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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 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....

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....

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....

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....

"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....

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....

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 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....

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....

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....

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....

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....

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....

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....

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) ....

Can You Manage Managed Care?

Author: Willner, Sue

Source: Journal of AHIMA

Publication Date: July 2001


HIM professionals’ data management skills make them a hot property in many settings, but none more so than managed care. In this second installment of the Journal of AHIMA’s special series on managed care, the author describes the ways managed care organizations use data and how HIM....

CAD vs. Angina

Author: Hansen, Abby

Source: CodeWrite | AHIMA newsletter article

Publication Date: December 2013



Unstable angina pectoris is a type of chest pain that happens suddenly and becomes worse over time. It can often be felt in the shoulders, arms, and neck. It is caused by poor blood flow through the blood vessels of the heart muscle and can evolve into a myocardial infarction. Coronary at....

Busy Year for the RACs

Author: Easterling, Sharon

Source: Journal of AHIMA

Publication Date: March 2012



Learning from last year's denials and preparing for what's ahead will help providers avoid being stung in 2012.


When the Recovery Audit Contractor (RAC) permanent program began in 2009, providers were hopeful that the process for identifying underpayments and overpayments w....

Building a Better CPT

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: November 2000


The Health Insurance Portability and Accountability Act (HIPAA) presents numerous challenges to HIM processes and systems. Not least among these areas is coding. Among the concerns is whether the CPT system will be sufficient to meet the demands of HIPAA. The American Med....

Bringing Physician Practices into the HIM Fold: Guidance on Making a Smooth Transition and Ensuring the MD/Hospital/HIM Relationship Remains Mutually Beneficial

Author: Lee, Christine

Source: Journal of AHIMA

Publication Date: April 2016



According to the American Medical Association (AMA), physician practices continued a slow but steady transition toward hospital ownership in 2015. In their July 2015 study, the AMA reported a decrease in physician-owned practices alongside a continual increase in physicians working direct....

Brief History of ICD-10-PCS

Author: Mullin, Robert L.

Source: Journal of AHIMA - Coding Notes

Publication Date: October 1999


The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) was developed as a replacement for the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) volume 3, Procedures. This version of ICD, in use since J....

Bridging the Translation Gap from ICD-9

Author: Butler, Rhonda R.

Source: Journal of AHIMA

Publication Date: March 2008



A recurring theme in the ongoing ICD-10 implementation debate has been the need for a crosswalk between the old and new code sets to help the industry make the transition. The lack of an “official” mapping between ICD-9-CM and ICD-10-CM/-PCS has long been seen as a major challe....

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....

Boosting Efficiency in Home Health Record Systems

Author: Abraham, Prinny

Source: Journal of AHIMA

Publication Date: April 2000


The growing pains of the past decade have led to medical record backlogs and record retrieval crises for many home healthcare agencies. These problems have pushed more than one agency director into enlisting the skills of an HIM professional to evaluate the medical record systems in pl....

Best Practices: What Works

Author: Carrier, Danielle

Source: Journal of AHIMA

Publication Date: July 1999




Medical record accuracy, record completion time, physician satisfaction—all of these are indicators of how well an HIM department is performing. The findings of a UHC benchmarking study may point the way to best practices that can be shared and adapted.

What....

Best Practices for Medical Necessity Validation

Author: Scichilone, Rita A

Source: Journal of AHIMA

Publication Date: February 2002


To protect the Medicare Trust Fund from being drained, government health plans must provide coverage restrictions for unnecessary health services in vulnerable patient populations. One restriction mechanism is the provision of edits that look for valid reason-for-visit codes for selected servi....

Benchmarking with National ICD-9-CM Coded Data

Author: Osborn, Carol E.

Source: Journal of AHIMA

Publication Date: March 1999


As HIM professionals, we want to be assured that we are providing the highest quality data for reimbursement and research purposes. We can review coded data internally, but this does not give us a clear picture of the total information that is being submitted to the Health Care Financing Admin....

Benchmarking Project Harvests Ideas for Network

Author: Zender, Anne

Source: Journal of AHIMA

Publication Date: November 1998


It started as a simple benchmarking project. But when Patricia Rhodes, RRA, Carol Keller, MPA, and their team finished, the project had taken them across the country, opened up lines of communication with staff members at nine other facilities, and helped them improve their....

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....

Avoiding a War of Words (and Numbers): the Uncertain Future of Terminologies and Classifications

Author: Roberts, Rosemary; Innes, Kerry; Walker, Sue; Scott, Peter

Source: Journal of AHIMA

Publication Date: October 2004


With major changes under way worldwide, the evolving roles and relationships of classifications and terminologies are uncertain. But the future lies in collaboration, not competition.
Classifications and clinical terminologies have coexisted for decades. Both use clinical language, but t....

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....

Audit of Automated Code Assignment in Israeli Hospital's Computerized Medical Information Systems

Author: Gill, Rhonda; Hecht, Rivka

Source: IFHRO Congress | AHIMA Convention

Publication Date: October 15, 2004

Introduction
How accurate and complete is the coded diagnostic (and procedure) data collected on patients who are discharged from Israeli government-owned general hospitals that have implemented automated code assignment? Can the individual facilities and the Israel Ministry of Health rely on....

Assigning Advance Care Planning Codes

Author: Huey, Kim

Source: CodeWrite

Publication Date: May 2016



Physicians have a new opportunity to bill and be paid separately for a counseling service they may already be performing. Advance Care Planning codes 99497-99498 were introduced in Current Procedural Terminology (CPT®) in 2015 but were not paid by Medicare until January 1, 2016. CPT code 9....

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