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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....

Screening Algorithms to Assess the Accuracy of Present-on-Admission Coding

Author: Pine, Michael; Fry, Donald E.; Jones, Barbara; Meimban, Roger

Source: Perspectives in Health Information Management

Publication Date: February 2009


Abstract

Present-on-admission modifiers for International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes are rapidly becoming a standard coding requirement. Inaccurate coding of these modifiers can distort analyses of risk-adjusted outcomes....

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....

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....

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....

FY 2009 Hospital IPPS Final Rule

Author: Schwab, Linda

Source: Journal of AHIMA - Coding Notes

Publication Date: November 2008


The final rule for the FY 2009 hospital inpatient prospective payment system (IPPS) went into effect October 1, 2008. Although there are relatively few changes to MS-DRGs and the complication and comorbidity (CC) and major CC (MCC) lists, the final rule signals that the Centers for Medicare an....

ABCs of Medicare Advantage

Author: Hernandez, Jeannette

Source: Journal of AHIMA - Coding Notes

Publication Date: November 2008


Although most Medicare beneficiaries receive their health coverage through the traditional Medicare Part A and B fee-for-service programs, more and more beneficiaries are enrolling in Medicare Part C, referred to as Medicare Advantage (MA), to manage their healthcare costs.

By June 2....

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....

Discover How to Survive Medicare Severity DRGs with a Successful Clinical Documentation Improvement Program and Present on Admission Indicators

Author: Blackford, Gwendolyn

Source: AHIMA Convention

Publication Date: October 17, 2008


Health Information Management Department at the University of Michigan Hospitals and Health Centers
Introduction

What changes will be next for the inpatient coding world? October 1, 2007 had a tremendous impact on hospitals as it relates to clinical documentation for facility re....

MS-DRGs: One Year and Counting

Author: Perez, Mario A. III; Tully, Melinda

Source: AHIMA Convention

Publication Date: October 17, 2008




Introduction




The most important changes in the Medicare inpatient prospective payment system in 25 years were initiated October 1, 2007. CMS began paying for inpatient hospital services using the CMS-developed Medicare severity DRGs (MS-DRGs). MS-DRGs represent....

Comprehensive CDI: Making it Happen

Author: Pinson, Richard D.; Tang, Cynthia L.

Source: AHIMA Convention

Publication Date: October 17, 2008

Introduction

MS-DRGs were introduced by CMS on October 1, 2007 in an effort to incorporate severity of illness in adjusting hospital reimbursement for inpatient acute care. In response, as CMS predicted, clinical documentation integrity (or improvement) programs [CDI] are springing up eve....

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....

Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates ...: Final Rule

Author: U.S. Department of Health and Human Services

Source: Government (U.S.)

Publication Date: August 19, 2008

[Federal Register: August 19, 2008 (Volume 73, Number 161)] [Rules and Regulations] [Page 48433-49083] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr19au08-13] [[Page 48433]] ----------------------------------------------------------------------- Part II Book 2 of 2....

Running a Successful CDIP

Author: Dimick, Chris

Source: Journal of AHIMA - website

Publication Date: July 22, 2008





Clinical documentation improvement programs can enhance the clinical record and capture lost reimbursement. But they can be a challenge. Getting physician buy-in, avoiding turf wars between documentation specialists, coders, and nurses, and measuring program succes....

Coding’s Biggest Challenges Today

Author: Heubusch, Kevin

Source: Journal of AHIMA

Publication Date: July 2008




Coding departments are hectic places in 2008, busy adapting to new requirements. To meet the challenges, they are seeking the right staffing, education, and coordination.



How many challenges does coding face today? Open positions, revenue cycle, MS-DRGs, POA, RACs,....

Skilled Knowledge Workers in Short Supply

Author: Kloss, Linda L

Source: Journal of AHIMA

Publication Date: July 2008


This is a demanding time for coders. MS-DRGs and present on admission requirements would have been challenging on their own; however, both came at virtually the same time, straining coders already stretched to meet their job requirements.

Recruitment and retention of coding staff is....

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....

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