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New Guidance for Home Health Coding

Author: Blevins, Ida K.

Source: Journal of AHIMA - Coding Notes

Publication Date: July 2009


Sweeping PPS changes for home health went into effect January 2008, making much of the prior coding guidance issued by the Centers for Medicare and Medicaid Services (CMS) incompatible with changes in the revised data collection set. Home health coding professionals anxiously awaited further i....

Home Health PPS Update

Author: Blevins, Ida K.

Source: Journal of AHIMA - Coding Notes

Publication Date: January 2008


The long-anticipated update to the Home Health Prospective Payment System (PPS), released in the August 29, 2007, Federal Register, goes into effect January 1, 2008. The final rule encompasses a wide range of changes for home health agencies.
An Overview of the Final Rule
....

Getting Quality Clinical and Coded Data: How UMHS's CDIP Improved Clinical Coded Data and Clinical Staff Relationships

Author: Blackford, Gwendolyn; Whitehouse, Rosanne

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: October 2007


Obtaining codeable clinical documentation at the point of care in a large teaching facility can be challenging. However, the HIM department at the University of Michigan Health System (UMHS) in Ann Arbor, MI, took on the task, implementing a clinical documentation improvement program (CDI....

Discover How to Survive Medicare Severity DRGs with a Successful Clinical Documentation Improvement Program and Present on Admission Indicators

Author: Blackford, Gwendolyn

Source: AHIMA Convention

Publication Date: October 17, 2008


Health Information Management Department at the University of Michigan Hospitals and Health Centers
Introduction

What changes will be next for the inpatient coding world? October 1, 2007 had a tremendous impact on hospitals as it relates to clinical documentation for facility re....

Final Push to ICD-10 Implementation

Author: Birnbaum, Cassi L

Source: Journal of AHIMA

Publication Date: June 2015



Chills run up and down my spine as I write this article, knowing how hard we have worked as a profession, association, and industry to get to this red letter date for ICD-10-CM/PCS.


Just before I wrote this column, I was on the edge of my seat along with the rest of indust....

Partnering with Revenue Cycle for Success

Author: Biesboer, Pat; Pace, Mary Anne

Source: AHIMA Convention

Publication Date: October 15, 2004

Introduction

For any business to be successful, revenue must flow quickly and efficiently into the organization. In healthcare, the revenue cycle is complicated, and success can be elusive, but there are plenty of success stories to know that good marks are achievable. Challenges have be....

Keeping Up with the CPT/HCPCS Changes

Author: Bielby, Judy A

Source: CodeWrite | AHIMA newsletter article

Publication Date: September 2011



Although January 1 is regarded by many professional coders as the date when CPT®/HCPCS code changes are implemented, it is becoming increasingly important for professional coders to pay attention to those new CPT/HCPCS codes which are implemented throughout the year. There may be insta....

Gestational Diabetes

Author: Bielby, Judy A

Source: CodeWrite | AHIMA newsletter article

Publication Date: October 2011



Objective:  To discuss coding for gestational diabetes.


Coding scenarios: Patient A is 30 weeks pregnant and is seen for treatment of gestational diabetes. Patient B is seen for diabetes screening. Patient B is not currently pregnant, does not currently have a diagnosis....

Acute, Subacute, and Chronic Conditions

Author: Bielby, Judy A

Source: CodeWrite | AHIMA newsletter article

Publication Date: August 2012



The coding of acute, subacute, and chronic conditions can be challenging. Acute conditions are typically sudden in onset or have a rapid onset in severe or sudden symptoms. Acute conditions often have a short course. Conversely, chronic conditions have a much slower course than acute condi....

Reporting and Sequencing of V Codes

Author: Bielby, Judy A

Source: CodeWrite | AHIMA newsletter article

Publication Date: August 2013



A few months ago, the Centers for Medicare and Medicaid Services (CMS) published the Inpatient Prospective Payment System fiscal year 2014 proposed rule. One of the proposals concerns ICD-9-CM code V45.88 for Tissue Plasminogen Activator (tPA) administration within 24 hours prior to admi....

Coding Neoplasms in ICD-10-CM

Author: Bielby, Judy A

Source: Journal of AHIMA - Coding Notes

Publication Date: October 2011


ICD-10-CM codes provide greater detail than ICD-9-CM codes for reporting neoplasms. In many instances, ICD-10-CM neoplasm codes can provide information on whether a neoplasm occurred in a right-sided or left-sided body part. ICD-10-CM also provides codes for reporting neoplasm sites with great....

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....

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....

CPT Category III Codes Cover New, Emerging Technologies: New Codes Developed to Address Issues in Light of HIPAA

Author: Beebe, Michael

Source: Journal of AHIMA - Coding Notes

Publication Date: October 2003


In 1998, the American Medical Association (AMA) initiated the CPT-5 Project. This project was a broad-based and comprehensive effort to make needed and practical enhancements to the CPT code set that would address challenges presented by emerging user needs and HIPAA. One of the initiatives tha....

Computer-Assisted Coding: A Year Later. Proof of Concept Pilot Results, The Department of Veterans Affairs

Author: Bebb, Jacki; Hanken, Mary Alice; Helbig, Susan; Longosky, Sean; Main, Renee; Wood, Shirley

Source: AHIMA Convention

Publication Date: October 05, 2009


Health Information Management, VHA Central Office and the VA Puget Sound Health Care System
Objective

Beginning in late 2008, the Veterans Health Administration (VHA) began a proof of concept project to determine if natural language processing (NLP) and computer assisted coding....

"Chutes and Ladders" of the Revenue Cycle: Strategies to Understand Data and Coding Quality Issues That Impact Your Ability to Successfully Play the Revenue Cycle Game

Author: Bauman, Carrie M.

Source: AHIMA Convention

Publication Date: October 15, 2004

Introduction

Since 1991, I have made a career in health information management. I entered the profession in the roles of assistant director and director of medical records in the acute care setting. After installing a Windows-based chart tracking system and a document imaging system, I f....

EHRs Offer Coders Opportunities, Challenges

Author: Batres, Janie

Source: Journal of AHIMA - Coding Notes

Publication Date: October 2012


With emerging technologies like electronic health record systems (EHRs) and computer-assisted coding (CAC) gaining traction in the healthcare industry, coding professionals are being presented with more challenges and opportunities than ever before. The shift from paper-based records to electr....

ICD-10-CM and ICD-10-PCS Preview Exercises

Author: Barta, Ann

Source: AHIMA book

Publication Date: January 02, 2010


Description:   ICD-10-CM and ICD-10-PCS are on their way, and it is imperative that coding professionals be prepared for the transition to the new coding system. This workbook will prepare current coding professionals for the increased knowledge required by the implement....

2014 ICD-10-CM/PCS Updates

Author: Barta, Ann

Source: Journal of AHIMA - Coding Notes

Publication Date: January 2014



This article highlights the 2014 ICD-10-CM/PCS updates as approved by the ICD-9-CM Coordination and Maintenance Committee, which includes representatives from the Centers for Medicare and Medicaid Services and the National Center for Health Statistics. As a result of the partial code set....

Coding ICD-10-PCS Medical and Surgical-Related Sections: Understanding Measurement and Monitoring, Extracorporeal Assistance and Performance, and Extracorporeal Therapies

Author: Barta, Ann

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: May 2014



Editor’s note: This is the second in a series of three articles discussing the Medical and Surgical-related sections of ICD-10-PCS.


In this article, the Journal of AHIMA continues its three part Coding Notes series focusing on the nine Medical and Surgical-related secti....

ICD-10-PCS Root Operation Groups, Part 2

Author: Barta, Ann

Source: Journal of AHIMA - Coding Notes

Publication Date: April 2010


Root Operations that Take Out Solids, Fluids, Gases from a Body Part, Involve Cutting or Separation Only, and Put In OR put Back or Move Some OR All of a Body Part

The medical and surgical procedure section of ICD-10-PCS contains most, but not all, procedures typically coded and repor....

ICD-10-CM Official Coding Guidelines

Author: Barta, Ann

Source: Journal of AHIMA - Coding Notes

Publication Date: June 2009


One of the keys to a successful transition to ICD-10-CM/PCS is a thorough understanding of the ICD-10-CM Official Coding Guidelines, which were posted to the National Center for Health Statistics Web site in January 2009. Similar to the ICD-9-CM coding guidelines, the ICD-10-CM guidelines are....

Coding ICD-10-PCS Medical and Surgical-Related Sections: Understanding Osteopathic, Other Procedures, and Chiropractic

Author: Barta, Ann

Source: Journal of AHIMA | Journal of AHIMA - Coding Notes

Publication Date: June 2014


Editor’s note: This is the third in a series of three articles discussing the Medical and Surgical-related sections of ICD-10-PCS.

IN THIS ARTICLE, the Journal of AHIMA continues its three-part Coding Notes series focusing on the nine Medical and Surgical-related sections of ICD-10-PC....

The Circulatory System and ICD-10-CM/PCS

Author: Barta, Ann

Source: Journal of AHIMA - Coding Notes

Publication Date: May 2011


Many coding professionals will need to learn new terminology and brush up on their anatomy and physiology (A&P) knowledge to prepare for the ICD-10-CM/PCS transition. Although it is still too early for intense training on the new code sets, now is the time for coding professionals to gain....

Obstetric Coding in ICD-10-CM/PCS

Author: Barta, Ann

Source: Journal of AHIMA - Coding Notes

Publication Date: June 2010


ICD-10-CM/PCS will capture a greater level of specificity for obstetric coding. This article highlights some of the new features in coding obstetric cases with ICD-10-CM/PCS.
OB Diagnoses Coding with ICD-10-CM

Obstetric cases require diagnosis codes from chapter 15 of ICD-10-CM,....

PRO-West's Payment Error Prevention Program

Author: Baron, Anne

Source: AHIMA Convention

Publication Date: October 10, 2001




Background

Beginning in 1997, the Office of the Inspector General (OIG) started conducting annual audits of Medicare billing practices. These audit results estimated that Medicare had paid more than $23 billion in incorrect payments in 1996 and more than $20 billion in 1997.....

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....

Closer Look at All-Patient Refined DRGs

Author: Averill, Richard F.

Source: Journal of AHIMA

Publication Date: January 2002


Are you fluent in DRG? This article takes a look at the evolution of the three distinct DRG systems and spotlights the most recent iteration, All-Patient Refined DRGs. It also sheds light on how this system, when codes are properly applied, can help an organization study morbidity and mortalit....

HCFA Publishes Final Home Health PPS Rule

Author: Asmonga, Donald D.

Source: Journal of AHIMA

Publication Date: September 2000


The Health Care Financing Administration (HCFA) published the final rule for the prospective payment system (PPS) for home health agencies in July. This rule, which takes effect October 1, 2000, replaces the retrospective reasonable-cost-based system used to pay for home health service....

The Year That Was and the Year to Be

Author: Asmonga, Donald D.

Source: Journal of AHIMA

Publication Date: February 2011


The second session of the 111th Congress began with the Democrats in firm control of the House and Senate. Working from their position of power enabled the Democrats to pass healthcare reform.

Although Congress was mired in contentious debates, AHIMA still advocated for its public po....

Bridging the ICD-10 Divide through Advocacy: New National AHIMA Advocacy Initiative will Mirror THIMA ICD-10 Outreach Efforts

Author: Asmonga, Donald D.

Source: Journal of AHIMA

Publication Date: November 2012



AHIMA has long advocated for ICD-10, and these advocacy efforts have overcome some stout barriers to ensure the implementation of the modern, more detailed classification system. Even with this recent success and the reassurance that comes with the final ICD-10 implementation date set for....

Clinical Documentation Improvement in the Outpatient Setting

Author: Arrowood, Danita; Johnson, Laurie M.; Wieczorek, Michelle M.

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: July 2015



Clinical documentation improvement (CDI) programs have proven their worth with over a decade of success and continued role expansion in the inpatient setting. As the healthcare industry prepares for new initiatives such as value-based purchasing, electronic health records (EHRs), and ICD-1....

Start to Finish Medical Necessity Review

Author: Arner, Kathy

Source: AHIMA Convention

Publication Date: October 10, 2001



Purpose: To identify why rejections occur and where the problem areas are located.


Why are rejections occurring on the professional side?


Medicare and other insurances are implementing local medical review policies.

Ordering providers are not supply....

ICD-10's Impact Reaches Far Beyond Coding: Examining the New Code Sets' Revenue Cycle Implications

Author: Arends-Marquez, Alexa; Knight, Nicole; Thomas-Flowers, Dwan

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: November 2014



The implications of ICD-10-CM/PCS (ICD-10) for coding operations are a common topic of industry discussion, but the impact of ICD-10 reaches far beyond coding alone. ICD-10 is embedded in the entire revenue cycle for providers. The conversion will impact almost every aspect of operations,....

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