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E-assistance for Coding Professionals

Author: Uppena, Mary

Source: Journal of AHIMA - Coding Notes

Publication Date: September 2001




Is the Web a part of your work day? Make sure it is. From purchasing products to distance learning to online coding, coding professionals can find all kinds of resources online to meet their needs.

A Look at the Future

In a recent survey, health system CEOs were ask....

2002 DRG Updates Already in Effect

Author: Uppena, Mary

Source: Journal of AHIMA - Coding Notes

Publication Date: November 2001



The 2002 diagnosis related group (DRG) updates went into effect October 1, 2001. With the implementation of these changes to the hospital inpatient DRGs portion of the prospective payment system (PPS), there will be 499 DRGs in 25 Major Diagnostic Categories (MDCs).


Changes t....

Preparing the Physician Office for HIPAA

Author: Uppena, Mary

Source: Journal of AHIMA - Coding Notes

Publication Date: February 2001




Change has been a constant factor in coding and reimbursement with the intensified focus on billing, compliance, and cost control. Out of necessity, coding professionals in physician settings have learned to be organized, adaptable, and armed with the latest information. The mandates....

Common E/M Documentation Issues

Author: Udell, Curtis

Source: Brief Encounter

Publication Date: July 02, 2001


One of the constant challenges facing managers today is evaluating physician documentation and then helping their physicians to improve the content of their patient notes, particularly for evaluation and management (E/M) services.

While physicians may have unique style or flair to t....

Coding for Medicare Advantage Plans

Author: Truscott, Tricia

Source: AHIMA Convention

Publication Date: October 02, 2011


Background


The Centers for Medicare and Medicaid Services (CMS) use a reimbursement methodology similar to the DRG system for coverage of Medicare patients enrolled in Medicare Advantage plans through private insurance companies. Using ICD codes from hospital and physician visit....

IRF PPS Coding Challenges

Author: Trela, Patricia

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

Publication Date: May 2007


Inpatient rehabilitation facility (IRF) coding can be a challenge due to the Medicare Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS), which was implemented in 2002 to cover patients paid under Medicare Part A. IRF PPS requires completion of the IRF-Patient Assessment In....

Implementation of Inpatient Computer Assisted Coding at the University of Pittsburgh Medical Center

Author: Towers, Adele L; Soso, Nancy; Needham, Tamara

Source: AHIMA Convention

Publication Date: October 05, 2009

Background

Coder productivity and accuracy has become even more important in this era of declining reimbursements, hybrid charts, increasing medical complexity, and continuous auditing. Computer Assisted Coding (CAC) for hospital inpatient charts is being proposed as a solution to improve....

Back to Basics: APC Payment Methodology

Author: Tomak, Tracey

Source: CodeWrite | AHIMA newsletter article

Publication Date: April 2017



In August of 2000, the Centers for Medicare and Medicaid Services (CMS) introduced the Ambulatory Payment Classifications (APCs) under the Outpatient Prospective Payment System (OPPS). The objective of the APC payment system was to control costs and increase efficiencies for outpatient ser....

Working Smarter with APCs

Author: Thoman, Deborah J.

Source: Journal of AHIMA

Publication Date: May 2001




Are HIM professionals ready to make the most of APCs? This article suggests some strategies to improve the way we work with APCs, focus on complete and accurate coding, and improve our expertise.
Are HIM professionals ready for the next step in APCs? Are we ready to use APC data....

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....

Impact of Implementing an EMR on Coding Professionals. A Case Study of Kaiser Permanente Colorado: Implementing an EMR for 1,000 Providers at 18 medical office buildings

Author: Taylor, James M

Source: AHIMA Convention

Publication Date: September 25, 2010


(If you are in a smaller practice and perform many of these functions yourself, the unintended consequences of EMR implementation discussed below still apply. You will need to alter your approach to coding in the new EMR environment and the strategies for successful post-implementation coder s....

Diabetes Mellitus

Author: Swindle, Jennifer

Source: CodeWrite | AHIMA newsletter article

Publication Date: December 2012



Coding diabetes to the highest degree of specificity with all the related manifestations has always been problematic. It’s not because the rules surrounding diabetes coding are so complex, it's because documentation does not always clarify the necessary elements.


According....

Modifers – ‘Friend or Foe’

Author: Swindle, Jennifer

Source: AHIMA Convention

Publication Date: October 02, 2011

ABSTRACT:

Background: The need for modifiers to further and appropriate identify accurate coding information to all payers is critical for appropriate and accurate reimbursement. Failure to use modifiers can have a negative impact on a physician or an organizations’ revenue as witho....

Assessing Coder Change Rates as an Evaluation Metric

Author: Stoner, Jean; Nossal, Michael; Resnik, Philip; Kapit, Andrew; Toren, Richard

Source: AHIMA Computer-Assisted Coding Meeting | Perspectives in Health Information Management

Publication Date: September 2006

In a typical model for computer-assisted coding, the system automatically identifies codes, which are then improved by a human review coder in order to more closely approach the codes that would be assigned to the note by an idealized "gold standard" coder. Assuming such a model, a natural method for evaluating system accuracy might be the coder change rate—specifically, the percentage of notes approved by a coder without modification in a day-to -day business setting. In this paper we look more carefully at change rates as a measure of coding accuracy.

Crossing the Rubicon: Developing a Strong Inpatient/Outpatient Coding Structure at Duke

Author: Stone, Fabian; Wooley, Barbara; Egan, Jeanne M.; Gallagher, Timothy

Source: AHIMA Convention

Publication Date: October 10, 2007

Overview

Duke University Health System (DUHS), based in Durham, NC, consists of Duke University Hospital, Duke Health Raleigh Hospital, Durham Regional Hospital, Duke University Affiliated Physicians (DUAP), Private Diagnostic Clinic (PDC), and the Patient Revenue Management Organization....

Opening Pandora's Box: Pure Coding vs. Charge Master Driven Coding--a Case Study at Duke University Health System

Author: Stone, Fabian; Egan, Jeanne M.; LeBoutillier, Richard; Blackwelder, Dean

Source: AHIMA Convention

Publication Date: October 31, 2006

Opening Pandora’s Box: Pure Coding vs. Charge Master Driven Coding
A Case Study at Duke University Health System
Fabian Stone, MBA, MHA, Duke University Hospital
Jeanne Egan, MBA, RHIA, CHP, CCA, BearingPoint
Richard LeBoutillier, MPA, CPHQ, BearingPoint
Dean Blackwel....

Know Your APCs: Data Analysis Made Simple

Author: Stegman, Melinda

Source: Journal of AHIMA

Publication Date: July 2001



You’ve adapted processes to the APC system, but do you really understand the financial impact of APCs on your organization? The author shows you how to analyze your billing data to assess the impact of APCs on your facility’s bottom line.



Since the implement....

What’s the Difference? SNOMED CT and ICD Systems are Suited for Different Purposes

Author: Stearns, Mike; Fuller, Jan C.

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

Publication Date: November 2014



The International Classification of Diseases (ICD) and SNOMED CT are similar in that both systems have alphanumeric codes associated with clinical concepts. But the systems differ in their purpose and structure, and are best used in different ways in healthcare. For starters, ICD is a cla....

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....

The Cardiac Cath Coding/Charging Crossover

Author: Stanton, Kristi

Source: AHIMA Convention

Publication Date: October 02, 2011

Introduction

Many hospitals utilize the charge description master (CDM) to code and charge for cardiac catheterization procedures. While this practice may have been acceptable in the past, increasingly complex procedures within the cardiac cath lab, such as intricate percutaneous coronary....

Preparing for ICD-10- CM/PCS Implementation: Impact on Productivity and Quality

Author: Stanfill, Mary H; Hsieh, Kang Lin; Beal, Kathleen; Fenton, Susan H.

Source: Perspectives in Health Information Management

Publication Date: July 2014


Abstract


Coding productivity is expected to drop significantly during the lead-up to and in the initial stages of ICD-10-CM/PCS implementation, now expected to be delayed until October 1, 2015. This study examined the differences in coding productivity between ICD-9-CM and ICD-10-....

Anthrax: What Every Coder Should Know

Author: Stanfill, Mary H

Source: Journal of AHIMA - Coding Notes

Publication Date: January 2002


The inhalation anthrax identified by a Florida physician in October 2001, during the recent series of bioterrorist attacks, was the first case of reported inhalation anthrax in the United States in more than 25 years.1 With the threat of anthrax as a biological weapon, correct coding could be....

AHIMA Supports Patient Friendly Billing Project

Author: Squazzo, Jessica

Source: Journal of AHIMA

Publication Date: September 2003


Joining the American Hospital Association, the Medical Group Management Association, and others, AHIMA announced its endorsement of the Patient Friendly Billing Project. Led by the Healthcare Financial Management Association (HFMA), the project was established in 2000 to help create a more pat....

Long-term Acute Care: the Effect of PPS

Author: Smith, Pam

Source: Journal of AHIMA

Publication Date: October 2003


Just when I thought I’d seen and done it all in the HIM world, a new opportunity for coders appeared in long-term acute care hospitals (LTCHs). HIM professionals have been employed in LTCHs since the inception of long-term acute care, but the change from cost-based reimbursement to inclus....

CPT Update 2011

Author: Smith, Gail I.; Endicott, Melanie

Source: Journal of AHIMA - Coding Notes

Publication Date: February 2011


Each year CPT adds codes to reflect new procedures and surgical techniques. For example, new codes were added in the surgical section to identify procedures performed using balloon catheters.

In addition, CPT continues to make editorial changes and add coding guidelines within the t....

On the Line: Professional Practice Solutions

Author: Smith, Cheryl M.

Source: Journal of AHIMA

Publication Date: February 2001




Q: Where can I find information on the interpretation of Joint Commission on Accreditation of Healthcare Organization standards?

Q: How does the Health Insurance Portability and Accountability Act of 1996 (HIPAA) define health information in the final rule for healthcare elec....

Navigating the Physician Services Maze

Author: Skurka, Margaret A.

Source: Journal of AHIMA

Publication Date: July 2001


As HIM professionals know, accurate and complete documentation is critical for providing care and supporting reimbursement. This is particularly true-and yet particularly problematic-in the area of E/M coding. Medical practices report and are paid for their services using E/M coding, yet there....

Practice Toolkit: Medicare Billing in Long-term Care

Author: Sims, Michelle

Source: Journal of AHIMA

Publication Date: June 2005


In order to accurately bill for long-term care, an organization must achieve consistency between the minimum data set (MDS) and the UB-92. The first step is to ensure compliance with the completion of the MDS. It is helpful to have a system that identifies the assessment reference date span an....

Year in Review: Highlights from 2014

Author: Sheber, Sarah

Source: Journal of AHIMA - website

Publication Date: December 2014



The Journal of AHIMA’s ongoing web series “HIM Frontlines,” explores pressing obstacles that health information management (HIM) professionals encounter in a rapidly changing healthcare environment. Major federal initiativs such as the “meaningful use” EHR Incentive Program, HITECH-HIPAA,....

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....

Providers Join Hands to Tell Medicare What They Think about OPPS/APC Policies: Making Progress in Changing Future Rules and Regulations

Author: Shah, Jugna

Source: AHIMA Convention

Publication Date: October 15, 2004


The Provider Roundtable is the name of the group that I formed to offer an opportunity for providers to come together and communicate to Medicare about their day-to-day operational challenges under the Outpatient Prospective Payment System (OPPS). My hope was that, by engaging providers to bra....

Understanding the New Role of the Coder Under OPPS/APCs

Author: Shah, Jugna

Source: AHIMA Convention

Publication Date: October 15, 2004

Background

Coding originated a long time ago as a way to classify causes of death, but has evolved to capture much more information. Coders now play a critical role in helping organizations to capture appropriate reimbursement and remain compliant with government rules and regulations. Si....

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