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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....

ICD-10 Preparation Checklist

Author: Bowman, Sue E; Zeisset, Ann M.

Source: AHIMA

Publication Date: June 02, 2007


The content in this checklist has been updated. More recent information is available here.

Editor's note: This article updates information contained in "ICD-10 Preparation Checklist, parts 1 and 2," originally published in the June and July-August 2004 issues of the Journal of AHIMA....

Effectiveness of ICD-10-CM in Capturing Public Health Diseases

Author: Watzlaf, Valerie J.M.; Garvin, Jennifer Hornung; Moeini, Sohrab; Firouzan, Patricia Anania

Source: Perspectives in Health Information Management

Publication Date: June 2007

This research study examined the usefulness of the ICD-10-CM system in capturing public health diseases (reportable diseases or the nationally notifiable infectious diseases, leading causes of death, and morbidity/mortality related to terrorism), when compared to ICD-9-CM. It also examined agreement levels of coders when coding public health diseases in both ICD-10-CM and ICD-9-CM.

Ensuring Proper Wound Care Service Coding: OIG Highlights Need for Organizations to Assess Wound Care Coding Practices

Author: Bryant, Gloryanne H.

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

Publication Date: November 2007



This year the Office of Inspector General (OIG) issued two reports relating to wound care services and Medicare payments. As the OIG has included wound care services as part of its 2007 work plan, coding and HIM professionals should review each report and re-assess their organization̵....

2008 CPT Coding Update

Author: Jorwic, Therese M

Source: Journal of AHIMA - Coding Notes

Publication Date: February 2008


The new CPT codes took effect January 1, 2008. Changes include 244 additions, 314 revisions, and 50 deletions. A comprehensive list of changes can be found in appendix B of the CPT book. Highlights of the changes by section are outlined here.
Evaluation and Management

A revised....

ICD-10 in the Big Picture

Author: Zender, Anne

Source: Journal of AHIMA

Publication Date: March 2008


As a professor at Temple University, Margaret (“Maggie”) Foley, PhD, RHIA, CCS, has to have an eye for details. But she also has an eye on the big picture—specifically on ICD-10 and the benefits it could offer to healthcare.

Before she became a professor, Foley was....

Brushing up on ICD-10-PCS

Author: Bowman, Sue E

Source: Journal of AHIMA

Publication Date: March 2008


ICD-10-PCS is intended to replace ICD-9-CM volume 3 for facility reporting of hospital inpatient procedures. It has a seven-character alphanumeric code structure. The letters I and O are not used to avoid confusion with the digits 1 and 0. A character is a stable, standardized code component th....

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....

ICD-10 Preparation Checklist

Author: Bowman, Sue E

Source: Journal of AHIMA

Publication Date: March 2008




The content in this checklist has been updated. More recent information is available here.



Preparing for ICD-10 is a monumental process. But like any large task, it can be broken down into discrete steps. A multiyear plan can be approached in four major phases, begi....

Coding Preventive Care Services

Author: Wilkinson, Dianne

Source: Journal of AHIMA - Coding Notes

Publication Date: March 2008


According to the Partnership for Prevention—a program-based organization of businesses, nonprofits, and government agencies—“the U.S. health care system suffers a quality deficit in part because too many patients do not get the effective preventive care they need when they ne....

ICD-10 Update

Author: Bowman, Sue E; Butler, Rhonda R.

Source: AHIMA Convention

Publication Date: October 17, 2008


Introduction


The ICD-9-CM classification system is obsolete and unable to meet current healthcare needs and cannot support the transition to interoperable health data exchange. The US is the only industrialized nation not using an ICD-10 based classification system for morbidit....

2008 AHIMA Convention Wrap-Up

Author:

Source: Journal of AHIMA

Publication Date: November 2008


AHIMA held its 80th Convention and Exhibit October 11–16, 2008, in Seattle, WA. It was a time for members to share ideas, challenges, and solutions and hear about some of healthcare’s hottest topics from industry experts. A full exhibit hall offered a collection of the latest in HIM....

Coding Radiology Services

Author: Walk, Gerri

Source: Journal of AHIMA - Coding Notes

Publication Date: January 2009


Because coding and radiology departments often share accountability for the quality of outpatient radiology coding, it is important that coding professionals share coding issues and charge capture expectations with radiology staff. This article outlines methods to improve the quality of coded....

AHIMA ICD-10 Tips

Author: AHIMA

Source: AHIMA

Publication Date: January 2009


Audience: Admitting


Medical Terminology/Terms need to be accurate even in the registration/admitting process.

Learn the basics of ICD-10-CM/PCS, the who, what, where, when and why





Audience: Payers/Finance



Conduct a busine....

2009 CPT Coding Update

Author: Majerowicz, Anita

Source: Journal of AHIMA - Coding Notes

Publication Date: February 2009


Changes to CPT codes for 2009 include 293 additions, 133 revisions, and 92 deletions. This article highlights some of the more notable changes; a comprehensive list can be found in appendix B of the 2009 CPT code manual. The changes took effect January 1.

E/M Codes


Nu....

Key Issues in the 2009 OPPS Final Rule

Author: Clark, Andrea

Source: Journal of AHIMA - Coding Notes

Publication Date: March 2009


The final rule for the 2009 Outpatient Prospective Payment System (OPPS) includes multiple revisions that hospitals must address in their practices, policies, and operations. Hospitals should develop strategies for analyzing the financial impact and operational challenges by reviewing the foll....

ICD-10 Reimbursement Mappings: New Mappings from CMS Help Organizations in the Transition to ICD-10

Author: Butler, Rhonda R.; Mills, Ronald E

Source: Journal of AHIMA - Coding Notes

Publication Date: April 2009


Starting October 1, 2013, healthcare claims will be submitted to payers using ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes. Some payers such as the Centers for Medicare and Medicaid Services (CMS) are converting their reimbursement systems to use ICD-10 codes directly. However, som....

ICD-10-CM Official Coding Guidelines

Author: Barta, Ann

Source: Journal of AHIMA - Coding Notes

Publication Date: June 2009


One of the keys to a successful transition to ICD-10-CM/PCS is a thorough understanding of the ICD-10-CM Official Coding Guidelines, which were posted to the National Center for Health Statistics Web site in January 2009. Similar to the ICD-9-CM coding guidelines, the ICD-10-CM guidelines are....

Preparing for ICD-10-CM: A Clinician's Perspective

Author: Rose, Eric

Source: Journal of AHIMA

Publication Date: July 2009


America’s physician practices are facing the biggest change in healthcare coding in decades: the replacement of ICD-9-CM by ICD-10-CM. This article discusses ICD-10-CM from a clinical perspective and reviews how electronic health record (EHR) systems will need to adapt to the transition.....

New Guidance for Home Health Coding

Author: Blevins, Ida K.

Source: Journal of AHIMA - Coding Notes

Publication Date: July 2009


Sweeping PPS changes for home health went into effect January 2008, making much of the prior coding guidance issued by the Centers for Medicare and Medicaid Services (CMS) incompatible with changes in the revised data collection set. Home health coding professionals anxiously awaited further i....

Preparing for ICD-10-CM in Physician Practices

Author: Kuehn, Lynn

Source: Journal of AHIMA

Publication Date: August 2009




What will change under ICD-10-CM, and what must be done to prepare? This is the year for physician practices to get their ducks in a row: become informed, assess their IT and training needs, and make a plan that leads to the October 1, 2013, deadline.



On September....

ICD-10-CM/PCS Project Management Resources

Author: AHIMA

Source: AHIMA practice brief attachment

Publication Date: October 2009


This practice brief has been retired. It is made available for historical purposes only.



Transitioning to ICD-10-CM/PCS will be a major undertaking for healthcare organizations. Below are ICD-10-CM/PCS project management resources and templates that organizations can use to h....

ICD-10 Update

Author: Bowman, Sue E; Butler, Rhonda R.

Source: AHIMA Convention

Publication Date: October 05, 2009

Introduction

On January 16, 2009, the Department of Health and Human Services (HHS) published a Final Rule for the adoption of the ICD-10-CM and ICD-10-PCS code sets to replace the currently used ICD-9-CM code sets under rules 45 CFR Parts 160 and 162 of the Health Insurance Portability a....

Experts Suggest Beginning ICD-10 Implementation Today

Author: AHIMA

Source: AHIMA Today

Publication Date: October 05, 2009


There is no time like the present to begin planning for the national coding switch to ICD-10-CM/PCS, according to several HIM professionals presenting here at convention.

Coding staff don’t need to start poring over new code books yet. But other preparations must be made for a facili....

Role-based Model for ICD-10 Implementation: Long Term Care

Author: AHIMA

Source: AHIMA

Publication Date: November 18, 2009

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Role-based Model for ICD-10 Implementation: Inpatient Coders

Author: AHIMA

Source: AHIMA

Publication Date: November 18, 2009

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Role-based Model for ICD-10 Implementation: Health Plans

Author: AHIMA

Source: AHIMA

Publication Date: November 18, 2009

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Role-based Model for ICD-10 Implementation: Outpatient Coders

Author: AHIMA

Source: AHIMA

Publication Date: November 18, 2009

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Health Plans: Tasks for 5010 & ICD-10-CM/PCS Compliance

Author: AHIMA

Source: AHIMA

Publication Date: November 18, 2009


The transition to 5010 and ICD-10-CM/PCS will be a challenge for Health Plans. A key to success in this transition is thorough and advance preparation as well as coordination of concomitant efforts to comply with 5010 and ICD-10. Payers may be tempted to focus on the 5010 compliance project fir....

Role-based Model for ICD-10 Implementation: Data Managers

Author: AHIMA

Source: AHIMA

Publication Date: November 18, 2009

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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....

Pain-free Wound Care Coding

Author: Endicott, Melanie

Source: Journal of AHIMA

Publication Date: January 2010


Wound care diagnoses and procedures can be challenging to code. In order for coders to code them correctly, clinicians must document diagnoses and procedures appropriately and thoroughly. Open communication between coders and clinicians can help facilitate better documentation.

Inpa....

ICD-10-CM and ICD-10-PCS Preview Exercises

Author: Barta, Ann

Source: AHIMA book

Publication Date: January 02, 2010


Description:   ICD-10-CM and ICD-10-PCS are on their way, and it is imperative that coding professionals be prepared for the transition to the new coding system. This workbook will prepare current coding professionals for the increased knowledge required by the implement....

2010 CPT Coding Update

Author: DeVault, Kathryn

Source: Journal of AHIMA - Coding Notes

Publication Date: February 2010


Changes to CPT codes for 2010 include 219 additions, 141 revisions, and 63 deletions. This article highlights some of the more notable changes; a comprehensive list can be found in appendix B of the 2010 CPT coding book. The changes took effect January 1.
Resequencing

The most n....

ICD-10-PCS Root Operation Guidelines

Author: Zeisset, Ann M.

Source: Journal of AHIMA - Coding Notes

Publication Date: February 2010


ICD-10-PCS has a completely different structure than ICD-9-CM. Each ICD-10-PCS code consists of individual values rather than lists of fixed codes and text descriptions, with each value containing a unique definition. The objective of the procedure is identified in the third character, the roo....

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