377 results.
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Calendar Year 2015 OPPS Update
Author: Maimone, Carol
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: March 2015
The Centers for Medicare and Medicaid Services (CMS) released a final rule providing required adjustments to the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for calendar year (CY) 2015 on October 31, 2014.....
Physician Fee Schedule Released for 2015
Author: Ward, Maria
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: March 2015
On October 31, 2014, the Centers for Medicare and Medicaid Services (CMS) released the 2015 Medicare Physician Fee Schedule (PFS) Final Rule. Because of section 101 of the Protecting Access to Medicare Act (PAMA) of 2014, no changes to the fee schedule will occur until April 1, 2015. At t....
CPT Updates for CY 2015
Author: Buttner, Patty
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: February 2015
On January 1, 2015, the updates to the American Medical Association’s Current Procedural Terminology (CPT) went into effect. The updates include 276 new codes, including three new Category II codes and 39 new Category III codes. There are a total of 129 revised codes and 137 deleted codes....
Hospital Discharge Status Codes: Risks and Rewards
Author: Haik, William E
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: February 2015
It is a well known fact that ICD-9-CM diagnosis and procedure codes impact hospital reimbursement and compliance. But there is an additional code that often flies under the radar—the discharge status code. Inaccurate discharge status code assignments for Medicare post-acute care transfers....
GEMs: Buyers Beware. Crosswalk and Translation Tools Can Bring Unexpected Risks
Author: Reed, Diana
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: January 2015
When it comes to converting superbills and claims from ICD-9-CM to ICD-10-CM, many healthcare providers believe that general equivalence mappings (GEMs) offer a cost effective and simple solution. The ability to purchase relatively cheap automated mappings of specialties’ top codes c....
CDI Tips Developed to Maximize ICD-10-CM/PCS
Author: Bryant, Gloryanne H.; Haik, William E; Hillstrom, Heidi
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: January 2015
Clinical documentation improvement (CDI) efforts have become a mainstay within hospitals, outpatient care facilities, physician practices, and post-acute care settings. CDI programs have a far-reaching impact on today’s data-centric healthcare system. When the appropriate level of detail....
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....
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,....
ABCs of HHS-HCCs: Taking a Closer Look at the Commercial Risk Adjustment
Author: Franklin, Janet
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: October 2014
There are three age-defined models under commercial risk adjustment. These are the Adult Model (ages 21 and up), the Child Model (ages 2–21), and the Infant Model (ages 0–1). The model applicable to a patient is dependent on their age at the end of the benefit year. If a 20-year-old patie....
Reliable Coded Data Require a Reliable Coding Process Framework
Author: Bielby, Judy A
Source: Journal of AHIMA | Journal of AHIMA - Coding Notes
Publication Date: October 2014
A poorly managed coding process can thwart the effective use of coded diagnosis and procedure data. Take for example Hospital A, a fictitious hospital that does not effectively manage their coding processes. At this hospital, the coding professionals are concerned primarily with the impact....
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