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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....

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....

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....

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....

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....

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....

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.

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....

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....

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....

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....

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....

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....

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....

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....

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....

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 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,....

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....

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