication Date: June 2004
Effective January 1, 1988, a provision of the Balanced Budget Act of 1977 (Section 4511) removed restrictions on settings where nurse practitioners, physician assistants, and clinical nurse specialists provide services. The definition of a clinical nurse specialist was also modified to requir....
Medicare Data Study Spotlights Coding Errors
Author: Cottrell, Carlton
Source: Journal of AHIMA
Publication Date: September 2000
Coding quality for Medicare claims is an area of constant concern. Coding errors can have far-reaching effects in the healthcare universe, and coders are experiencing increased scrutiny from both regulators and hospitals looking to control costs. As a follow-up to results of a Medica....
Re-engineering the Coding Workflow: Assessing Today with an Eye toward Tomorrow
Author: Coplan-Gould, Wendy; Carolan, Katie; Friedman, Beth
Source: Journal of AHIMA
Publication Date: July 2011
EHRs, CAC, ICD-10-coding is in the midst of profound change. Which makes this the best time to re-engineer coding workflow. Five steps help HIM professionals assess and evolve coding workflows with an eye toward tomorrow.
Synergism-where total outcome is greater than the s....
Understanding New Medicare Coverage Determinations
Author: Cooper, Steve
Source: Journal of AHIMA - Coding Notes
Publication Date: July 2004
Recent legislation included in both the Benefits Improvement and Protection Act (BIPA) and the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 has affected the content and implementation processes for Medicare coverage determinations. This column reviews differenc....
National Correct Coding Initiative Affects CPT Reporting
Author: Cooper, Mary; Ahern, Kitty; Dietz, Linda S.
Source: Journal of AHIMA - Coding Notes
Publication Date: February 2000
This article has been abstracted from the AHIMA Nov. 4, 1999 audio seminar "National Correct Coding Initiative" conducted by the authors. For a copy of the complete 90-minute seminar tape, contact AHIMA at (312) 233-1100.
Since 1996, the Health Care Financing Administration (HCFA) has us....
How the Indian Health Service Implemented the Electronic Health Record
Author: Cooper, Margaret; Gowan, Patricia
Source: AHIMA Convention
Publication Date: October 21, 2005
Introduction
The Indian Health Service is an agency within the Department of Health and Human Services, and it is responsible for providing federal healthcare services to American Indians and Alaska Natives. The Indian healthcare delivery system serves approximately 1.6 million of the nat....
Clarification on the Use ICD-10-CM External Cause and Unspecified Codes in ICD-10-CM
Author: Cooperating Parties for ICD-10-CM/PCS and ICD-9-CM Coding
Source: Government (U.S.)
Publication Date: May 14, 2013
Approved by the four Cooperating Parties for ICD-10-CM/PCS and ICD-9-CM Coding, which includes American Health Information Management Association, American Hospital Association, Centers for Medicare & Medicaid Services, and National Center for Health Statistics
External Cause Codes
Universal Adapters: Terminology Standards Enable Meaningful Data Exchange
Author: Cook, Jane; Foley, Margaret M.; Giannangelo, Kathy; Paterno, Marilyn D.; Scichilone, Rita A; Schwarz, Kathleen M.
Source: Journal of AHIMA
Publication Date: January 2009
Standardized clinical terminologies are critical connectors that allow systems to exchange health information.
In the winter of 1904 a major fire broke out in Baltimore, MD. The resulting damage—an entire swath of the downtown destroyed—was blamed largely on a lack of uni....
Understanding National Coverage Policies: Navigating the Maze of HACs, Serious Reportable Events, and Wrong Surgical Sites
Author: Cook, Jane; D'Amato, Cheryl; Garrett, Gail S.; Ruhnau-Gee, Becky; Hyde, Linda A.; Novak, Natalie
Source: Journal of AHIMA - Coding Notes
Publication Date: June 2009
Present on admission indicators, hospital-acquired conditions, serious reportable events, and “wrong” surgical events are each hot topics. However, they also can be a hot topic together, because a number of these reporting requirements are interrelated. HIM professionals must under....
Gauging Stakeholder Response to ICD-10
Author: Comfort, Angie; Maimone, Carol; Rugg, Donna
Source: Journal of AHIMA
Publication Date: February 2016
Starting with services provided on or after October 1, 2015, health systems across the country transitioned to coding with the International Classification of Diseases, 10th Revision (ICD-10). Implementation of ICD-10 is intended to deliver both immediate and long-term benefits including....
Hospital Outpatient Prospective Payment System Updated for 2014
Author: Comfort, Angie
Source: Journal of AHIMA - Coding Notes
Publication Date: March 2014
With only a few weeks left in 2013, the Hospital Outpatient Prospective Payment System (OPPS) final rule for calendar year (CY) 2014 was released on November 27, 2013 and went into effect on January 1, 2014. The final rule is normally provided to the public around the first week of Novemb....
CY 2017 OPPS Update
Author: Comfort, Angie
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: February 2017
As last year drew to a close, facilities began the looming task of reviewing the Hospital Outpatient Prospective Payment System (OPPS) final rule to ensure their chargemaster and systems were up-to-date with the 2017 changes. The final rule for calendar year (CY) 2017 was released on Novem....
CY 2013 OPPS Update
Author: Comfort, Angie
Source: Journal of AHIMA - Coding Notes
Publication Date: March 2013
As 2012 drew to a close, US healthcare facilities began the daunting task of reviewing the Centers for Medicare and Medicaid Services’ (CMS) hospital outpatient prospective payment system (OPPS) update to ensure their chargemaster and systems were up-to-date with the 2013 changes. Th....
Ensuring Remote Coding Compliance
Author: Comfort, Angie
Source: Journal of AHIMA - Coding Notes
Publication Date: April 2012
More and more HIM department managers are turning to remote coding. However, before implementing this staffing model, managers must answer several questions regarding the privacy and security of patient information, including:
What are the compliance risks?
How will privacy and secu....
Coding Root Operations with ICD-10-PCS- Understanding Restriction Occlusion and Dilation
Author: Comfort, Angie
Source: Journal of AHIMA - Coding Notes
Publication Date: October 2013
Editor’s note: This article is the sixth in a series of 10 articles discussing the 31 root operations of ICD-10-PCS.
With the upcoming implementation of ICD-10-PCS, there are new definitions and descriptions used to describe the procedures performed. Coding professiona....
Coding Open Fractures in ICD-10-CM
Author: Comfort, Angie
Source: Journal of AHIMA - Coding Notes
Publication Date: September 2012
Fractures are a common medical malady, and coders encounter them often. But the differences between coding fractures in ICD-9-CM and ICD-10-CM are vast.
Upon implementation of ICD-10-CM the code system currently in place for fractures within ICD-9-CM will cease to exist, and a new,....
Resolving Conflict in the CDI-Coding Professional Relationship
Author: Combs, Tammy
Source: AHIMA blog post | Journal of AHIMA - website
Publication Date: April 27, 2016
If a couple were to decide they wanted to build a house, they would need to communicate regularly to complete the home and make sure it fit the needs of both of them. If one of them were to say, “We need three bedrooms,” and the other one instead said, “No, we must have four bedrooms,” the....
Ensuring Data Quality in the Pharmaceutical Industry
Author: Collins, Christine M.
Source: Journal of AHIMA
Publication Date: June 1998
Education and training play a considerable part in efforts to enhance data quality in healthcare. How do other fields work toward data consistency? The author describes how professionals in the pharmaceutical industry manage their data.
Today healthcare data serve a variety of sign....
Implementing a Mobile Coding Solution
Author: Colgan, Peter
Source: In Confidence (newsletter)
Publication Date: July 02, 2001
Wireless computing technologies capable of enabling clinical and administrative decision support throughout the extended healthcare enterprise have arrived! Among the benefits of any wireless healthcare solution is the wide distribution of information throughout the enterprise. This benefit r....
Importance of Clinical Terminologies and Mapping
Author: Cohn, Simon P.
Source: AHIMA Convention | AHIMA Clinical Vocabulary Mapping Meeting
Publication Date: October 15, 2005
Perspectives on Managing Regulations: HIPAA and Medicare Supervision
Author: Cogley, Janis; Derricks, Joette
Source: AHIMA Convention
Publication Date: October 15, 2004
The focus of this paper is to discuss one of the major considerations that come into play regarding the Centers for Medicare and Medicaid Services (CMS) requirements for supervision of ancillary personnel, the incident to requirement.
CMS defines incident to as "services and supplies fur....
Diagnosis Coding and Medical Necessity: Rules and Reimbursement
Author: Cogley, Janis
Source: AHIMA Convention
Publication Date: October 15, 2004
Introduction
The origins of using diagnosis codes in hospitals and other healthcare settings goes back to the early 1950s when the US Public Health Service and the Veterans Administration extended the concept of using the International Classification of Diseases to hospital indexing of m....
Synthesis and Future Directions
Author: Clinical Vocabulary Mapping Methods Institute
Source: AHIMA Convention | AHIMA Clinical Vocabulary Mapping Meeting
Publication Date: October 15, 2005
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