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Clear Focus on Coding

Author: Moses, Rhona

Source: Journal of AHIMA

Publication Date: April 1999


For the past three years I have been manager of coding education and billing guidelines at Group Health Cooperative, a 600,000-member HMO. Group Health has 25 primary care clinics, four specialty centers, an ambulatory surgical center, and two hospitals. We have about 700 staff physic....

Benchmarking with National ICD-9-CM Coded Data

Author: Osborn, Carol E.

Source: Journal of AHIMA

Publication Date: March 1999


As HIM professionals, we want to be assured that we are providing the highest quality data for reimbursement and research purposes. We can review coded data internally, but this does not give us a clear picture of the total information that is being submitted to the Health Care Financing Admin....

CPR in Long Term Care

Author: Schoenfelt, Suzanne

Source: Journal of AHIMA

Publication Date: February 1999


Throughout the healthcare industry, the computer-based patient record (CPR) is in various stages of development. This article assesses the progress long term care facilities are making in moving toward the CPR. The article also suggests some ways HIM professionals can devel....

AHIMA's Response to HCFA on the Notice of Proposed Rule-Making on the Proposed Prospective Payment System for Hospital Outpatient Services

Author: Kloss, Linda L

Source: AHIMA testimony and comments

Publication Date: January 06, 1999


Text:

The American Health Information Management Association (AHIMA) is pleased to have the opportunity to submit comments on the proposed prospective payment system for hospital outpatient services.

Description of the Ambulatory Payment Classification (APC) Groups
W....

1999 CPT Revisions

Author: Willard, Dianne

Source: Journal of AHIMA

Publication Date: January 1999


This article will summarize some of the major additions and revisions in the 1999 Current Procedural Terminology (CPT). A complete review of all the code and guideline changes -- including the rationale for these changes -- can be found in the November 1998 issue of the CPT Assistant newslette....

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....

Journal Q&A (10/98)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: October 02, 1998


Q: I work in a skilled nursing facility and want to know if it is mandatory for all states to use Resource Utilization Groups III (RUGS III). If so, when was the deadline?

A: The Balanced Budget Act of 1997 mandates the implementation of a per diem prospective payment sy....

FY1999 Inpatient PPS Changes: ICD-9-CM Revisions

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: October 1998


All of the inpatient DRG and other inpatient Prospective Payment System (PPS) changes described below became effective with discharges occurring on or after October 1, 1998. Complete details of these changes can be found in the Federal Register.1
Transfers to Postacute Settings

....

Performance Improvement for Documentation

Author: Labak, Carol

Source: Journal of AHIMA

Publication Date: October 1998


We've all seen it before: that look of bewilderment on a physician's face when a discussion about documentation arises. While this is not the first incidence of this discussion between the physician and the health information manager, neither is it the first time the HIM professional ....

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....

Development of the ICD-10 Procedure Coding System (ICD-10-PCS)

Author: Averill, Richard F.; Mullin, Robert L.; Steinbeck, Barbara A.; Goldfield, Norbert I; Grant, Thelma M.

Source: Journal of AHIMA

Publication Date: May 1998


The ICD-10 Procedure Coding System (ICD-10-PCS) has been developed as a replacement for Volume 3 of ICD-9-CM. This article will describe the development and structure of ICD-10-PCS‹as well as describe the modifications that have been made to the system as a result of extensive review and test....

Testing ICD-10-PCS

Author: Brooks, Patricia E.

Source: Journal of AHIMA

Publication Date: May 1998



HCFA conducted a formal test of ICD-10-PCS (procedure coding system) in order to determine if it would be a practical replacement for the current ICD-9-CM, Procedures. This coding system was developed after an open competition contract was awarded to 3M/HIS. In order to avoid any con....

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, ....

Managed Care: The Dominant Paradigm in US Healthcare

Author: Welch, Julie J.

Source: Journal of AHIMA

Publication Date: April 1998


What does "managed care" really represent -- and what effect has managed care had on the healthcare market? The author describes how managed care came to be a critical market force, offers a snapshot of its proliferation, and examines its effects on the traditional payment system.
It's....

ICD-9-CM Revisions (effective 10/1/97)

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: November 1997


The revisions to ICD-9-CM became effective with discharges occurring on or after October 1, 1997. Highlights of the changes are summarized below. Since every revision is not described in this article, it is important to review the Official Authorized Addendum. The complete addendum is publish....

Physician Office Billing Compliance Program

Author: Eisenhauer, Sue

Source: Journal of AHIMA

Publication Date: October 1997


Physician offices try to adhere to the coding and billing guidelines as defined by Medicare. However, claims to commercial insurance carriers frequently are not handled as precisely. The passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) has brought to our atte....

Hypertensive Disorders of Pregnancy

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: September 1997


Hypertension complicates at least 10 percent of all pregnancies. The hypertensive disorder of pregnancy most likely to result in significant adverse clinical outcomes is preeclampsia.

Preeclampsia
Preeclampsia is unique to pregnancy and is characterized by elevated blood press....

Managing Clinical Data: A Cancer Registries Update

Author: Watkins, Sue

Source: Journal of AHIMA

Publication Date: July 1997


Introduction
The American Cancer Society estimates that about 1.38 million new cancer cases will be diagnosed, and about 560,000 Americans will die of cancer, in 1997.1 These estimates do not include carcinoma in situ or basal and squamous cell skin cancer. To monitor trends in cancer i....

Overview of Trauma Registries in the United States

Author: Garthe, Elizabeth

Source: Journal of AHIMA

Publication Date: July 1997

Overview of Trauma Registries

How many trauma registries are there in the US? This is a tough question to answer. According to a survey conducted by members of the Emergency Nurses' Association (ENA), the number of clients reported by trauma registry software companies exceed 1850 organi....

ICD-9-CM Revisions -- Effective October 1, 1996

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: October 1996


The revisions to ICD-9-CM became effective with discharges occurring on or after October 1, 1996. Highlights of the changes are summarized below. Since not every revision is described in this article, it is important to review the official authorized addendum published in a special edition of....

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....

Disorders of the Breast

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: May 1996

Carcinoma

Breast cancer is the most common form of cancer in women. Risk factors include a personal or family history of breast cancer, delayed childbearing, and personal history of benign breast disease.
A tumor may be identified by mammogram or self-examination. Many tumors are d....

Physician Attestation [selections from 9/1/95 Federal Register]

Author: U.S. Health Care Financing Administration

Source: Federal Register

Publication Date: September 01, 1995

[Federal Register: September 1, 1995 (Volume 60, Number 170)] [Rules and Regulations] [Page 45777-45946] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr01se95-14] [[Page 45777]] _______________________________________________________________________ Part II Departmen....

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