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How to Battle Coding Denial Trends: Creating a Proactive Appeal Strategy
Author: Powers, Malissa; Gregrich, Sabrena
Source: Journal of AHIMA
Publication Date: March 2019
By Malissa Powers, BS, RHIT, CCS, CICA, and Sabrena Gregrich, MBA, RHIA, CHPS, CPEHR
As healthcare moves toward value-based reimbursement, provider organizations are experiencing a new level of complexity in coding denial trends, which requires effective strategies for managing de....
IFHIMA Prepares for 19th Congress as Health Information Goes Global and Digital
Author: Fernandes, Lorraine M.; Butler-Henderson, Kerryn CHIA, FAHIMA; MacDonald, Marci; Skurka, Margaret A.; Lewis, Carol; AlBishi, Hussein; Axford, Kylie
Source: Journal of AHIMA
Publication Date: March 2019
By Lorraine Fernandes, RHIA; Kerryn Butler Henderson, PhD; Carol Lewis, MPH, RHIA; Marci MacDonald, CHIM; Margaret Skurka, MS, RHIA, CCS, FAHIMA; Hussein AlBishi; and Kylie Axford
Healthcare, like manY other segments of society and the economy, has become truly global.
<....
The Evolution of Technology in HIM: Where Are You in Your Journey?
Author: Plimpton, Julie MSHI, RHIA, CPHI; Wickard, Amanda
Source: Journal of AHIMA
Publication Date: March 2019
By Julie Wulf Plimpton, MSHI, RHIA, CPHI, and Amanda Wickard, MBA, RHIA, CPHI
As with any journey, understanding where you started is the key to understanding where you are going. Those who have been in the health information management (HIM) industry for many years have seen rapi....
How to Use Patient Data to Boost Acquisition and Retention Numbers
Author: Druckenmiller, Gary Jr.
Source: Journal of AHIMA
Publication Date: March 2019
By Gary Druckenmiller Jr.
Consider these three statistics: Acquiring a new patient is six to seven times costlier than retaining an existing one.1 A five percent increase in patient retention produces a 25 percent increase in profit.2 Additionally, the volume of healthcare data is....
Keeping Our Eye on the Revenue Cycle Ball
Author: Wiggs Harris, Wylecia
Source: Journal of AHIMA
Publication Date: March 2019
By Wylecia Wiggs Harris, PhD, CAE, chief executive officer
How would you spend $262 billion? It’s an eye-popping number, but according to a 2017 report by Change Healthcare, that’s how much in claims are initially denied every year due to insufficient clinical documentation. The r....
Digital Assistants Record First Privacy Breaches
Author: AHIMA
Source: Journal of AHIMA
Publication Date: March 2019
Incidents Create Questions About the Emerging Tech’s Use in Healthcare
Unquestionably, artificial intelligence (AI) is destined to revolutionize healthcare. It’s also highly likely that in the near future, lawmakers in the United States will pursue legislation to strengthen privacy law....
Addressing Privacy and Security Risks in Today’s Healthcare Ecosystem
Author: Meehan, Ann M.
Source: Journal of AHIMA
Publication Date: March 2019
By Ann Meehan, RHIA
Information is a healthcare organization’s most strategic asset and requires enterprise-wide management to ensure that it is protected and secured in the most compliant way—for patient care and other business purposes. More than ever, healthcare org....
Running Toward AHIMA’s Mission, Vision, Values, and Long-Term Strategy
Author: Wilson, Valerie
Source: Journal of AHIMA
Publication Date: March 2019
By Valerie Watzlaf, PhD, MPH, RHIA, FAHIMA
The process for preparing to run a marathon is similar to that of building strategy. Both begin with asking a seemingly simple question: “Why?”
We may decide to run a marathon for personal achievement, to support charity, o....
Surgical Site Infection Coding Update
Author: Minski, Melissa
Source: Journal of AHIMA
Publication Date: March 2019
By Melissa Minski, RHIA, CCS, CCDS
According to the Agency for Healthcare Research and Quality (AHRQ), more than 10 million patients undergo surgical procedures as inpatients each year, accounting for over 25 percent of all hospital stays. The most common types of inpatient s....
CY 2019 CPT Code Update
Author: Maccariella-Hafey, Patricia C
Source: Journal of AHIMA
Publication Date: March 2019
By Patricia Maccariella-Hafey, RHIA, CDIP, CCS, CCS-P, CIRCC
Calendar year (CY) 2019 brings robust changes to the CPT code set with 212 new codes, 73 deleted codes, and 50 revised codes. That puts the total number of CPT codes at an all-time high of 10,294. This article will highl....
Security Risk Analyses Can Offer Significant Findings
Author: Morris, Wes; Nunn, Sandra L.
Source: Journal of AHIMA
Publication Date: March 2019
By Wes Morris, CHPS, CIPM, HCISPP, and Sandra Nunn, MA, RHIA, CHP
ONE OF THE critical information governance (IG) functions is successful execution of an organization’s privacy and security responsibilities. Chief among these responsibilities is to conduct an accurate and thorough....
Check Yourself: Internal Revenue Cycle Audits Gain Importance
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: February 2019
By Mary Butler
Being told “there’s going to be an audit” triggers a fight or flight reaction of sorts. Visions of G-men in suits and ties, ominously wielding briefcases and calculators, spring to mind before the bearer of the bad news can clarify the context or minimize the i....
Guidelines for Achieving a Compliant Query Practice (2019 Update)
Author: AHIMA
Source: Journal of AHIMA
Publication Date: February 2019
Editor’s Note: This Practice Brief supersedes the January 2016 Practice Brief titled “Guidelines for Achieving a Compliant Query Practice (2016 Update).”
This American Health Information Management Association – Association of Clinical Documentation Im....
Guidelines for Achieving a Compliant Query Practice (2019 Update)
Author: AHIMA
Source: Journal of AHIMA
Publication Date: February 2019
Editor’s Note: This Practice Brief supersedes the January 2016 Practice Brief titled “Guidelines for Achieving a Compliant Query Practice (2016 Update).”
This American Health Information Management Association – Association of Clinical Documentation Im....
Strong Data Fundamentals Critical to Maximizing Data Opportunity
Author: Crabb, Stephanie; Fullem, Leah MHCDS
Source: Journal of AHIMA
Publication Date: February 2019
By Stephanie Crabb, MA, and Leah Fullem, MHCDS
Value-based healthcare IS changing how things work for everyone. The front end of this change—the way that clinicians, patients, and caregivers participate in healthcare—is anchored by the electronic health record (EHR) an....
MACRA 2019 Update: What to Know
Author: Marron-Stearns, Michael
Source: Journal of AHIMA
Publication Date: February 2019
By Michael Marron-Stearns, MD, CPC, CFPC
On November 1, 2018, the Centers for Medicare and Medicaid Services (CMS) released the 2019 Medicare Physician Fee Schedule.1 This document includes policy information for the third performance year of the CMS Quality Payment Program (QPP).....
CY 2019 Updates to the Hospital Outpatient Prospective Payment System
Author: Hansen, Abby
Source: Journal of AHIMA
Publication Date: February 2019
By Abby Hansen, MHA, RHIA, CCS, CCS-P
As always, the new year has brought the annual round of updates to code sets and coding procedures, including the newly released Hospital Outpatient Prospective Payment System (OPPS) update for 2019. The final rule for calendar year (CY)....
The Pros and Cons of Getting ‘App-y’
Author: Wise, Lee A; Miller, Nicole
Source: Journal of AHIMA
Publication Date: February 2019
By Nicole Miller, MS, RHIA, and Lee Wise, MS, RHIA, CHCO
We live in an era where we can order groceries online and have them delivered right to our kitchen. We are able to do nearly all banking online, making it possible to never set foot in a brick-and-mortar bank branch. It can....
Don’t Let Pagers Blindside your Privacy and Security Program
Author: Roth, Julie A.
Source: Journal of AHIMA
Publication Date: February 2019
By Julie Roth, JD, MHSA, RHIA
Imagine the following scenario. Jane has served as the HIPAA security officer for a 200-bed community hospital for five years. Fortunately, the hospital’s governing board understands the importance of HIPAA compliance and provides the health informati....
Down to the Basics: Policies and Procedures
Author: Fahy, Kristi
Source: Journal of AHIMA
Publication Date: February 2019
By Kristi Fahy, RHIA
Streamline, streamline, streamline! Organizations keep hearing that streamlining the way business is conducted will maximize outcomes and returns. Luckily, the path to a more streamlined organization takes us all the way down to the basics: policies and p....
Importance of Analytics in Mental Health
Author: Clack, Lesley; Woeppel, Jacqueline
Source: Journal of AHIMA
Publication Date: February 2019
By Lesley Clack, ScD, MS, and Jacqueline Woeppel, ScD, MBA, RHIA, CCS
With the overwhelming amount of data available in healthcare, analytics has increasingly become an important tool for organizations. Data analytics can help organizations make informed decisions and predict what....
HIM Can Play a Role in Price Transparency
Author: AHIMA
Source: Journal of AHIMA
Publication Date: February 2019
While a lot has been done to fight some of the biggest inequities in healthcare—such as higher premiums or insurance denials for pre-existing conditions—some mysteries of the system remain impenetrable for consumers. Chief among those is price transparency and the quagmire that must be navigate....
A Resolution To Be Meaningful
Author: Wells, Shawn
Source: Journal of AHIMA
Publication Date: February 2019
By Shawn Wells, RHIT, CHDA
As we move into the second month of the new year I am reminded of our optimistic, yet often-abandoned, list of New Year’s resolutions. These promises we make to ourselves every January originated as promises to the pagan gods over 4,000 years ago, with....
Health Information Proliferating in Non-Acute Settings
Author: Wiggs Harris, Wylecia
Source: Journal of AHIMA
Publication Date: February 2019
By Wylecia Wiggs Harris, PhD, CAE, chief executive officer
Recently, the Network for Excellence in Health Innovation (NEHI) released a report on “Health Care Without Walls.” The authors describe “Health Care Without Walls” as “a system that came to people, meeting them where they....
Tackling Non-Acute Care’s Unique Privacy and Security Challenges
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: February 2019
By Mary Butler
Patient privacy is at a true premium in retail pharmacies. Patients can choose to present at a drive-thru window, a desk that shares space with a cash register or two, a consultation window, or a script drop-off area where the only privacy barrier is behind the coun....
How to Write for Your Profession
Author: Sandefer, Ryan
Source: Journal of AHIMA
Publication Date: February 2019
By Ryan Sandefer, PhD, and Amy Watters, EdD, RHIA, FAHIMA
In the January issue of Journal of AHIMA, health information professionals were asked to take action by highlighting their work and the value of the health information management (HIM) profession through publishing. Yes, t....
Telehealth Privacy and Security: An Opportunity for HIM Professionals
Author: Watzlaf, Valerie J.M.
Source: Journal of AHIMA
Publication Date: January 2019
By Valerie Watzlaf, PhD, MPH, RHIA, FAHIMA
While I have not yet had the opportunity to do so, I am looking forward to participating in my first telehealth visit. While telehealth is an exciting new avenue for healthcare delivery, the success with which providers have deployed tele....
Best Practices in the Art and Science of Clinical Documentation Improvement (2018 Update)
Author: AHIMA
Source: Journal of AHIMA | AHIMA practice brief
Publication Date: January 2019
Editor’s Note: This Practice Brief update supersedes the July 2015 Practice Brief titled “Best Practices in the Art and Science of Clinical Documentation Improvement.”
Clinical documentation improvement (CDI) is a discipline focused on improv....
Effectively Managing a Growing Coding Workforce
Author:
Source: Journal of AHIMA
Publication Date: January 2019
By Clark Chaffin, MBA, RHIA, CCS
Health information management (HIM) departments across the United States, whether small or large, are experiencing a multitude of challenges and growing pains in today’s healthcare landscape. As more experienced members of the workforce are retirin....
Why You Need to Write for Your Profession
Author: Sandefer, Ryan
Source: Journal of AHIMA
Publication Date: January 2019
By Ryan Sandefer, PhD, and Amy Watters, EdD, RHIA, FAHIMA
The May 2014 cover of Journal of AHIMA featured an image of a chameleon and the words “Adapt or Disappear.” This hyperbolic warning for health information management (HIM) professionals was delivered in the context of the r....
Weathering the Storm: How to Lead through the Chaos of Change
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: January 2019
By Mary Butler
When the once-dominant retailer Sears filed for bankruptcy in 2018, many attributed its decline—and that of brick and mortar retailers in general—to the existential threat of Amazon and online retail. While Amazon played a role in the demise of....
Drivers for Solid Information Management Expanding in Healthcare
Author: Green, Deborah
Source: Journal of AHIMA
Publication Date: January 2019
By Deborah Green, MBA
Everything that is done in healthcare revolves around data and information. From new sources of data to new technological advancements, the drivers and needs for solid information management have not only grown but have become reinforced by and intertwin....
IPPS Final Rule Changes for Fiscal Year 2019
Author: AHIMA
Source: Journal of AHIMA
Publication Date: January 2019
By Moira Hunger, RHIT
Though hard to believe, a new fiscal year (FY) is already well underway. The Centers for Medicare and Medicaid Services (CMS) released the final rule for the Hospital Inpatient Prospective Payment System (IPPS) on August 17, 2018. All changes were e....
General Data Protection Regulation and Research in the United States
Author: Berry, Shamsi Daneshvari PhD, MS, CPHI; Flanigan, Jill
Source: Journal of AHIMA
Publication Date: January 2019
By Shamsi Daneshvari Berry, PhD, MS, CPHI, and Jill Flanigan, MLS, MS, RHIT
The European Union (EU) protects the personal information of EU citizens through the General Data Protection Regulation (GDPR),1 which went into effect on May 25, 2018 and replaced the Data Protection Dire....
In Pursuit of Compatible Coding Audit Benchmarks
Author: Stanfill, Mary H
Source: Journal of AHIMA
Publication Date: January 2019
By Mary H. Stanfill, MBI, RHIA, CCS, CCS-P, FAHIMA
People like benchmarkS. They like to know how they are doing in comparison to someone else. In health information management (HIM), a common benchmark is the de facto standard of 95 percent accuracy rate for medical coding. HIM pr....
President's Message: Be Heard, Be Fearless
Author: Watzlaf, Valerie J.M.
Source: Journal of AHIMA
Publication Date: January 2019
By Valerie Watzlaf, PhD, MPH, RHIA, FAHIMA
As AHIMA transitions into our strategy reset, it is more important than ever to keep our passion for the HIM profession strong, as well as align our passions with what is best for our profession and association. So, how do we find our voi....
Inside Look: Navigating Change with Courage
Author: Wiggs Harris, Wylecia
Source: Journal of AHIMA
Publication Date: January 2019
By Wylecia Wiggs Harris, PhD, CAE, chief executive officer
Navigating change can be exciting—or it can be scary. It can be especially hard to cope when you feel like you’re right in the middle of change and you don’t know how everything’s going to turn out.
In his se....
Addendum: Spring Forward, Fall Back… Over a Record Keeping Cliff
Author: AHIMA
Source: Journal of AHIMA
Publication Date: January 2019
Most hospitals weathered the dreaded Y2K glitch with nary a problem, but nearly 20 years later, for even the largest electronic health record (EHR) vendors, turning the clock back for daylight saving time is a bridge too far.
“It’s an hour where you’re sort of flying blind,” said....
The Business Reality of HIM Outsourcing Explained
Author: Carey, Susan
Source: Journal of AHIMA
Publication Date: January 2019
By Susan Carey, MHI, RHIT, PMP, FAHIMA
Outsourcing, whether delegating work to companies within the US or to other countries (offshore outsourcing), has become a strategic consideration and business model in many areas of the healthcare industry, including healthcare IT, health in....
Mitigating Security Risks Associated with Wireless Infusion Pumps
Author: Shenton, William R JD
Source: Journal of AHIMA
Publication Date: January 2019
By William R. Shenton, JD
Wireless infusion pumps must provide a steady inflow of life-saving or life-sustaining medications, but these critical devices come with significant risks that every healthcare organization must address. To operate effectively and efficiently, i....
Redisclosure of Protected Health Information (PHI) (2018 Update)
Author: AHIMA
Source: AHIMA practice brief | Journal of AHIMA
Publication Date: November 2018
Editor’s Note: This update supersedes the 2013 Practice Brief “Redisclosure of Patient Health Information.”
Redisclosure is the act of sharing or releasing health information that was received from another source, such as an extern....
Relevance of Interprofessional Education for HIM Professionals
Author: Lalani, Karima; Gibbs, David
Source: Journal of AHIMA
Publication Date: November 2018
By Karima H. Lalani, MBA, RHIA, and David L. Gibbs, PhD, CPHI, CHPS, CPHIMS, CISSP
The practice of “interprofessional education” (IPE) is growing in importance across all healthcare disciplines, including health information management (HI....
Ensuring Data Integrity During Health Information Exchange
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: November 2018
By Mary Butler
When handled poorly, the process of health information exchange can mimic the classic childhood game “Telephone.” Even though the person who kicks off the game whispers a message as clearly as they can to the person next....
HIM’s Central Role in Health Information Exchange Using C-CDA
Author: Meyer, Melanie; Fabian, Diane; Stearns, Michael; Doyle, Carlyn MSHI, RHIA, CHPS, HCISPP; Slivochka, Sharon RHIA
Source: Journal of AHIMA
Publication Date: November 2018
By Melanie Meyer, PhD, MHA, RHIA, CCS, CPHQ; Carlyn Doyle, MSHI, RHIA, CHPS, HCISPP; Diane P. Fabian, MBA, MS, RHIA; Sharon Slivochka, RHIA; and Michael Stearns, MD, CPC, CFPC
Information exchange using the Consolidated-Clinical Document Arc....
2019 ICD-10-PCS Coding Updates
Author: Bruce, Tina MHIM, MHI, RHIA, CCS, CDIP
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: November 2018
By Tina Bruce, MHIM, MHI, RHIA, CCS, CDIP
Healthcare practices, clinical documentation improvement specialists, auditors, and coding professionals are on the edge of their seats anxiously awaiting the annual release of coding updates by the....
FY 2019 ICD-10-CM Updates: Getting Back to Normal
Author: Johnson, Laurie M.
Source: Journal of AHIMA | Journal of AHIMA - Coding Notes
Publication Date: November 2018
By Laurie M. Johnson, MS, RHIA, FAHIMA
Since the implementation of ICD-10-CM/PCS in October 2015, the periodic coding updates have included many changes. For FY 2019, the diagnosis update includes a more manageable number: 279 new codes, 143 revised....
Producing Better Data to Help Combat Opioid Dependence
Author: Clack, Lesley; Kadlec, Lesley; Wendicke, Annemarie; Spiro, Shelly RPh
Source: Journal of AHIMA
Publication Date: November 2018
By Lesley Clack, ScD, MS; Lesley Kadlec, MA, RHIA, CHDA; Shelly Spiro, RPh; and Annemarie Wendicke, MPH, CHDA
Healthcare organizations are just beginning to leverage data analytics to take on a variety of emerging urgent topics related to ma....
The Role of Information Governance in the Implementation of Patient Portals
Author: Coffey, Patricia S; McKeeby, Jon W; Starr, Marisa RHIA; Lardner, Michelle DNP, RN-BC
Source: Journal of AHIMA
Publication Date: November 2018
By Patricia Coffey, RHIA, CPHIMS, CPHI; Marisa Starr, RHIA; Michelle Lardner, DNP, RN-BC; and Jon Walter McKeeby, D.Sc., MBA, CPHIMS, CPHI
A robust information governance program helped the National Institutes of Health Clinical Center (NIHC....
Employer Data Breach Liability: The Employee as a Threat Vector
Author: Herrin, Barry S.
Source: Journal of AHIMA
Publication Date: November 2018
By Barry S. Herrin, JD, FAHIMA, FHIMSS, FACHE
“We have met the enemy, and he is us,” said famous cartoonist Walt Kelly. The phrase can easily be applied to healthcare privacy and security threats.
According to a 2014 IBM study....
Embracing and Leading the Possibilities of the Future
Author: Wiggs Harris, Wylecia
Source: Journal of AHIMA
Publication Date: November 2018
By Wylecia Wiggs Harris, PhD, CAE, chief executive officer
In late 2017, a Vox.com article titled “The fax of life: Why American medicine still runs on fax machines” had people talking. It described the endurance of fax machines and their us....
Examining the Importance of Data Governance in Healthcare
Author: Fuller, Shannon MBA
Source: Journal of AHIMA
Publication Date: November 2018
By Shannon Fuller, MBA
Healthcare has always focused on managing information from application to application, instead of looking at information holistically and defining it holistically. The industry’s shift of focus onto analytics—whethe....
Future Forward
Author: Smith, Diann H. MS, RHIA, CHP, FAHIMA
Source: Journal of AHIMA
Publication Date: November 2018
By Diann H. Smith, MS, RHIA, CHP, FAHIMA
It is hard to believe this is my last Journal of AHIMA column as AHIMA’s President/Chair of the Board of Directors. I am genuinely grateful to have joined you in bringing to life the theme for AHIMA’s....
What’s in a Name?
Author: AHIMA
Source: Journal of AHIMA
Publication Date: November 2018
It’s not at all uncommon for organizations to change their names several times before landing on one that captures their presence in the past, the present, and the future—especially if they are technology-focused. Take NCR Corp., which today sells every....
Blockchain’s Role in Health IT
Author: Viola, Allison F.
Source: Journal of AHIMA
Publication Date: October 2018
By Allison Viola, MBA, RHIA
When innovative technologies make a splash on the international stage, healthcare professionals wonder how these technologies can translate or be scaled for the healthcare industry. Health information management (HIM) profession....
Building a Bridge Between Data and Knowledge
Author: Wiggs Harris, Wylecia
Source: Journal of AHIMA
Publication Date: October 2018
By Wylecia Wiggs Harris, PhD, CAE, chief executive officer
This summer, the healthcare industry was reminded of the value of data with an announcement regarding the rules of ICD-10-CM. Coding Clinic published guidance reaffirming that providers can as....
“Alexa, Let’s Schedule Some HIPAA Training”
Author: AHIMA
Source: Journal of AHIMA
Publication Date: October 2018
When a new technology emerges, there’s always a split between the early adopters and their more cautious counterparts. So when it comes to using a digital voice assistant like Amazon’s Echo, Google Home, or Apple’s Siri in a hospital’s intensive care unit (ICU), do....
Qualities of an Excellent Healthcare Data Analyst
Author: Spears, Amanda MA, CHDA
Source: Journal of AHIMA
Publication Date: October 2018
By Amanda Spears, MA, CHDA
Some people think that looking at numbers on a spreadsheet for more than 20 minutes is tantamount to torture. Others get excited uncovering trends and turning huge, complex datasets into simple, elegant reports that allow leaders....
Engaging and Aligning to Build Momentum for Our Future
Author: Smith, Diann H. MS, RHIA, CHP, FAHIMA
Source: Journal of AHIMA
Publication Date: October 2018
By Diann H. Smith, MS, RHIA, CHP, FAHIMA
Last month, I wrote about our commitment to create a vibrant future for AHIMA with clarity of strategy and resources aligned. This month, I want to explore how outreach to internal and external stakeholders upgrades....
Enterprise Information Management and Information Strategy: A Brief How-To Guide
Author: Dickey, John MSHI, RHIA, PMP
Source: Journal of AHIMA
Publication Date: October 2018
By John H. Dickey, MSHI, RHIA, PMP
The road to information governance (IG) varies greatly between healthcare organizations. Some organizations may compare it to a pathway with trampled grass, partially filled with gravel, while others find a freshly paved....
HIM’s Vital Role in Healthcare Ratings
Author: Land, Daniel
Source: Journal of AHIMA
Publication Date: October 2018
By Daniel Land, RHIA, CCS
Coded data has a long and influential life span, and its importance goes beyond that of just today’s revenue cycle. It is important for health information management (HIM) professionals to understand the micro and macro purposes of cod....
Deliverance in the Data
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: October 2018
Mother’s Crusade to Help Daughter with Genetic Syndrome Leads to Work in Health Data Analytics Research
By Mary Butler
Megan O’Boyle keeps track of her daughter Shannon’s medical records using this voluminous binde....
Niche Analytics
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: October 2018
Specialty and Non-Acute Data Analytics Initiatives Offer Focus and Opportunity for HIM
By Mary Butler
In the fast-paced world of emergency medicine, it’s hard to conjure a metric that’s more important to both prospective patients and clinicians than emergency....
WHO Releases ICD-11 Preview
Author: Palkie, Brooke; Kerr, Katie MA, RHIA
Source: Journal of AHIMA | Journal of AHIMA - Coding Notes
Publication Date: October 2018
By Katie Kerr, MA, RHIA, and Brooke Palkie, EdD, RHIA
The World Health Organization (WHO) released ICD-11 in June 2018, 18 years after the launch of ICD-10. It has been hailed as a vast improvement and was released in a completely electronic format th....
Data Analytics: The Power of Coded Data
Author: Thomas, Felicia A; Harding, Wahiyda A
Source: Journal of AHIMA | Journal of AHIMA - Coding Notes
Publication Date: October 2018
By Felicia A. Thomas, RHIT, CCS, CPC, CIC, CPC-I, CCDS, and Wahiyda Harding, MSA, RHIA, CCS
To understand the power of coded data, let’s first take a look at its definition. Data analytics is the science of examining raw data with the purpose of drawing conclus....
Best Practices for Data Analytics Reporting Lifecycles: Quality in Report Building and Data Validation
Author: Clack, Lesley; Houser, Shannon H.; Kadlec, Lesley; Mikaelian, Raymound; Wendicke, Annemarie; Cain, Jeannine MSHI, RHIA, CPHI; Spears, Amanda MA, CHDA
Source: Journal of AHIMA | AHIMA practice brief
Publication Date: October 2018
While the importance of data quality in providing high-quality clinical care in today’s healthcare setting is typically well understood, the quality of data for report building and validation activities is often not well articulated—and potential data quality....
AHIMA Turns 90
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: September 2018
Examining the Past, Present, and Future of the Association through its Members
By Mary Butler
Etiquette experts abide by a set of rules about what makes for an appropriate wedding anniversary gift. Paper, for example, is advised for one-year anni....
Beyond the Basics for Health Informatics Professionals - Retired
Author: Campbell, Angela; Houser, Shannon H.; Paulson, Dawn; Ryznar, Barbara; Smith, Clarice Pittillo; Woebkenberg, Jami; Hernandez, Sandra MSMIS, RHIA, CPHI, CCS, CHC; Pirie-St. Pierre, Mari RHIA, CPHI; Plimpton, Julie MSHI, RHIA, CPHI
Source: AHIMA practice brief | Journal of AHIMA
Publication Date: September 2018
Editor’s Note: This Practice Brief supersedes the September 2014 Practice Brief “Defining the Basics of Health Informatics for HIM Professionals.”
Data, data everywhere! We are living in the age of “Big Data” and healthcare informat....
The Importance of Histology in Neoplasm Coding
Author: Bumgarner, Charlotte CDIP, CCS; Latva, Jennifer CCS, COC, CPC, CGSC
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: September 2018
By Charlotte M. Bumgarner, CDIP, CCS, and Jennifer C. Latva, CCS, COC, CPC, CGSC
CODERS OFTEN RELY on a neoplasm’s behavior and location for ICD-10-CM code assignment, rather than first referencing histological type. This oversight can lead....
Double Trouble
Author: Houser, Shannon H.; Harris, Shannon MBA, RHIA
Source: Journal of AHIMA
Publication Date: September 2018
Using Health Informatics to Tackle Duplicate Medical Record Issues
By Shannon Harris, MBA, RHIA, and Shannon H. Houser, PhD, MPH, RHIA, FAHIMA
Are You battling with duplicate medical record issues in your organization? Data quality issues are trending....
How to Prepare for EHR Downtime
Author: Primeau, Debra
Source: Journal of AHIMA
Publication Date: September 2018
Whether Due to Cyberattacks, System Upgrades, or Myriad Other Potential Causes, Healthcare Organizations Need Solid EHR Contingency Plans
By Debra Primeau, MA, RHIA, FAHIMA
In May 2016, the Office of the National Coordinator for Health IT (ONC) p....
Enterprise-Wide PHI Disclosure Management—Why Information Governance Matters
Author: Bowen, Rita K.
Source: Journal of AHIMA
Publication Date: September 2018
By Rita Bowen, MA, RHIA, CHPS, CHPC, SSGB
Managing the disclosure of protected health information (PHI) is complex for a variety of reasons—the growing number of disclosure points, steeper penalties for noncompliance and breach, and the rise of....
Using Population Health, Inclusive HIM Practices to Better Treat LGBTQ Patients
Author: Dooling, Julie A; Kadlec, Lesley; Pruente, Megan; Ward, Maria; Woebkenberg, Jami; Butler-Henderson, Kerryn CHIA, FAHIMA; Ginn, Dustin MA, MHA, RHIA; Retallack, Donna RHIT; Young III, John RHIA, CHPS, CPHIMS, HCISPP
Source: Journal of AHIMA
Publication Date: September 2018
By Kerryn Butler-Henderson, CHIA, FAHIMA; Julie Dooling, MSHI, RHIA, CHDA, FAHIMA; Dustin Ginn, MA, MHA, RHIA; Lesley Kadlec, MA, RHIA, CHDA; Megan Pruente, RHIA; Donna Retallack, RHIT; Maria Ward, MEd, RHIA, CCS, CCS-P; Jami Woebkenberg, MHIM, RHIA, CPHI; and....
SNOMED CT and the EHR: Why Should a HIM Professional Care?
Author: Mason, Cheryl MSHI
Source: Journal of AHIMA
Publication Date: September 2018
By Cheryl Mason, MSHI
Health information management (HIM) professionals serve as the data stewards of the patient medical record. They are responsible for capturing all necessary information about a patient and managing that information over time. As....
Coding’s Impact on Suicide Prevention
Author: Hansen, Abby
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: September 2018
By Abby Hansen, MHA, RHIA, CCS, CCS-P
The Centers for Disease Control and Prevention (CDC) reports that suicide rates have increased by more than 30 percent since 1999. In 2014, suicides accounted for 42,773 deaths in the United States; 2015....
Privacy and Security Risks with Biometrics
Author: Hedges, Ron
Source: Journal of AHIMA
Publication Date: September 2018
By Ron Hedges, JD
Collection and use of biometric information may be useful to healthcare providers looking for new and better ways to positively identify patients as well as fight fraud. Biometric technologies include facial recognition, retinal....
Streamlining the Process in Opioid Data Collection
Author: Clack, Lesley; Schecter, Aaron PhD
Source: Journal of AHIMA
Publication Date: September 2018
By Lesley Clack, ScD, and Aaron Schecter, PhD
The opioid epidemic has become a major topic of conversation in healthcare in the United States—in part because the statistics are staggering. According to the US Department of Health and Human S....
Change—and Great Potential—Ahead for HIM
Author: Wiggs Harris, Wylecia
Source: Journal of AHIMA
Publication Date: September 2018
By Wylecia Wiggs Harris, PhD, CAE, chief executive officer
You can tell a lot about an industry by reading its news headlines. Some recent examples illustrate how health information and patient data are becoming part of the transformation of the....
Understanding Strategy Beyond Today
Author: Smith, Diann H.
Source: Journal of AHIMA
Publication Date: September 2018
By Diann H. Smith, MS, RHIA, CHP, FAHIMA
AS HEALTH INFORMATION management (HIM) professionals, we must constantly evaluate our role in the healthcare ecosystem as the industry continues to evolve. After all, healthcare has many stakeholders and H....
Celebrating 90 Years of AHIMA Conventions
Author: AHIMA
Source: Journal of AHIMA
Publication Date: September 2018
From its founding era to present day, AHIMA’s signature event has been its annual convention and exhibit. The event has consistently drawn the most talented health information management (HIM) professionals for educational sessions and keynote speakers, sporting ba....
Big Privacy Concerns for Small Practices
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: September 2018
By Mary Butler
Anyone who has ever been to a doctor’s office or mental health provider where the seating area is sparse can quickly ascertain that they’re giving up some modicum of privacy to see that doctor. Tiny waiting areas with chairs or benches....
You Got Proof? Payers, Auditors Increase Clinical Validation Checks
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: July 2018
By Mary Butler
Healthcare providers and health information management (HIM) departments have been learning the hard way—for some time—that no good deed goes unpunished.
Case in point is how providers embraced cli....
A Dive into Section I.A.19: Code Assignment and Clinical Criteria
Author: Combs, Tammy
Source: Journal of AHIMA - Coding Notes
Publication Date: July 2018
By Tammy Combs, RN, MSN, CDIP, CCS, CCDS
Have you ever wondered what it means to be an effective communicator? In his article “Why Communication Is Today’s Most Important Skill,” Greg Satell discusses Michael Faraday, who helped tr....
Utilizing the CMS Website for Additional Coding Direction
Author: DeVoe, Megan
Source: Journal of AHIMA - Coding Notes
Publication Date: July 2018
By Megan DeVoe, CCS
Editor’s Note: This is the final article in a three-part series on how to master the information available on the Centers for Medicare and Medicaid Services website.
Have you ever wondered how a code bec....
How to Obtain C-suite Buy-in for Outpatient CDI Programs
Author: Fee, James P; Phillips, Rachel; Trepina, Sonia
Source: Journal of AHIMA
Publication Date: July 2018
By James P. Fee, MD, CCS, CCDS; Sonia Trepina; and Rachel Phillips, RHIA, CCS, CCDS
In an era of risk-adjusted payments, organizations—particularly those embarking on the journey toward becoming an Accountable Care Organization (ACO)&mdas....
Advancing a Nationwide Patient Matching Strategy
Author: Viola, Allison F.; Halamka, John; Torkzadeh, Rita MS; Moscovitch, Ben MA; Rising, Josh MD; Asnaani, Jitin MBA; De Mooy, Michelle MA; Ferguson, Jamie BS; Gingrich, Mark MS; Grannis, Shaun MD; Heflin, Eric BS; Hohwald, Andrew MBA; Miri, Aaron MBA; Rudin, Robert S PhD; Schulten, Catherine BS; Worzala, Chantal PhD
Source: Journal of AHIMA
Publication Date: July 2018
By Rita Torkzadeh, MS; Ben Moscovitch, MA; Josh Rising, MD; Jitin Asnaani, MBA; Michelle De Mooy, MA; Jamie Ferguson, BS; Mark Gingrich, MS; Shaun Grannis, MD; Eric Heflin, BS; Andrew Hohwald, MBA; Aaron Miri, MBA; Robert S. Rudin, PhD; Catherin....
Death and Data—Where Basic Medical Record Keeping Saves Lives
Author: AHIMA
Source: Journal of AHIMA
Publication Date: July 2018
Doctors and nurses get to witness firsthand how their interventions can save or lose a life. People who work for payers, like medical directors, may get a charge out of covering treatments for chronic conditions or lifesaving treatments. But for....
Appendix B: Query Escalation and Retention
Author: AHIMA
Source: Journal of AHIMA
Publication Date: July 2018
Whatever the size and structure of the practice, and regardless of who is responsible for the query, general practices for escalation and retention should apply.
Timeframes
A pre-visit review of documentation may be usefu....
How Staffing and Workflow Evolves with Move to All-Payer CDI
Author: Reiter, Autumn BSN, RN, CCDS, CDIP, CCS; Dixon, Lori A. MSN, RN-BC, CDIP
Source: Journal of AHIMA
Publication Date: July 2018
A Case Study in CDI Expansion at an 11-Hospital Health System
By Autumn Reiter, BSN, RN, CCDS, CDIP, CCS, and Lori A. Dixon, MSN, RN-BC, CDIP
Clinical documentation improvement (CDI) programs have proven they are worth t....
Appendix C: Query Examples
Author: AHIMA
Source: Journal of AHIMA
Publication Date: July 2018
Example #1: Diagnosis is documented but is not clinically validated
Dear Doctor,
COPD exacerbation is documented within the clinic note dated 3/5/xx.
There is no documentation in the current h....
Appendix A: Query Monitoring/Auditing
Author: AHIMA
Source: Journal of AHIMA
Publication Date: July 2018
Physician practices vary greatly in terms of number of physicians, size of staff, type of setting, management structure, and even whether they have CDI and/or credentialed coding professionals. As the healthcare industry moves toward population....
Expanding Roles: HIM’s Terminology Management Opportunity
Author: Mason, Cheryl MSHI
Source: Journal of AHIMA
Publication Date: June 2018
By Cheryl Mason, MSHI
Data and documentation in healthcare have become increasingly more complex. The healthcare industry’s push toward greater value means healthcare organizations must have systems in place to support high-level d....
Audits Offer Fix for Poor Coding Compliance, Lagging Reimbursement
Author: Hammerman, Julia
Source: Journal of AHIMA
Publication Date: June 2018
By Hammerman, RHIA, CPHQ
The ever-increasing complexity of healthcare is driving the need for coding quality and compliance programs. Given the transition to ICD-10, advancements in treatments and procedures, a move to quality reporting....
Auditing Across the Continuum: One Size Doesn’t Fit All
Author: DeVault, Kathryn; Sartori, Natalie
Source: Journal of AHIMA
Publication Date: June 2018
By Kathryn DeVault, MSL, RHIA, CCS, CCS-P, FAHIMA, and Natalie Sartori, MEd, RHIA
All coding professionals have been involved in coding audits, in one form or another. Many hear the term “coding audit” and expect it to be a quality....
How to Get Ahead in Coding: One Company’s Grassroots Programs Offer New Grads and Seasoned Coders Opportunities for Professional Development
Author: Land, Daniel
Source: Journal of AHIMA
Publication Date: June 2018
Untitled Document
By Daniel Land, RHIA, CCS
When one reaches a certain point in their career, thoughts often turn to the subject of legacy. While there are myriad ways to give back to one’s profession, mentoring those with the earne....
Show Me Some ID: Tips for Trusting Identity in the Era of Cybercrime and Fraud
Author: Butler, Mary
Source: Journal of AHIMA
Publication Date: June 2018
Untitled Document
By Mary Butler
Meet Maria, a fictional emergency department (ED) registration clerk who’s been on the job at a big city trauma center for six months. When Maria starts her shift she gets an alert that the patient p....
Documentation and Coding Practices for Risk Adjustment and Hierarchical Condition Categories
Author: Watson, Monica M
Source: Journal of AHIMA | AHIMA practice brief
Publication Date: June 2018
Documentation and Coding Practices for Risk Adjustment and Hierarchical Condition Categories
Risk adjustment is a statistical process that considers the underlying health status and health spending of patients when examining their healthcare outcomes....
Appendix C: Details for CMS-HCC Model Structure
Author:
Source: Journal of AHIMA
Publication Date: June 2018
Structure Concept
Details
Hierarchical
In the HCC models, HCC conditions are hierarchical, meaning diagnoses that are clinically related are ranked by....
Bringing Inpatient, Outpatient Coding to the Foreground
Author: Wiggs Harris, Wylecia
Source: Journal of AHIMA
Publication Date: June 2018
By Wylecia Wiggs Harris, PhD, CAE, chief executive officer
We don’t often see HIM in the headlines, due to the “behind the scenes” nature of the profession. But we may be seeing that change as patients and patient advocates ma....
Appendix D: MEAT approach details
Author:
Source: Journal of AHIMA
Publication Date: June 2018
Appendix D: MEAT approach details
Article citation:
. "Appendix D: MEAT approach details." Journal of AHIMA 89, no.6 (June 2018): extended online version.
....
Appendix A: Ten Principles of Risk Adjustment
Author:
Source: Journal of AHIMA
Publication Date: June 2018
Principle
Description
1. Clinically meaningful diagnostic categories
Each diagnostic category is a set of ICD-10-CM codes that relate to a reasonably well-s....
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