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Catching Up with PEPP

Author: Bryant, Gloryanne H.; Fletcher, Robin

Source: Journal of AHIMA

Publication Date: September 2000


A year ago, the Journal of AHIMA reported on the newly created Payment Error Prevention Program (PEPP), which went into effect in August 1999. What has happened since then?
Best Billing Practices

PEPP was created to reduce Medicare prospective payment system (PPS) ....

CCHIIM Releases New Details on ICD-10 Recertification for AHIMA Certified Professionals

Author: AHIMA

Source: ICD-TEN Top Emerging News | AHIMA newsletter article

Publication Date: January 06, 2011


Preparation has begun for the transition to ICD-10-CM/PCS. As transition quickly grows closer, it is critical that all AHIMA-certified Professionals are ready to adapt to the new changes. The Commission on Certification for Health Informatics and Information Management’s (CCHIIM) new recertific....

CCS/CCS-P Credential Maintenance Frequently Asked Questions

Author:

Source: AHIMA

Publication Date: 2001

1. What are the requirements for maintenance of the CCS/CCS-P credential?

Each certified specialist must complete an annual self-assessment and pay the annual maintenance of certification fee to retain the credential.

2. When does my self-assessment begin and how will I know....

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....

Changes Abundant for CPT 2004

Author: Hull, Susan

Source: Journal of AHIMA - Coding Notes

Publication Date: January 2004


Changes for CPT 2004 affect all chapters, and it’s important to stay up to speed. This article presents a summary of CPT changes for 2004. Because a number of the procedures may be unfamiliar to some coding professionals, AHIMA has provided online links to descriptive articles on these s....

Changes Ahead in Data Standards

Author: Giannangelo, Kathy

Source: Journal of AHIMA

Publication Date: June 2011


HIM professionals are most familiar with the data standards mandated through HIPAA. However, the data standard adoption process is also now part of the requirements for EHR technology in the meaningful use program.

Understanding the data standards adoption process under HIPAA and th....

Checks, Balances, and Ethics: Implementing Financial Controls for Associations

Author: Dunn, Rose T; Klaver, Jill Callahan; Rinehart-Thompson, Laurie A.

Source: Journal of AHIMA - website

Publication Date: November 2014


Health information management (HIM) professionals are recognized for their compliance-focused activities. Coding professionals, for example, assign codes based on the available documentation and the rules that define proper code application. When hospital coders are asked to resequence a condit....

Choosing Consultants Without Compromising Compliance

Author: Hammen, Cheryl

Source: Journal of AHIMA

Publication Date: October 2001




Auditing coding and DRG accuracy has become an important component in the daily operation of the HIM department. Many providers are choosing to contract with external coding consultants to perform this task. This can be an appropriate solution as long as the vendor meets the necessary....

Choosing Modalities for Carotid Stenosis

Author: Wiley, Sean

Source: Journal of AHIMA - Coding Notes

Publication Date: October 2003


One of the leading causes of stroke and transient ischemic attack (TIA) is carotid artery disease (CAD). With technology changing at such a rapid rate, it is difficult for physicians to decide on the gold standard of care when it comes to visualizing carotid stenosis. This article will explain....

Choosing the Right Coding Credential

Author: Buck, Stacie L

Source: AHIMA community resource

Publication Date: January 02, 2007


As the demand for qualified coders has increased, so has the number of coding programs and coding certifications available to coding professionals seeking to demonstrate their coding proficiency. The business of offering credentials is indeed a lucrative one with many organizations competing....

"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....

Clarifying Patient Status Code

Author: Bryant, Gloryanne H.

Source: Journal of AHIMA - Coding Notes

Publication Date: June 2008


The patient status code reflects the level of care a patient was discharged or transferred to when leaving an acute care hospital as an inpatient or outpatient (i.e., emergency department or emergency room). A recent Centers for Medicare and Medicaid Services MLN Matters publication provides a....

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....

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....

Clinical Coding Internationally: A Comparison of the Coding Workforce in Australia, America, Canada, and England

Author: McKenzie, Kirsten; Walker, Sue; Dixon-Lee, Claire; Dear, Gareth; Moran-Fuke, Judy

Source: IFHRO Congress | AHIMA Convention

Publication Date: October 15, 2004

Introduction

Recently, researchers in Australia, America, England, and Canada have conducted national surveys of clinical coders in their respective countries. In Australia in 2002, the National Centre for Classification in Health (NCCH) in collaboration with the Health Information Manag....

Clinical Coding: Part of the HIM Mosaic

Author: Kloss, Linda L

Source: Journal of AHIMA

Publication Date: July 2003


Many in healthcare today understand coding only in the context of billing, not recognizing that the very same coded data are used for important healthcare operations, policy, epidemiology, and many other uses. For 75 years, AHIMA has been the professional forum to advance the quality of health....

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....

Clinical Documentation Improvement Program Strategies

Author: Mills, Mary

Source: AHIMA Convention

Publication Date: October 21, 2005

Introduction
What Is CDIP?

Aclinical documentation improvement program (CDIP) is a program focused on improving clinical documentation on a concurrent basis where a coder or documentation specialist, such as a nurse, reviews the medical record and consults with physicians regarding....

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....

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....

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....

CMS Eliminates Reimbursement for Consultations

Author: Nelson, Tanai S

Source: AHIMA newsletter

Publication Date: December 02, 2009


As proposed, the Centers for Medicare and Medicaid Services (CMS) finalized their decision to eliminate the use of all consultation codes (inpatient and office/outpatient codes for various places of service except for telehealth consultation G-codes). What does that mean? That means that CMS w....

CMS Responds to RAC Myths

Author: Phelps, Charles

Source: CodeWrite | AHIMA newsletter article

Publication Date: April 2013



There is a lot of information available about the Recovery Audit Contractor (RAC) program. Some of what you hear, though, may not be completely accurate. It is important that providers obtain their information from reliable sources. The Centers for Medicare and Medicaid Ser....

Coder Education: Will Demand, Will Deliver

Author: Carol, Ruth

Source: Journal of AHIMA

Publication Date: July 2004


As the bar rises for coding, healthcare organizations require more education from coders—and they are willing to deliver it, too.
The bar has always been high for mdical coding, but recent years have seen it boosted higher. As a result, healthcare organizations need more from code....

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