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Trouble with DRGs: Part 2

Author: Mahoney, Robert J.

Source: Journal of AHIMA - Coding Notes

Publication Date: March 2005


Last issue’s article presented some ways that DRG criteria redefine well-established clinical entities such as respiratory failure and sepsis. This article will discuss two other incompatibilities between DRG criteria and clinical practice: the clinical distinctions required by the DRG s....

Trouble with DRGs

Author: Mahoney, Robert J.

Source: Journal of AHIMA - Coding Notes

Publication Date: February 2005


A major frustration among coding professionals, particularly in the inpatient setting, is the difficulty in translating physician documentation into diagnostic related group (DRG) data. Some hospitals have attempted to improve their coding effectiveness by establishing time-consuming physician....

UB-04 Data Set and Claim Form

Author: Bowman, Sue E

Source: AHIMA testimony and comments

Publication Date: January 29, 2005


January 29, 2005

To: National Uniform Billing Committee c/o George Argus, Chairman

RE: UB-04 Data Set and Claim Form

Dear Chairman Argus:
This letter is sent to provide comment from the American Health Information Management Association (AHIMA) on the new....

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....

Audit of Automated Code Assignment in Israeli Hospital's Computerized Medical Information Systems

Author: Gill, Rhonda; Hecht, Rivka

Source: IFHRO Congress | AHIMA Convention

Publication Date: October 15, 2004

Introduction
How accurate and complete is the coded diagnostic (and procedure) data collected on patients who are discharged from Israeli government-owned general hospitals that have implemented automated code assignment? Can the individual facilities and the Israel Ministry of Health rely on....

Seizing the Moment to Improve the Quality of Health Information Management

Author: Goshen, Naomi; Nachmani, Frances ; Sasson, Nadine ; Itzchak, Tzipi ; Sayfan, J; Kopelman, D; Kolton, L; Vigder, L; Almog, D; Tiosano, T

Source: IFHRO Congress | AHIMA Convention

Publication Date: October 15, 2004

Introduction

The need for accurate and complete records pertaining to operative procedures and diagnoses in surgery wards is almost self-evident. It is so because human life issues are at stake and erroneous and incomplete documentation may harm follow-up treatment as well as research da....

Critical Success Factors in Establishing the Electronic Health Record: the Experience of St. Michael's Hospital, Canada

Author: Wegener, John; Woodman, Anna Jane

Source: IFHRO Congress | AHIMA Convention

Publication Date: October 15, 2004

Overview

This presentation will provide insight into planning, implementing, and managing the transition of a health records department, moving from an overburdened and inefficient paper environment toward an automated electronic setting. This success story will look at how staff, work pr....

Re-abstraction Studies to Assess Data Quality for Use in the Development of a Grouping Methodology

Author: Mitchell, Sandra; Bartoli, Holly

Source: IFHRO Congress | AHIMA Convention

Publication Date: October 15, 2004

Purpose

The purpose of this paper is to provide an overview of the data quality re-abstraction studies that have been conducted in Canada. These studies provide a baseline of reliability for clinical administrative data submitted to the Discharge Abstract Database (DAD). Canada began a s....

Providers Join Hands to Tell Medicare What They Think about OPPS/APC Policies: Making Progress in Changing Future Rules and Regulations

Author: Shah, Jugna

Source: AHIMA Convention

Publication Date: October 15, 2004


The Provider Roundtable is the name of the group that I formed to offer an opportunity for providers to come together and communicate to Medicare about their day-to-day operational challenges under the Outpatient Prospective Payment System (OPPS). My hope was that, by engaging providers to bra....

Understanding the New Role of the Coder Under OPPS/APCs

Author: Shah, Jugna

Source: AHIMA Convention

Publication Date: October 15, 2004

Background

Coding originated a long time ago as a way to classify causes of death, but has evolved to capture much more information. Coders now play a critical role in helping organizations to capture appropriate reimbursement and remain compliant with government rules and regulations. Si....

Registries and Networks in Healthcare

Author: Wiedemann, Lou Ann

Source: AHIMA Convention

Publication Date: October 15, 2004

Introduction

Trauma registry is a relatively new development in the US when compared to other countries such as New Zealand. Many states, such as Oklahoma, has had a trauma registry reporting system for less than five years. During that time, Oklahoma has made this a mandatory reporting....

Pitfalls in Endovascular Coding

Author: Zielske, David R.

Source: AHIMA Convention

Publication Date: October 15, 2004

Overview

Endovascular refers to those procedures that involve percutaneous access to the vascular system. Diagnostic angiography and interventional procedures, such as angioplasty, stent placement, embolization, and dialysis access maintenance, are some of the procedures performed. These....

Improving Patient Care Through Data Quality Management of Regulatory Reporting of Outcome Measures

Author: Panico, Mary; Hall, Debra; Berman, Regina; Siegel, Barbara

Source: AHIMA Convention

Publication Date: October 15, 2004

Introduction

In the fourth quarter of 2002, regulatory agencies began to align their initiatives driven by the National Quality Forum (NQF) evidenced-based measures, which drove the CMS 7 th Scope of Work. Project designs were to address morbidity and mortality of high-risk and high-vari....

Preparing for Automated Coding

Author: Cummins, Ruth

Source: AHIMA Convention

Publication Date: October 15, 2004

Introduction

On an ongoing basis, the coding staff and HIM management teams in healthcare facilities anticipate and prepare for changes in codes, coding guidelines, payment systems, and coding regulations. Additionally, the proposed upgrade of the coding classification system to ICD-10 is....

Coding Dementia

Author: Laakso, Roz

Source: Journal of AHIMA - Coding Notes

Publication Date: October 2004


Dementia is defined as “a deterioration of intellectual function and other cognitive skills, leading to a decline in the ability to perform activities of daily living.”1 Alzheimer’s disease is an age-related, irreversible brain disorder that occurs gradually and results in me....

Coder Education: Will Demand, Will Deliver

Author: Carol, Ruth

Source: Journal of AHIMA

Publication Date: July 2004


As the bar rises for coding, healthcare organizations require more education from coders—and they are willing to deliver it, too.
The bar has always been high for mdical coding, but recent years have seen it boosted higher. As a result, healthcare organizations need more from code....

Vanishing Supervisor

Author: Brandt, Mary D.

Source: Journal of AHIMA

Publication Date: March 2004


The bottom line is calling. Here’s how to decide if your HIM department has the right number of supervisors.
Down-sizing, right-sizing, streamlining. It doesn’t really matter what you call it, but it has had a significant impact on healthcare operations and staffing. Organizat....

HIM Spin on the Revenue Cycle

Author: Youmans, Karen

Source: Journal of AHIMA

Publication Date: March 2004



HIM plays an integral role in an organization’s revenue cycle. That means health information managers have a role to play in revenue cycle management.
Is the following scenario familiar? The CEO is complaining about accounts receivable (AR) climbing to $10 million. The coders a....

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