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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....

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,....

Working Smarter with Computer-Assisted Coding

Author:

Source: AHIMA Today

Publication Date: October 05, 2009

Clinical Coding Community Sessions Explore Worklow Efficiencies and Quality Benefits

Today’s code assignment and workflow processes can be inefficient, error prone, and costly. Presenters at Saturday’s Clinical Coding Community Meeting described the latest in computer-assisted coding (CA....

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....

Word is Collaboration: How HIM, Revenue: Cycle, and Compliance Team Up for Success

Author: McDavid, Jan P; Truscott, Tricia; Crump, Dawn; Brocato, Lori

Source: AHIMA Convention

Publication Date: October 02, 2011

Background:

The need for HIM, Compliance and Revenue Cycle Management to work together is more important than ever. New initiatives, regulations and more stringent compliance demands are crossing the lines of various departments throughout the healthcare continuum. Departments which may....

Winning the Coding Trifecta: CAC, CDI, and ICD-10. How CAC Can Strengthen Your CDI Program and Increase Collaboration with Coding and Quality Improvement

Author: Whittle, Kelly

Source: Journal of AHIMA

Publication Date: September 2016



It’s no surprise that the volume of clinical documentation has multiplied exponentially with the advent of electronic health records (EHRs). Templates, shortcuts, drop-down menus, and copy-and-paste functions make it easier than ever to document copious amounts of data with just a few cli....

Wider World of Coding

Author: Kloss, Linda L

Source: Journal of AHIMA

Publication Date: July 2009


Coding reminds me of the parable of three blind men describing an elephant. Each one touches just one part of the elephant.

The blind man who examined the elephant’s tail likened it to a straw fan swinging back and forth; the man who explored the legs described the elephant as....

Why ICD-10 Is Worth the Trouble

Author: Bowman, Sue E

Source: Journal of AHIMA

Publication Date: March 2008


Transitioning to ICD-10 is a major disruption that providers and payers may prefer to avoid. But it is an upgrade long overdue, and the benefits are far-reaching.

It has been nearly five years since the National Committee on Vital and Health Statistics recommended to the secretary o....

Why ICD-10 Can’t Wait

Author: Rode, Dan

Source: Journal of AHIMA

Publication Date: October 2008


In August the Department of Health and Human Services (HHS) published two notices of proposed rule making (NPRMs): one for the adoption of ICD-10-CM and ICD-10-PCS and one for an upgrade to the HIPAA transaction standard. Comments on the proposed rules are due on October 21. Once the comment p....

Who's Covered by HIPAA (HIPAA on the Job)

Author: Rode, Dan

Source: Journal of AHIMA

Publication Date: March 2001




One of the mysteries of the administrative simplification section of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) is determining who is covered or comes under the requirements of the act. This article will examine HIPAA to unravel some of the mystery of &quo....

Which Should You Take: the CCA or CCS Exam?

Author: Horn, Kelli

Source: CodeWrite | AHIMA newsletter article

Publication Date: November 2013



As a CCS exam course review instructor and in my efforts to help students and coders obtain a coding credential, I am often asked which credential would be the most beneficial, and whether an individual is better prepared to pass the Certified Coding Associate (CCA) or the Certified Codin....

Where We've Been, Where We're Going

Author: Scichilone, Rita A

Source: Journal of AHIMA

Publication Date: July 1999



As conditions in the healthcare industry have become more challenging, many jobs have evolved. Not least among them in the HIM world is the role of the coder. In more ways than one, coding professionals are making their mark in the industry. And today, changes in coding requirements are pa....

Where in the World Is ICD-10?

Author: Brouch, Kathy L.

Source: Journal of AHIMA

Publication Date: September 2000




Where and how is ICD-10 being used? Learn how countries all over the world have adapted to the newest version of this coding system and how coders in the US can prepare for an eventual transition.


Are you ready for ICD-10? If you're a coder in the United State....

Where Bad Billing Can Lead You

Author: Potter, Jeanne

Source: AHIMA Convention

Publication Date: October 21, 2005

Overview

In this day and age, any company that does not have a process in place to ensure their business practices are compliant with federal and state laws and regulations are putting themselves at serious risk. A physician’s billing practices are subject to federal and state rules....

Where Are They Now? CPR Leaders Assess Their Progress

Author: Zender, Anne

Source: Journal of AHIMA

Publication Date: September 2000


Five years ago the first recipients of the Davies awards showed us successes of CPR systems across the country. Where are they now? This article catches up with these CPR leaders.
Is your job exactly the same as it was five years ago? For most HIM professionals, the answer....

When Health Information and Fiscal Management Meet

Author: Dunn, Rose T

Source: Journal of AHIMA

Publication Date: January 2001




HIM professionals have skills that can allow them to contribute to the bottom line in many ways. The author describes areas where HIM expertise can make a difference in evaluating an organization's fiscal performance through analysis of services driven by health information.
HI....

When Good Chargemasters Go Bad

Author: Leeds, Erica

Source: AHIMA Convention

Publication Date: October 10, 2001



Introduction: What Is a Chargemaster?

A chargemaster is a master list of services, supplies, and drugs used for patient care. A chargemaster used by outpatient facilities (emergency rooms, clinics, same-day surgery centers, and so on) will have the associated HCPCS codes and rev....

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....

What is Gulf War Syndrome (Part II)

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: September 1998


Presidential Advisory Committee on Gulf War Veterans' Illnesses

President Clinton established the Presidential Advisory Committee on Gulf War Veterans' Illnesses in May 1995 to ensure an independent, open, and comprehensive examination of health concerns related to Gulf War service....

Web FAQ

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: October 2002

What are the documentation requirements for Observation Patients?
It is interesting to note that the observation service (OBS) did not originate from the government but by the healthcare marketplace in response to PPS/DRG conditions. When hospitals are not sure whether a patient will meet admi....

Web FAQ

Author: AHIMA Coding Team

Source: AHIMA Q and A

Publication Date: October 2002

What Documentation Source Is Used to Assign Diagnosis Codes for Outpatient Testing?
A completed medical record is the best source of diagnosis coding, without regard to setting. However, recently there was confusion concerning whether the reason for testing found on a requisition for the test....

Web FAQ

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: October 2002

What guidance is available for determining an organization's definition of "attending physician" or "physician of record"?
The Department of Health, Education, and Welfare adopted the UHDDS (Uniform Hospital Discharge Data Set) as department policy for Medicare and Medicaid patient populations....

Web FAQ

Author: AHIMA Coding Team

Source: AHIMA Q and A

Publication Date: October 2002

Where Can I Find a Sample Job Description and the Standard Productivity Rate for a Coder?

Because of the wide variety of duties included in the tasks for a coding professional, AHIMA does not publish a standard job description and has found it impossible to create meaningful coding produ....

Web FAQ

Author: AHIMA Coding Team

Source: AHIMA Q and A

Publication Date: October 2002

Where can I find the APC regulations?

The HCFA regulations are found in the November 13, 2000 Federal Register, Vol. 65. No.219 pp.67798-68005. Go to http://www.access.gpo.gov/su_docs/fedreg/a001113c.html, and scroll down to Health Care Financing Administration.

HCFA has impleme....

Web FAQ

Author: AHIMA Coding Team

Source: AHIMA Q and A

Publication Date: October 2002

Who Has the Official Guidelines for Interpretation of Coding Guidelines or Appropriateness of Code Assignment?
For ICD-9-CM coding questions and guidelines we look to Cooperating Parties for ICD-9-CM. The National Center for Health Statistics and the Health Care Financing Administration receiv....

Web FAQ

Author: AHIMA Coding Team

Source: AHIMA Q and A

Publication Date: October 2002

Where Can I Find Coding Guidelines for Use in Long Term Care or for Skilled Nursing Facility Reporting?

The official coding guidelines (see earlier question regarding who has the official guidelines for code assignment) are applicable in long term care. These guidelines have been develope....

Web FAQ

Author: AHIMA Coding Team

Source: AHIMA Q and A

Publication Date: October 2002

Where Can I Find the Regulations on Medicare Payment Methodologies Used in Non-acute Care Settings?


http://www.hcfa.gov/medicare/payment.htm is a site that provides links to pages on Medicare payment methodologies. On these pages you will find helpful information on various payment....

Web FAQ

Author: AHIMA Coding Team

Source: AHIMA Q and A

Publication Date: October 2002

What Is the NCCI and How Can I Get It?

The National Correct Coding Initiative is a huge set of edits to be applied to CPT codes for outpatient hospital claims in anticipation of the APC (Ambulatory Payment Classification) system. It was created by HCFA for use by carriers for processing P....

V-ery Important Codes: V-Codes Matter!

Author: Wallace, Susan

Source: CodeWrite | AHIMA newsletter article

Publication Date: September 2010




V-codes have long been considered step-children, supplemental codes that are typically relegated to the end of the list of ICD-9-CM codes. Since Medicare has only processed the top nine (9) diagnosis codes, even when all of the pertinent V-codes are assigned, they are frequently omitt....

Vanishing Supervisor

Author: Brandt, Mary D.

Source: Journal of AHIMA

Publication Date: March 2004


The bottom line is calling. Here’s how to decide if your HIM department has the right number of supervisors.
Down-sizing, right-sizing, streamlining. It doesn’t really matter what you call it, but it has had a significant impact on healthcare operations and staffing. Organizat....

Validating MDS and OASIS Data with DAVE

Author: Dougherty, Michelle

Source: Journal of AHIMA

Publication Date: March 2004


In January 2004 the Center for Medicare and Medicaid Services (CMS) launched a new initiative to improve the accuracy and reliability of Minimum Data Set (MDS) data in long-term care. The Data Assessment and Verification program (DAVE) is a collaborative effort between multiple CMS program ar....

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....

US Must Adopt ICD-10-CM and ICD-10-PCS

Author: AHIMA

Source: AHIMA position statement

Publication Date: July 21, 2005

Immediate Action to Upgrade Medical Code Set Standards Needed


AHIMA's Position


The Department of Health and Human Services (HHS) must immediately initiate the regulatory process for adoption and implementation of ICD-10-CM and ICD-10-PCS code sets (referred to as ICD-1....

Using the 3MTM APRTM DRG Classification System in Healthcare Payment and Performance Measurement: Maryland's New Payment System and Other State Initiatives

Author: Rothermich, Cheryl; Lessig, Robbyn

Source: AHIMA Convention

Publication Date: October 21, 2005

Session Objectives
Learn about new state and provider initiatives to adopt more precise classification methodologies for setting reimbursement rates and measuring provider performance.
Evaluate the key attributes of the 3M APR DRG Classification System, which expands basic DRG classificat....

Using Intrinsic and Extrinsic Metrics to Evaluate Accuracy and Facilitation in Computer-Assisted Coding

Author: Resnik, Philip; Niv, Michael; Nossal, Michael; Schnitzer, Gregory L.; Stoner, Jean; Kapit, Andrew; Toren, Richard

Source: AHIMA Computer-Assisted Coding Meeting

Publication Date: September 06, 2006

Computer-assisted coding (CAC) evaluation can be viewed from two related but distinct perspectives: accurately identifying codes, and more generally facilitating the process of human coding and information flow within and among healthcare organizations. The first perspective calls for intrinsic metrics, grounded in comparison with a gold standard. The second perspective calls for extrinsic techniques, grounded in the real-world task. We discuss this distinction and present an experimental evaluation of CAC using both intrinsic and extrinsic measures.

Using Internal and External Resources to Negotiate Contracts

Author: Kane, Cheri

Source: Brief Encounter

Publication Date: October 02, 2000


Managed care is here to stay and it is incumbent upon the health plan and the providers to develop positive long-term relationships. These agreements are only limited by the creativity of the provider and the health plan. Financial arrangements may take a variety of forms, from fee for servic....

Using CPT Modifier -25 for Professional Billing

Author: Yoder, Lois M.

Source: Journal of AHIMA

Publication Date: January 2000


You may want to consider a focused review of how your practice assigns CPT modifier -25, "a significant, separately identifiable Evaluation & Management (E&M) service by the same physician on the same day of the procedure or other service."1 The Health Care Financing Admini....

Using CDI to Meet Federal Quality Measures

Author: Wiedemann, Lou Ann

Source: Journal of AHIMA

Publication Date: January 2013



Clinical documentation is the foundation of every health record, specifically outlining the reasons for treatment and the quality of care provided to the patient. The lack of consistent and standard clinical content within the health record has been an ongoing challenge to health informati....

Using Additional Diagnoses to Improve Productivity

Author: Martin, Ginny

Source: CodeWrite

Publication Date: February 2016



ICD-10 has now been in effect for several months and coding professionals have become more familiar with the new codes and guidelines. The initial training and education is complete and ongoing quality reviews are being done to analyze coding accuracy. But what else can this data tell us?....

User's Guide to AHIMA Coding Credentials

Author:

Source: Journal of AHIMA

Publication Date: July 2002


This year, AHIMA introduces a new coding credential—the Certified Coding Associate (CCA). The credential is different from AHIMA’s other coding credentials—the Certified Coding Specialist (CCS) and the Certified Coding Specialist—Physician-based (CCS-P)—in some importan....

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