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Keeping up to Date: 2005 CPT Surgery Changes

Author: Hull, Susan

Source: Journal of AHIMA - Coding Notes

Publication Date: January 2005


CPT changes for 2005 affect all portions of the manual, although there are very few changes in the pathology and laboratory section. This article will focus on the changes for the surgery section. The January and February 2005 issues of CodeWrite (available through the Coding Community of Prac....

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....

Last Call for ICD-9-CM

Author: AHIMA

Source: Journal of AHIMA

Publication Date: October 2013


October 1, 2013 could be a day sentimental HIM veterans raise a glass to a longtime friend—or perhaps foe. For October 1 signifies the end of an era; it is the effective date of the final ICD-9-CM update before ICD-10-CM/PCS codes kick in on October 1, 2014.


In a statement t....

Leading the Transition to ICD-10

Author: AHIMA House of Delegates

Source: AHIMA HoD Resolution

Publication Date: June 18, 2010

Preamble

Whereas, October 1, 2013, has been set by the United States Department of Health and Human Services as the date for adopting the ICD-10-CM and ICD-10-PCS (ICD-10-CM/PCS);
Whereas, ICD-10-CM/PCS provides significant improvements in reporting diagnostic and procedural data an....

Look at Modifiers for Hospital Use

Author: Philippou, Karla E.

Source: Brief Encounter

Publication Date: July 02, 2001


Modifiers have been a continuing problem in the hospital setting. Although modifiers were mandated for hospital use in June 1998, many hospitals were unable to comply until the implementation of Ambulatory Payment Categories, (APCs), on August 1, 2000. The initial problems were related to info....

Major Changes for Heart Failure Codes in 2003: New Codes Put Sharper Focus on Diagnosing, Preventing Heart Failure

Author: Casey, Patricia E.; Zeisset, Ann M.

Source: Journal of AHIMA - Coding Notes

Publication Date: February 2003


Are you up to date with the latest revisions to the heart failure codes? A revision of the heart failure codes, effective October 1, 2002, was originally presented at the May 2001 ICD-9-CM Coordination and Maintenance Committee meeting. At that meeting, representatives from Kaiser Permanente e....

Making a Proactive Transition to APCs

Author: Willett, Lyn

Source: Journal of AHIMA

Publication Date: July 2000


There's no doubt APCs are going to change the way your facility operates, but do you know how? By taking a look at your existing systems, you'll get a better idea of how to prepare for changes. This article spotlights specific functions to consider and optimize for the new outpatient prospect....

Malignancy: Aftercare or Follow-Up?

Author: Parman, Cindy C

Source: CodeWrite | AHIMA newsletter article

Publication Date: May 2015




Physician documentation has always supported accurate diagnosis code reporting, but never more so than with the transition to ICD-10-CM codes. Specific terminology and the use of key words and phrases is essential, especially with terms such as "aftercare" and "follow-up," which phy....

Mapping Systematized Nomenclature of Medicine–Clinical Terms (SNOMED CT) to International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): Lessons Learned from Applying the National Library of Medicine’s Mappings

Author: Nandigam, Hari; Topaz, Maxim

Source: Perspectives in Health Information Management

Publication Date: July 2016


Abstract


The Systematized Nomenclature of Medicine–Clinical Terms (SNOMED CT) and the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) are two commonly used standardized health terminologies in the United States. In fall 2015, healt....

Modifers – ‘Friend or Foe’

Author: Swindle, Jennifer

Source: AHIMA Convention

Publication Date: October 02, 2011

ABSTRACT:

Background: The need for modifiers to further and appropriate identify accurate coding information to all payers is critical for appropriate and accurate reimbursement. Failure to use modifiers can have a negative impact on a physician or an organizations’ revenue as witho....

Modifications to ICD-10-CM/PCS Under Review

Author: AHIMA Advocacy and Policy Team

Source: Journal of AHIMA

Publication Date: February 2014

The ICD-9-CM Coordination and Maintenance (C&M) Committee, a public forum on ICD-9-CM and ICD-10-CM/PCS code updates, met in September 2013. Meetings of this committee are co-chaired by the National Center for Health Statistics (NCHS) and the Centers for Medicare and Medicaid Services (CMS). Coding proposals are presented at these meetings and the public is given the opportunity to comment. No final decisions regarding the adoption of code proposals are made at the meetings, but are made by the director of NCHS and the administrator of CMS.

Myocardial Infarctions: Frequently Asked Questions

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 1996

Myocardial Infarctions

Many coders still have questions regarding the correct coding and sequencing of myocardial infarctions (MI), particularly in relation to the use of the fifth digits, transfers, underlying diagnosis, and performance of procedures. The following information is provide....

Navigating the Physician Services Maze

Author: Skurka, Margaret A.

Source: Journal of AHIMA

Publication Date: July 2001


As HIM professionals know, accurate and complete documentation is critical for providing care and supporting reimbursement. This is particularly true-and yet particularly problematic-in the area of E/M coding. Medical practices report and are paid for their services using E/M coding, yet there....

New Changes De-Spookify Modifier -59

Author: Wilson, Donna D

Source: Journal of AHIMA - website

Publication Date: October 30, 2014



The proper application of modifier -59 (Distinct Procedural Service) has mystified many a coder. The Centers for Medicare and Medicaid Services (CMS) has recently indicated that modifier -59 is the most commonly used and abused of all the modifiers—mainly due to the fact that it is used to....

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....

New ICD-9-CM Committee Presents New Codes, Changes

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: September 2002


This is part 1 of a two-part summary of proposals from the April 2002 ICD-9-CM Coordination and Maintenance Committee meeting and includes procedure proposals. Part 2 will include diagnosis proposals and will be published in the October Journal of AHIMA.
The ICD-9-CM Coordination and Main....

New ICD-9-CM Diagnosis Codes for FY 2012

Author: Endicott, Melanie

Source: Journal of AHIMA - Coding Notes

Publication Date: September 2011


The new ICD-9-CM diagnosis codes go into effect October 1, 2011. This date marks the last regular annual update to the ICD-9-CM code set before the partial code freeze. On October 1, 2012, there will be only limited code updates to ICD-9-CM to capture new technology and new diseases. There wil....

New Study Illuminates the Ongoing Road to ICD-10 Productivity and Optimization

Author: Alakrawi, Zahraa M; Watzlaf, Valerie J.M.; Nemchik, Scot; Sheridan, Patty Thierry

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

Publication Date: March 2017



To quantify the impact of ICD-10-CM/PCS (ICD-10) on coding productivity, Ciox Health, in partnership with the University of Pittsburgh’s Department of Health Information Management, School of Health and Rehabilitation Sciences, conducted a previous study published in the August 2016....

Next Generation of E/M Guidelines

Author: Hill, Emily

Source: Journal of AHIMA - Coding Notes

Publication Date: November 2000


Few non-clinical issues have inspired as much discussion, revision, and anxiety as the evaluation and management (E/M) services and their accompanying documentation guidelines. E/M services have produced a cottage industry focused on ensuring that medical records contain necessary docu....

Nothing Lasts Forever: How Physicians Can Prepare for the End of the One-Year Amnesty from Post Payment Reviews Due to Unspecified Codes

Author: Lee, Christine

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

Publication Date: May 2016




Just as ocean tides shift with the earth's gravitational pull, physician practice administrators align staff and focus resources to address their organizations' most pressing concerns. This year, the tsunami grabbing administrators' attention is the conclusion of a one-year grace peri....

Not Your Average Encounter: Quirky ICD-10 Codes

Author: AHIMA

Source: Journal of AHIMA

Publication Date: August 2012


One look at the ICD-10-CM/PCS codebook proves that life is full of surprises. With ICD-10 stepping up the specificity of clinical codes, coders now have access to descriptions that can accurately capture even the most surprising of medical conundrums.


The increased specificity is....

No Uncertain Terms

Author: Zender, Anne

Source: Journal of AHIMA

Publication Date: May 1998


HIM professionals think of classification systems such as ICD-9-CM as tools for everyday use. But these familiar systems are evolving and changing rapidly—as Donna Pickett, RRA, is well aware.

Pickett is medical systems administrator for the Office of Data Standards, ....

Observation Services

Author: Hapner, Peggy

Source: AHIMA Convention

Publication Date: September 25, 2010



Observation is a necessary, though cumbersome, service provided in hospitals today. Many facilities would like to see observation eliminated because it is a logistical nightmare, particularly when it comes to charges and reimbursement.

The most stringent rules about observation....

Observation Services Present Compliance Challenges

Author: Prophet-Bowman, Sue

Source: Journal of AHIMA

Publication Date: March 2003


Observation services have been a top fraud and abuse target of the Office of Inspector General (OIG) of the Department of Health and Human Services, primarily due to the complexity of the Medicare billing regulations and the potential for abuse. New regulations regarding reimbursement for thes....

Obstetric Coding in ICD-10-CM/PCS

Author: Barta, Ann

Source: Journal of AHIMA - Coding Notes

Publication Date: June 2010


ICD-10-CM/PCS will capture a greater level of specificity for obstetric coding. This article highlights some of the new features in coding obstetric cases with ICD-10-CM/PCS.
OB Diagnoses Coding with ICD-10-CM

Obstetric cases require diagnosis codes from chapter 15 of ICD-10-CM,....

Optimizing Anatomy and Physiology Review for ICD-10

Author: Henderson, Kellie

Source: AHIMA Convention

Publication Date: September 25, 2010

Overview

As we move into the ICD-10 landscape an increased knowledge of anatomy and physiology is a critical requirement for success. Every coder has a different level of knowledge they draw from today. Identifying knowledge gaps and shoring up our defenses will provide us with informati....

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....

Post ICD-10 Implementation: Where Are We Now?

Author: Maccariella-Hafey, Patricia C

Source: CodeWrite

Publication Date: November 2015



We heard deep sighs of relief as October 1, 2015, came and went and ICD-10 was finally implemented in the United States. This has been a long time coming for coding and documentation improvement professionals in the HIM world. At the time of this article's writing, we are two weeks into im....

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.....

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....

Preparing for ICD-10- CM/PCS Implementation: Impact on Productivity and Quality

Author: Stanfill, Mary H; Hsieh, Kang Lin; Beal, Kathleen; Fenton, Susan H.

Source: Perspectives in Health Information Management

Publication Date: July 2014


Abstract


Coding productivity is expected to drop significantly during the lead-up to and in the initial stages of ICD-10-CM/PCS implementation, now expected to be delayed until October 1, 2015. This study examined the differences in coding productivity between ICD-9-CM and ICD-10-....

Preparing for ICD-10 While in an ICD-9 World: The Importance of Clinical Documentation and Coding Integrity (CDCI™) Programs Being Early Adopters of ICD-10

Author: Doty, Laura; Kruse, Marion G.

Source: AHIMA Convention

Publication Date: October 02, 2011

Introduction

Unless you are living under a rock or plan on retiring (or plan on winning the lottery) you are probably aware of the United States adopting ICD-10 and beginning to worry about what this means for you and your organization. The focus of this paper is to explore the impact of....

Progress on ICD-10: Survey Shows Advances with Two Years to Go

Author: AHIMA

Source: Journal of AHIMA

Publication Date: November 2011


With the ICD-10-CM/PCS deadline less than two years away, results of a recent AHIMA survey show that more organizations are getting their transitions in motion. In total, 85 percent of respondents to the August 2011 survey said that their organizations had begun work on ICD-10 planning and imp....

Projected Impact of the ICD-10-CM/PCS Conversion on Longitudinal Data and the Joint Commission Core Measures

Author: Fenton, Susan H.; Benigni, Mary Sue

Source: Perspectives in Health Information Management

Publication Date: July 2014


Abstract


The transition from ICD-9-CM to ICD-10-CM/PCS is expected to result in longitudinal data discontinuities, as occurred with cause-of-death in 1999. The General Equivalence Maps (GEMs), while useful for suggesting potential maps do not provide guidance regarding the frequen....

Provider’s Condensed Resource for Revenue Cycle, Coding Tools, and More

Author: Clack, Crystal; Freeman, Rae; Lewis, Laquette

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: January 2017


A cyclone of regulatory requirements for providers has officially touched down in the United States. The Affordable Care Act (ACA), Medicare Access and CHIP Reauthorization Act (MACRA), patient-centered medical home (PCMH), and value-based purchasing (VBP) initiatives are contributing to dramat....

Putting the ICD-10-CM/PCS GEMs into Practice (2016 update) - Retired

Author: Archer, Anita; Campbell, Angela; D'Amato, Cheryl; McLeod, Melissa; Rugg, Donna

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: January 2016


Editor's Note: This Practice Brief supersedes the May 2013 and March 2010 Practice Briefs titled "Putting the ICD-10-CM/PCS GEMs into Practice."


Mappings between ICD-9-CM and ICD-10-CM/PCS will play a critical role in the successful utilization of ICD-10-CM/PCS. The Centers for Me....

Quality Approach to the ICD-10 Transition: Ensuring Accurate Data Integrity and Care Delivery During the Move to the New Code Set

Author: Nemchik, Scot

Source: Journal of AHIMA

Publication Date: October 2013



With the ICD-10-CM/PCS compliance deadline looming, most healthcare organizations are working to educate staff and update technology to prepare for the transition. Despite this preparation, there is very little to indicate how the transition to ICD-10 will affect quality tied to data, repo....

Rare and Unlikely ICD-10 Codes are Needed

Author: Journal of AHIMA Staff

Source: Journal of AHIMA

Publication Date: October 2015


This summer, if you listened very closely, you could almost hear a vast chorus of coders saying “I told you so,” after a freak accident alarmed local boaters in Southern California. On June 21, an over-excited dolphin accidentally jumped into a California family’s speed boat and broke both ankl....

Review of E/M Guidelines

Author:

Source: Brief Encounter

Publication Date: July 02, 2001


The Evaluation and Management guidelines are found in the Medicare Carriers Manual in the following sections. You may download the entire manual from the Center for Medicare and Medicaid Services or CMS (formerly HCFA) Web site by going to http://www.hcfa.gov/, click on Medicare, select laws an....

Rheumatoid Arthritis

Author: Prophet, Sue

Source: Journal of AHIMA - Coding Notes

Publication Date: November 1998


Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, and other organs in the body. An autoimmune disease is one in which the body tissues are mistakenly attacked by the body's own immune system. Patients have antibodies in....

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