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On the Line

Author: Quinsey, Carol Ann

Source: AHIMA Q and A | Journal of AHIMA

Publication Date: July 2004


Q: Can clinical information system design influence patient safety or the quality of care?
A: In an era of increasingly complex clinical information systems, the time may have come to ask whether systems might contribute to problems during follow-up and investigation of patient care inci....

Policies and Procedures for a Legal EHR

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: April 2007


As organizations move from paper to electronic health records (EHRs), one of the most critical steps is ensuring that there are policies that support the EHR as the legal health record.

Most managers know the importance of having up-to-date policies and procedures. Good pol....

Practice Toolkit: Public Health

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: May 2005


HIM professionals working in public health have the opportunity to make a difference in the health of neighbors, friends, and family members living in their communities. Public health includes both the care delivered to individuals and care delivered to populations of patients such as diabetic....

How to Safely Recycle PCs

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: June 2005


Securing the privacy of both protected health information and personal information should be a primary concern when personal computers have outlived their usefulness. Recycling or disposing of a computer safely can be a challenge.

It’s not enough to simply give an old computer....

On the Line (3/04)

Author: Quinsey, Carol Ann

Source: AHIMA Q and A | Journal of AHIMA

Publication Date: March 2004


Q: What is meant by the term “system life cycle?”

A: The term “system life cycle” generally comes up in conversations about software development with our IT colleagues. However, it may also be used when assessing your organizational needs for computer systems.....

IT Angle

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: April 1999


Since my first years managing health information, it has been my goal to deliver information to clinicians in a format that is timely and useful. My current job is practically made to order to meet my personal goals as well as contribute to the vision that Kaiser Permanente, my employer....

In Case of a Crash ... Computer Backups

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: May 2004


If you ever experience significant problems with—or the outright death of—your computer’s hard drive, you will most likely suddenly remember how much material you saved in assorted folders that you did not back up. With luck, friends in your information technology department....

Avian Flu

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: June 2006


There has been a great deal of publicity about the avian flu. Whether you agree with the concerns being voiced, it behooves us all to learn as much as we can about anything that has the potential for an epidemic or pandemic. This column reviews the facts about avian flu as they are known today....

Foundational Concepts of the Legal EHR

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: January 2007


The concept of a legal health record (whether paper or electronic) is generally well understood within the HIM profession. However, during the transition from paper to electronic records some organizations are expressing concern about the use of the terms “legal health record” and “legal....

Obtaining Satisfactory Assurance for PHI Disclosure

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: June 2003


Obtaining “satisfactory assurance” in the privacy rule may sound like something new, but the concept has been around for a long time. Do you know what it means and how it affects your HIM department? This article will explain what obtaining satisfactory assurance means and how it can....

On the Line: Professional Practice Solutions (9/03)

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: September 2003


Q: Under HIPAA, how should covered entities respond to requests from public health officials who state that they need protected health information (PHI) to carry out their duties?

Q: Does HIPAA prohibit physicians from using cell phones to dictate reports?

Carol Quinsey....

On the Line (January 2005)

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: January 2005


Q: What is medical informatics, and is there a connection between it and health information management?

Q: Is there a standard addressing who should document in medical records?

Carol Ann Quinsey (carol.quinsy@ahima.org) is a professional practice manager at AHIMA.Article....

CCR--Not an EHR

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: March 2005



In 2003 the American Society for Testing and Materials (ASTM) kicked off the development of the Continuity of Care Record (CCR) standard, which was finalized in that year and passed by ASTM in April 2004. Sponsorship of the CCR brought together ASTM International, the Massachusetts Medical....

Developing E-Health Standards for Web Sites

Author: Quinsey, Carol Ann

Source: Journal of AHIMA

Publication Date: January 2004


Healthcare consumers are increasingly turning to the Internet for information about services critical to their health. An estimated 80 percent of adult American Internet users (approximately 93 million people) have searched the Internet for information on at least one of 16 major health topics....

HL7 Overview

Author: Quinn, John

Source: Journal of AHIMA

Publication Date: July 1999


As one of the co-developers of Health Level Seven (HL7), I am very close to the issue. So in describing it, I'm going to start with the basics, beginning with the current definition that has evolved over HL7's brief existence:

"The Health Level Seven (HL7) Standard, an ANSI approved....

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....

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....

Is the FCA Effectively Fighting Healthcare Fraud?

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: May 2002


How effective has the False Claims Act (FCA) been in reducing healthcare fraud? A recent six-month study conducted by New Directions for Policy for Taxpayers Against Fraud sought to determine just that.1 What the study found is that the FCA is very effective in fighting fraud and should not be....

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....

Coding Compliance: Practical Strategies for Success

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: January 1998


"Fraud," "abuse," "upcoding," "unbundling," and "compliance" have all become buzzwords in the news media. Eliminating healthcare fraud and abuse has become a top priority for the federal government. Government investigations are on the rise and providers everywhere tremble at the thought of b....

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

....

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....

Roundtable Takes on Compliance Challenges

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 1999


The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) and the Health Care Compliance Association conducted a one-day joint roundtable on healthcare compliance to gain new insights into the challenges of creating effective compliance programs. The ro....

Building a Better CPT

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: November 2000


The Health Insurance Portability and Accountability Act (HIPAA) presents numerous challenges to HIM processes and systems. Not least among these areas is coding. Among the concerns is whether the CPT system will be sufficient to meet the demands of HIPAA. The American Med....

Fraud and Abuse: What You Can Do

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: January 1998



During AHIMA's National Convention, HIM professionals convened to network and share practical ideas on issues pertaining to fraud and abuse. While most of the participants worked in hospitals, other work settings, including colleges, consulting firms, and government agencies were als....

ICD-10 on the Horizon

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 2002


ICD-10 has taken hold around the globe, so why is the US still using ICD-9-CM? This article reviews the history of ICD-10 in the US.


Other countries are using it. Why aren't we? Coding professionals across the country and around the world are wondering why ICD-10-CM hasn't been....

ICD-9-CM Code Revision for 2001

Author: Prophet, Sue

Source: Journal of AHIMA - Coding Notes

Publication Date: November 2000


Effective October 1, 2000, 100 new ICD-9-CM diagnosis codes and nine new ICD-9-CM procedure codes have been implemented. Because there were no ICD-9-CM revisions last year, these new codes are the result of two years’ worth of revisions. Coding professionals should familiarize themselves with....

Fraud and Abuse Implications for the HIM Professional

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: April 1997

Healthcare Fraud and Abuse Legislation

On August 21, 1996, President Clinton signed into law the Health Insurance Portability and Accountability Act. This law addresses several issues including the creation of a Health Care Fraud and Abuse Control Program. This program is intended to com....

Make Clinical Research Top Priority

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: January 2002


Whenever biomedical or behavioral research is conducted and supported by government agencies, it’s critical to comply with federal regulations designed to protect human subjects. For compliance officers, this means understanding and constantly monitoring a number of federal laws, regulati....

Hot Spots in the 2002 OIG Work Plan

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: March 2002


Organizational compliance programs are never static. Rather, they must continually be refined and updated to respond to changes in healthcare delivery and system vulnerabilities. The 2002 Work Plan of the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) pr....

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....

Comparing the OIG Guidances

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: June 2000


One of the first places to begin when creating a compliance program is the Office of Inspector General (OIG) compliance program guidances, designed to help healthcare organizations develop and implement effective programs. These documents (available online at http://www.hhs.gov/oig) include s....

What is Gulf War Syndrome (Part I)

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 1998


In 1990 and 1991, nearly 700,000 members of the US armed forces served in the Persian Gulf. Since their return home, thousands of these veterans have reported illnesses they believe are related to their service in the Gulf. Due to the nature of these illnesses, there has been considerable deb....

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....

Laboratory Services Regulations Carry HIM Implications

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: September 2002


This is Part 1 of a two-part article on national coverage and policies for clinical diagnostic laboratory services payable under medicare Part B. Part 1 concentrates on the administrative policies. Part 2, which will appear in the October issue of the Journal, will focus on the national covera....

OIG Releases Compliance Program Guidelines for Hospitals

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: April 1998


On February 11, 1998, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) released its Compliance Program Guidance for Hospitals. This document is intended to assist hospitals in developing corporate compliance programs that assure the establishment of e....

Group Builds Consensus on Laboratory Test Policies

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: July 1999


The Balanced Budget Act of 1997 (BBA) mandated that the Health Care Financing Administration (HCFA) use a negotiated rulemaking process to develop national administrative and coverage policies for clinical diagnostic laboratory tests under Medicare Part B. The BBA stipulates that the p....

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....

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....

On the Line: Professional Practice Solutions

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: January 1998


Q: I am a coder in a hospital HIM department. I am being pressured to code in a manner I believe to be fraudulent in order to maximize reimbursement and improve the hospital's case mix. What should I do?

Q: I am employed as a coder and am concerned about my potential risk with....

GAO Evaluates Implementation of False Claims Act Guidance

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: November 1999


With the increased attention to healthcare fraud and abuse in recent years, the Department of Justice (DOJ) has been using the False Claims Act to prosecute healthcare providers for practices that, in the past, might have been dealt with by seeking repayment. The damages and penalties....

Alternative Medicine: Growing Trend for the New Millennium

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: April 1999


Please note that the information contained in this article concerning alternative medicine treatments and their underlying principles and theories is provided for educational purposes only. It does not represent a position of either AHIMA or the author regarding the efficacy or scientific val....

Stevens-Johnson Syndrome

Author: Prophet, Sue

Source: Journal of AHIMA - Coding Notes

Publication Date: March 1998


The term "erythema multiforme" was first used by von Hebra in 1866 to describe a disease characterized by symmetrically distributed, pleomorphic, evolving cutaneous lesions, located primarily on the extremities, and by a proclivity for recurrence. In 1922, Stevens and Johnson....

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....

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