11/14/14

Managing denials after ICD-10 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Managing denials after ICD-10 | Healthcare Finance News

 Carl Natale 



Healthcare providers will need a denials manager who can track denials and communicate with healthcare payers



Healthcare providers can expect an increase in medical claim denials after Oct. 1, 2015. But that doesn't have to mean that revenue will be lost.



The Centers for Medicare and Medicaid Services (CMS) predicts denials could increase from 100 percent to 200 percent and lengthen accounts receivable cycles an extra 40 percent.



The easy answer is to stockpile savings or get a line of credit, so your facility can last a couple months without reimbursements. But how much sense does that make for smaller organizations?



Sounds like this problem is going to require attention and investment.





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What the ICD-10 transition means for cancer programs #ICD10 #ICDRemediator #ICD10Matters #HealthIT

What the ICD-10 transition means for cancer programs | The Advisory Board Company

11:00 AM on November 14, 2014 by Lindsay Conway



The countdown has begun. We are now less than one year away from CMS’s deadline for provider compliance with ICD-10. Fortunately U.S. health care organizations have been preparing for ICD-10 for years—but there’s still work to be done.



The transition from ICD-9 to ICD-10 will increase the number of codes from less than 20,000 to over 72,000, and it promises to increase the specificity of coding for diagnoses and procedures. The tradeoff is that it will also require increased documentation specificity by physicians and increase the difficulty of coding and billing.





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Preparations for ICD-10 Still Lagging #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Preparations for ICD-10 Still Lagging - MDeverywhere

November 13, 2014/in MDe Insights /by MDeverywhere



Findings from a new survey from AHIMA and the eHealth Initiative show that a significant number of providers are still missing some of the basic building blocks of a successful ICD-10 transition plan, including financial impact assessments and plans for internal and external testing.  As the ICD-10 deadline of October 1, 2015 begins to loom, the industry faces a lack of education, understanding of the changes, and firm plans that puts some organizations at risk for potentially devastating reimbursement disruption.



And there is a growing gap between well-prepared organizations and those with preparations yet underway.  Familiar challenges such as clinical documentation improvement, coder productivity, and the scope of financial investment still top the list of worries as the industry moves closer to the deadline.





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Guest Post: ICD-10 holds true promise for improved clinical terminology #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Guest Post: ICD-10 holds true promise for improved clinical terminology | ICD10 Watch

Posted on Thu, Nov 13, 2014 - 08:00 am



It is common knowledge that ICD-10 CM & PCS code sets will increase granularity, improve axes of classification and provide a more scientific approach to coding, opening up tremendous growth in our understanding of disease conditions and associated treatment protocols.



For the first time in 36 years, we have the opportunity to revamp the clinical terminology being used to measure effectiveness of healthcare services, refine clinical grouping and associated reimbursement methodologies and enhance capability to conduct public health surveillance.





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Med Schools to Rep Curric w Year course in ICD-10 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Medical Schools to Replace Curriculum with Year Long course in ICD-10 and E & M Coding | GomerBlog

Gomerblog Team - Nov 14, 2014

  

In a visionary statement, the Deans of ten of this nation’s top medical schools, including four Ivy League Schools announced today that they are replacing their schools’ entire 3rd year curriculum with an intensive year-long course on diagnostic and evaluation and management coding.



“We are have come to the realization that coding is central to a physician’s work day, with estimates that it comprises up to 50% of their professional time, and thus it is incumbent upon us to train our top physicians in this very important task,” said a spokesperson for the group.



He continued, “Moreover, with the explosion of journal articles devoted to this topic and an entire industry of coding consultants developing around it, we realize that our students must master the body of knowledge necessary to become effective and skillful coders and thus deliver top notch care, if not innovators in the field.  We hope that eventually we will also be able to offer fellowships in this discipline.”





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New ICD-10 Implementation Date Generates Mixed Responses #ICD10 #ICDRemediator #ICD10Matters #HealthIT

New ICD-10 Implementation Date - Generates Mixed Responses

POSTED BY MEGHANN KIERNAN ON NOVEMBER 14, 2014 2:35 AM



ICD-10 Implementation DateWith President Barack Obama signing H.R. 4302, the Protecting Access to Medicare Act of 2014 on April 1, 2014, the healthcare industry witnessed a further delay in ICD-10 implementation date. Section 212 of this bill has set the final ICD-10 implementation date as October 1, 2015. The new bill has generated several conflicting opinions among healthcare entities across the care continuum regarding the continuous delays of ICD-10.



Advocates of the legislation say that this delay has turned out to be a positive opportunity for those small organizations that were not fully prepared for the ICD-10 transition. This new move will give a major break to those hospitals and physicians who were literally struggling with the idea of such a transition. This will give them more time to prepare and concentrate on training programs for medical coders, programmers and other technical experts, which will subsequently strengthen the chance of streamlined operation and business success within the new system.





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Do Delays in ICD-10 Implementation Teach the Wr... #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Do Delays in ICD-10 Implementation Teach the Wr... 

From ehrintelligence.com - November 13, 8:17 AM



The healthcare industry has less than a year to complete its ICD-10 implementation efforts to be compliant by Oct. 1, 2015, but that additional time means nothing if providers continue working with the wrong kind of EHR, practice management, and health IT vendors.



That is the opinion of James Libecco, MD, a single practitioner at Akron Skin Center in Ohio. According to the dermatologist, his practice and its technology were ready for ICD-10 to go live last month. Instead, Akron Skin Center is in a holding pattern as it awaits the actual transition to the newer code set in 2015.



As Libecco explains in this one-on-one interview with EHRIntelligence.com, dual-coding in ICD-9 and ICD-10 provides a short-term strategy for bridging the gap between the two code sets but ultimately the lesson learned from the most recent ICD-10 delay is a negative one and one that could prove costly to secondary and tertiary uses of quality data moving forward.



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Were Estimates of ICD-10 Implementation Costs Miscalculated? #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Were Estimates of ICD-10 Implementation Costs Miscalculated? | EHRintelligence.com

Author Kyle Murphy, PhD | Date November 13, 2014



A team of researchers explains how previous ICD-10 implementation cost estimates were higher than their own.



A recent survey of small physician practices and published reports has led a team of researchers to dispute the accuracy of ICD-10 implementation cost estimates from a popular and widely referenced report published several years ago.



“The new data suggests that the estimated costs, time and resources required by physician offices are dramatically lower than initially estimated as a result of readily available free and low cost solutions offered by coding, education and software vendors,”





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11/13/14

ICD-10 FAQs– Health Care Professionals #ICD10 #ICDRemediator #ICD10Matters #HealthIT

ICD-10 FAQs– Health Care Professionals | Aetna

ICD-10 frequently asked questions



What is Aetna's position on the final rules?



We plan to meet all applicable compliance timeframes. We also continue to work closely with providers and clearinghouses, exchanging information in preparation for ICD-10 implementation and compliance.



The more detailed coding brings the United States in line with countries that have already adopted ICD-10. The ICD-10 codes allow for more specific descriptions, which improves the accuracy of claims payments and coverage decisions.





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Cost Conv Small Phys Pract ICD-10 Much Lower #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Cost of Converting Small Physician Practices to ICD-10 Much Lower than Reported | Journal of AHIMA

Nov 12, 2014 12:57 pm

posted by Rich Averill



The controversial delay of ICD-10 implementation was based in part on the perceived time, cost, and lost productivity for physician offices to perform the necessary assessment, training, software conversions, testing, and “super bill” updates.



However, current evidence suggests that the initial estimates of the costs and effort associated with ICD-10 implementation for physician offices has been overestimated and that vendors, health plans, and physicians have made considerable progress with fewer resources than had been previously estimated.



This article will re-examine the estimated costs for ICD-10 conversion for a typical small physician practice based on results from recent surveys and published reports, as well as ICD-10 conversion experience with numerous hospitals and physicians.





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How to manage denials after ICD-10 implementation #ICD10 #ICDRemediator #ICD10Matters #HealthIT

How to manage denials after ICD-10 implementation | ICD10 Watch

Posted on Wed, Nov 12, 2014 - 08:00 am



Medical practices can expect an increase in medical claim denials after Oct. 1, 2015. But that doesn't have to mean that revenue will be lost.



The Centers for Medicare and Medicaid Services (CMS) predicts denials could increase from 100 percent to 200 percent and lengthen accounts receivable cycles an extra 40 percent.



The easy answer is to stockpile savings or get a line of credit so medical practices can last a couple months without reimbursements. Who can afford that?



This is going to require attention and investment.



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Arizona HC Company Eliminates the Financial Burden of ICD-10 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

CHANDLER, Ariz.: Arizona Healthcare Company Eliminates the Financial Burden of ICD-10 and Helps Physicians Make More Money | Business Wire | Rock Hill Herald Online

November 13, 2014 



CHANDLER, ARIZ. — Nobility RCM, a new healthcare company in Chandler, AZ, is creating the Nobility Pre-Funding Program.



The program solves the problem of declining reimbursements and rising costs by providing medical practices with predictable revenue every month. This provides financial stability, opens up great opportunity for better care, and helps build more successful practices.



"Our program provides outright predictability of revenue and decreases the expense of utilizing an EHR," says Matt Gauer, COO of Nobility.



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SCOTUS and the ACA: How ICD-10 might figure in #ICD10 #ICDRemediator #ICD10Matters #HealthIT

SCOTUS and the ACA: How ICD-10 might figure in | Government Health IT

November 12, 2014



If you're wondering how ICD-10 will affect reimbursements after Oct. 1, 2015, you can figure it out with some time and spreadsheets. If you're wondering if ICD-10 implementation will happen Oct. 1, 2015, you're going to have to guess.



Because no one really knows. No one.



Dan Haley is Vice-President of Government and Regulatory Affairs at athenahealth — you would think his job would mean he knows, says he doesn't have much insight to offer when asked if ICD-10 implementation will happen in 2015. But he offered some reasons why ICD-10 implementation is likely in 2015.



I took a stab at it — sort of — by examining the forces that will have some influence over ICD-10's fate. And I missed one.





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11/12/14

Other Writings

Here are links to some of my other writings on Quality Assurance...

To Report or Not Report - That is the Question?

I am available as a consultant to advance your quality goals
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Providers Have Mixed Feelings About ICD-10 Readiness #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Providers Have Mixed Feelings About ICD-10 Readiness 

By Katie Wike, contributing writer



A recent survey of providers conducted by AHIMA found the majority are ready for end-to-end testing.



The American Health Information Management Association (AHIMA) conducted a survey of individuals representing delivery systems, acute care hospitals, clinics, and physician practices finding optimism about ICD-10, but concerns about readiness.



Health Data Management reports many providers have progressed far enough into ICD-10 implementation to begin end-to-end testing. Others, mostly smaller physician practices, are unsure when their organization will begin testing.



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9 in 10 providers pursuing telemed #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Nine in 10 providers pursuing telemedicine, despite hurdles — Health IT stays high on agenda at AMA meeting - POLITICO Morning eHealth - POLITICO.com 

By ASHLEY GOLD | 11/11/14 10:02 AM EDT

With help from Arthur Allen (@ArthurAllen202) and David Pittman (@David_Pittman)



TELEMEDICINE GROWS DESPITE OBSTACLES: Health care providers are expanding their use of telemedicine despite the reimbursement and regulatory challenges, according to a survey of health care executives released today by Foley & Lardner LLP. Nine of 10 say their organizations have started developing or implementing a telemedicine program. 84 percent say meaningful telemedicine services “will be central to the success of their organizations.” The majority of respondents already offer remote patient monitoring services (64 percent), store and forward technology (54 percent) and real-time interaction capabilities (52 percent). “In the post-Obamacare paradigm, providers bear a much greater responsibility for the sustained wellness of their patients,” says Nathaniel Lacktman, a Foley partner. “Telemedicine offers new ways for providers to manage this new level of risk and keep their patients healthy, happy and out of the hospital.” While 41 percent of survey respondents don’t get any reimbursement for telemedicine services, they’re hopeful Congress will change that soon



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61% of Struggling Hospital CFOs Expect to Be Fired by 2016 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

61% of Struggling Hospital CFOs Expect to Be Fired by 2016 

by Fred Pennic 11/11/2014 Leave a Comment



61 percent of hospital chief financial officers (CFOs) and business managers in “struggling” hospitals expect to be fired by 2016 due to outdated revenue cycle management solutions, according to a recent Black Book report. The report reveals hospital CFOs could potentially lose their jobs because their outdated revenue cycle management software, staff, and solutions were powerlessly stuck in fee for service mode too long. CFOs self identified as “struggling financially” believe they must leverage new best of breed revenue cycle management solutions including software and outsourced services in order to keep their organizations financially solvent. 



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Do Delays in ICD-10 Implementation Teach the Wrong Lesson? #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Do Delays in ICD-10 Implementation Teach the Wrong Lesson? | EHRintelligence.com 

Author Kyle Murphy, PhD | Date November 12, 2014



The healthcare industry has less than a year to complete its ICD-10 implementation efforts to be compliant by Oct. 1, 2015, but that additional time means nothing if providers continue working with the wrong kind of EHR, practice management, and health IT vendors.



That is the opinion of James Libecco, MD, a single practitioner at Akron Skin Center in Ohio. According to the dermatologist, his practice and its technology were ready for ICD-10 to go live last month. Instead, Akron Skin Center is in a holding pattern as it awaits the actual transition to the newer code set in 2015.

As Libecco explains in this one-on-one interview with EHRIntelligence.com, dual-coding in ICD-9 and ICD-10 provides a short-term strategy for bridging the gap between the two code sets but ultimately the lesson learned from the most recent ICD-10 delay is a negative one and one that could prove costly to secondary and tertiary uses of quality data moving forward.



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Larger Healthcare Providers Mostly Prepared For ICD-10 Testing #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Larger Healthcare Providers Mostly Prepared For ICD-10 Testing 

By Christine Kern



CMS ICD-10 Transition Date

Larger organizations are more prepared than smaller ones for the ICD-10 end-to-end testing.



A recent AHIMA/eHealth Initiative survey found a higher number of healthcare executives recognize the long-term benefits of using ICD-10 compared to last year and have plans to utilize the code set for quality improvement and performance measurement after implementation.



The survey queried 454 healthcare representatives from hospitals and physicians practices, examining readiness for testing and implementation, anticipated financial, clinical, and operational impact, as well as the strategic implications of an expanded code set.



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Eight Mistakes Hospitals Make with EPR #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Logicalis US Reveals Eight Mistakes Hospitals Make with Electronic Patient Records -- NEW YORK, Nov. 11, 2014 /PRNewswire/ -- 



7. Missing out on ICD-10 Readiness: Many institutions have taken a wait-and-see approach to implementing ICD-10, a list of medical classification codes.  The requirement to adopt ICD-10 has been delayed until October 1, 2015, but providers that continue to wait will be ill-prepared to address the huge amount of change ICD-10 will bring to the coding environment.  Moving from ICD-9 will increase classifications from 17,000 codes to 141,000 codes. ICD-10 requires more diagnostic specificity, so doctors may now have to use multiple codes for the same condition. This requires a greater attention to detail and a working knowledge of the codes. Fortunately, through careful thought and planning, providers only need to train clinicians on a small subset of the entire code set. Doing so will avoid assumptions and misinformation and will reduce denied insurance claims and reimbursements.  A thorough assessment, planning, communication and training will give providers the tools they need to prepare for this transition. 



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5 Key Resourcing Factors to Consider with ICD-10 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

5 Key Resourcing Factors to Consider with ICD-10 - M*Modal 



With the ICD-10 implementation deadline less than a year away, this is a perfect time for a tune-up of your resourcing strategy. Coding demands due to strategic needs, performance goals, DNFB management, and ICD-10 compliance requirements needs to be matched against your current coding capabilities, capacity, turnover, and workflows. This process should take account of five key factors:



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Prepare to waste more money on ICD-10 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Prepare to waste more money on ICD-10 | Healthcare Payer News 

November, 11 2014

By:  Anthony Brino



A new Republican majority focused on curbing regulation may give the healthcare industry the opposite of what most are looking for: uncertainty. Or they could turn to a fairly simple option to help the stakeholders long resistant to ICD-10.



"ICD-10 will never happen, we'll just keep spending money on it."

So one health system CIO told a colleague at the College of Health Information Management Executives’ (CHIME) recent gathering, before the November elections ushered in a GOP majority in the House and Senate and raised new questions about the viability of ICD-10.

The American healthcare system was originally supposed to adopt ICD-10 in 2011, then the Department of Health and Human Services moved the proposed implementation date to 2013, and then delayed it again for a year, to October 2014.



Then, this past spring, tucked into annual Medicare bill that temporarily postpones long-ago mandated physician reimbursement decrease, Congress forbade HHS from implementing ICD-10 until October 2015, in what some saw as a concession to a political constituency and a long-time ICD-10 skeptic, the American Medical Association.



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CIPROMS to Participate in ICD-10 E-to-E Testing #ICD10 #ICDRemediator #ICD10Matters #HealthIT

News & Events - CIPROMS to Participate in ICD-10 End-to-End Testing via GE's C-EDI Services 

11/11/2014 4:31 PM  



GE Healthcare’s Centricity EDI Services (C-EDI), CIPROMS’ claims clearinghouse, recently was selected by several Medicare Administrative Contractors (MACs) to perform true end-to-end testing for ICD-10 claim submission during the first round of testing January 26-30, 2015. This testing will include full adjudication of claims for 50 submitters within each MAC’s system, along with returning a test ERA (remit file) for users to see how Medicare would have adjudicated the claim if it were a true claim.



C-EDI, in turn, has selected several of its users, including CIPROMS, to submit files. CIPROMS will submit one file of five patients, 2 providers, and 25 claims each for three of the MACs: Indiana Medicare (WPS), Ohio Medicare (CGS Admin), and Georgia Medicare (Cahaba). C-EDI is limited to 50 total test claims in no more than 3 files for no more than 5 provider identification numbers for each MAC.



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Impact of ICD-10 on MC Reimb Now #ICD10 #ICDRemediator #ICD10Matters #HealthIT

www.ebglaw.com/content/uploads/2014/11/HCLS-Client-Alert_Why-Providers-Should-Think-About-the-Impact-of-ICD-10-on-Managed-Care-Reimbursement-Now.pdf 



Why Providers Should Think About the Impact of ICD-10 on Managed Care Reimbursement Now

by Jackie Selby and Bethany J. Hills

November 2014



ICD-10 implementation has been delayed by Medicare until October 2015. Many believe it may be delayed again and are putting off thinking about its impact until it is clear that the updated code set will be implemented by Medicare. However, providers need to appreciate that many of the managed care agreements that they are signing today likely include binding language that will impact reimbursement changes resulting from ICD-10 implementation, particularly for inpatient services.1 Proactively thinking through such provisions, and their implications, now may avoid heartache later (even if ICD-10 were to be delayed again).



Many commentators have focused on the coding details of the ICD-10 transition and the language and coding specificity that will be required. What may be overlooked in these coding discussions is that the updated code set will not only allow, but will likely require, changes in the way that plans reimburse for certain services and coverage is determined.



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Medicare ICD-10 Acknowledgement Testing Opportunity #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Medicare ICD-10 Acknowledgement Testing Opportunity 

Published on November 10, 2014



Would you like to test your ICD-10 coding skills? Do you want to ensure your business can successfully submit ICD-10 coded claims to Medicare? If so, there is a great opportunity for you and your business.



The Centers for Medicare & Medicaid Services (CMS) is providing three (3) dedicated week-long opportunities for ICD-10 acknowledgment testing in 2014 and 2015. While acknowledgment testing does not confirm that a test claim would be paid or produce a remittance advice, it does ensure that you can successfully submit ICD-10 coded claims to Medicare. The ICD-10 acknowledgment testing opportunities will take place as denoted below. Be sure to update your personal calendar with these testing opportunities.



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ICD-10 Resources You May Have Missed #ICD10 #ICDRemediator #ICD10Matters #HealthIT

ICD-10 Resources You May Have Missed | Phoenix Health Systems 

By Andrea Steffes-Tuttle



Over the past few months, our own D’Arcy Guerin Gue has been a contributing author to the online publisher, ICD-10 Monitor. If you’re a Phoenix subscriber, you might have missed some of these posts, so we want to be sure that you get a chance to read through the thoughts and guidance D’Arcy is providing outside PhoenixHealth.com.



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Ask again later #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Ask again later | ICD-10 Trainer 



Ever play with a Magic 8 Ball? (If not, there’s an app for that.) Ask it a question, shake it up, and get an answer. Usually something vague (and vaguely ominous) like, “Reply hazy try again.”



Asking whether ICD-10 will indeed (finally) be implemented October 1, 2015, feels a little like asking a Magic 8 Ball.



CadusiusThe AMA is continuing its efforts to kill ICD-10 outright (at the same time it is trying to make money on training for ICD-10). In an address to the AMA’s House of Delegates November 9, Robert M. Wah, MD, president of the American Medical Society, once again showed how little physicians (at least those in leadership positions at physician societies) understand ICD-10.



In his remarks, Wah hyped the increased number of codes as a reason not to go to ICD-10. Sue Bowman, RHIA, CCS, senior director of coding policy and compliance for AHIMA in Chicago, has pretty much blown that complaint out of the water.



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Would Darth Vader really embrace ICD-10 implementation? #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Would Darth Vader really embrace ICD-10 implementation? | ICD10 Watch 

Posted on Tue, Nov 11, 2014 - 08:00 am



The American Medical Association (AMA) House of Delegates met in Dallas during the weekend without advancing any stands against ICD-10 implementation. Usually they're good for a statement of vigorous opposition.



Not that the AMA ignored it. AMA President Robert Wah addressed the delegates and had three paragraphs:



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ICD-10: Featured Resource AAPC News #ICD10 #ICDRemediator #ICD10Matters #HealthIT

ICD-10: Featured Resource AAPC News | AAPC News 

Diabetes Quick Reference Guide



ICD-10-CM will require new skills. AAPC has created a diabetes mellitus coding resource to help you make the transition to the new system. It explains the categories for diabetes in ICD-10-CM with the important diabetes guidelines. There are examples to ensure understanding of the new codes. These complimentary sheets can be downloaded and make great desk references for your specialty practice.



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CMS Offers CEs and CMEs on ICD-10 Resources #ICD10 #ICDRemediator #ICD10Matters #HealthIT

CMS Offers CEs and CMEs on ICD-10 Resources | HIMSS | News 

by CMS

November 11, 2014



Prepare for ICD-10 while earning CE’s or CME’s by accessing three new CMS resources to help small physician practices prepare for ICD-10. Healthcare professionals who complete the learning modules will earn a certificate of completion



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(WEBINAR) ICD-10: Expert Views on Preparation #ICD10 #ICDRemediator #ICD10Matters #HealthIT

(WEBINAR) ICD-10: Expert Views on Preparation | Medical Economics 

November 11, 2014



The ICD-10 transition represents a major update to how providers get paid, impacting almost every aspect of service delivery, billing, claims processing and reimbursement. It will require testing changes in PM and EMRs, billing reporting packages, decision and analytical tools, as well as training coders and providers.





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Is your facility ready for the October 1,2015 implementation of ICD‐10? #ICD10 #ICDRemediator #ICD10Matters #HealthIT

www.acsteam.net/sites/acs/uploads/documents/free_webinar_flyer_2014.pdf 



Is your facility ready for the October 1,2015 implementation of ICD‐10?



Join us December 2nd for an important review of planning steps that are invaluable to your success.



a complimentary webinar from ACS



Topics Include:

 Documentation GapAnalysis

 ICD‐10 Policies

 ICD‐10 Education: coders, CDI, physicians, and data users

 Dual / Double Coding

 Pre‐Implementation Testing



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Take the Stress Out of ‘Hypertension Coding’ in ICD-10 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Take the Stress Out of ‘Hypertension Coding’ in ICD-10 |authorSTREAM 



Presentation Description 

Hypertension can be defined as the increase of pressure in the arteries, which can differ in the degree of severity, based on the level of the blood pressure reading. Essentially, there are two types of hypertension – primary or essential hypertension and secondary hypertension. While the primary or essential hypertension develops gradually over many years, secondary hypertension seems to appear suddenly. Most hypertension is considered primary.



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11/11/14

7 things for ASC leaders to know for Monday #ICD10 #ICDRemediator #ICD10Matters #HealthIT

7 things for ASC leaders to know for Monday 

Written by Carrie Pallardy | November 10, 2014



Here are seven things for ambulatory surgery center industry leaders to know for Nov. 10, 2014.



Healthcare industry adds jobs in October.

The healthcare industry contributed 25,000 of the overall 214,000 new jobs that were added in the U.S. last month. Within the healthcare industry, ambulatory healthcare services added the most new jobs, clocking in at 19,000. Read the full report on Becker's Hospital Review.



Dallas Ebola outbreak ends. 

The Ebola outbreak in Dallas — the first city in the U.S. to experience transmission of the virus — has ended, as the last person being monitored for the disease reaches the end of the 21-day incubation period without showing symptoms. Read the full report on Becker's Hospital Review. 



More than half of providers expect ICD-10 to slow claims processing.

An AHIMA and eHealth initative survey has found more than half of providers, 59 percent, expect to experience difficult, slower claims processing following the transition to ICD-10. Despite concern over slowed claims processing, only one third of providers expect to see a decrease in revenue



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AMA's Robert Wah channels Yoda on HIT's future - #ICD10 #ICDRemediator #ICD10Matters #HealthIT

AMA's Robert Wah channels Yoda on HIT's future - FierceHealthIT 

November 10, 2014 | By Susan D. Hall



While American Medical Association President Robert Wah referred to "Star Trek" in his inaugural address in June, he called upon the spirit of "Star Wars" in his address to the House of Delegates at the AMA Interim Meeting last week in Dallas.



More precisely, the edict from Master Yoda: "Do. Or do not. There is no try."



One thing the industry must do, not try, is to end the sustainable growth rate, Wah said. Though the Senate approved a one-year delay, the AMA was deeply disappointed in the outcome. He said the association came away with a framework to end the SGR, with the support of both parties and more than 600 physician groups.



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ROI of ICD-10 on Executive Insight #ICD10 #ICDRemediator #ICD10Matters #HealthIT

ROI of ICD-10 on Executive Insight 



It's critical to prioritize and prepare now, despite the delay

By Chris Pass



Posted on: November 10, 2014



The shadow of ICD-10 has been hovering over the healthcare industry in the United Stated for years, as has the promise of its implementation. In light of the most recent delay, facilities are facing a transitional period. For some, the extra time was much-needed, while others have been left to reassess their operational practices in the interim. Despite the in-between state of the industry, this is not the time to become stagnant, but rather to continue pushing forward in preparation for the eventual shift away from ICD-9. 



At John Muir Health, the delay was actually a blessing in disguise. It was announced, of all times, during our multi-hospital go-live weekend for the transition to Epic. Although the plan had originally been to switch to Epic six months prior to the implementation of ICD-10 to allow for whatever learning curve might be associated with the new system, the delay forced our health system to adapt. In hindsight, the added timeline will help us to form a more in-depth understanding of Epic and prepare for a smoother switch to ICD-10. 



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ICD-10-PCS Char Analysis: Test Your Knowledge of Char 7 – Qualifier #ICD10 #ICDRemediator #ICD10Matters #HealthIT

ICD-10-PCS Character Analysis: Test Your Knowledge of Character 7 – Qualifier 

Written by  Lolita M. Jones, RHIA, CCS

Monday, 10 November 2014 00:00



The process of constructing codes in ICD-10-PCS is designed to be logical and consistent: individual letters and numbers called "values" are selected in sequence to occupy the seven spaces of the code, called "characters."



In ICD-10-PCS the seventh character defines the qualifier – i.e., an additional attribute of the procedure, if applicable.



Official Qualifier Guidelines:



Biopsy Procedures: Biopsy procedures are coded using the root operations Excision, Extraction, or Drainage, and the qualifier Diagnostic. The qualifier Diagnostic is used only for biopsies (ICD-10-PCS Guideline B3.4a).



Bypass Procedures: Bypass procedures are coded by identifying the body part bypassed “from” and the body part bypassed “to.” The fourth-character body part specifies the body part bypassed from, and the qualifier specifies the body part bypassed to (ICD-10-PCS Guideline B3.6a).



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Value-Based Payments and the Transition to ICD-10 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Value-Based Payments and the Transition to ICD-10 

Written by  Gregory M. Adams, FHFMA

Monday, 10 November 2014 00:00



Those of you who are listeners of our weekly Talk-Ten-Tuesday Internet broadcasts may have heard my “Follow the Money” segment and my comments on the financial implications regarding the implementation of ICD-10.



Recently I gave some general statistics on the growth in value-based payments (VBP) and how both the federal government and commercial payers are quickly moving larger and larger portions of provider payments onto some type of VBP. Well, here are some more points to consider.



According to the group Catalyst for Payment Reform, of the value-based payment models in action, 53 percent of commercial payer VBPs put providers at some financial riskif they fail to contain costs or improve care.



However, on the flip side, many value-based payments still fall into the category of pay-for-performance, which offers providers only potential financial rewards and no risk. I believe that the progression of VBPs will move quickly away from this model into models that will penalize providers for poor quality.



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Inoculate Your ER Dept Staff Against ICD-10 Stress Syndrome #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Inoculate Your Emergency Department Staff Against ICD-10 Stress Syndrome 

Written by  Herman M. Fountain, MD, MBA, CPE

Monday, 10 November 2014 05:00



According to the most recent statistics from the Centers for Disease Control and Prevention (CDC), there were 129.8 million visits to emergency departments across America last year. Almost 38 million were injury-related and 13.3 percent of those seeking treatment were admitted. To put that into perspective, during that same reporting period, the total population of the U.S. was roughly 308 million, meaning that the equivalent of 41 percent of the population visited the emergency room. 



The drama inside emergency rooms as depicted on popular television shows doesn’t correlate to what really happens. While there are many life-threatening cases involving heart attacks and traumatic injuries or poisonings, there are also a lot of colds, flus, and insect bites. It’s no surprise that emergency departments have become a default source of care for populations without access to primary care, and that high rates of repeat patient visits to emergency departments and readmissions are straining the resources in our healthcare delivery system. Many of these patients are over 65 and suffer from multiple chronic conditions.



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Outline its Own Roadmap for ICD-10 Adoption #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Agency Holds National Call to Outline its Own Roadmap for ICD-10 Adoption 

Written by  Rhonda Taller, MHA | Monday, 10 November 2014 



During the Nov. 5 MLN Connects™ national provider call on transitioning to ICD-10, Centers for Medicare & Medicaid Services (CMS) speakers covered a variety of topics, providing very useful information to audience members preparing for the Oct. 1, 2015 compliance date. 



A transcript of the call will be available at a later date, while slides used during the session are available on the MLN Connects website now. 



Denesecia Green with the CMS Administrative Simplification Group focused her remarks on CMS readiness efforts (including an update on CMS industry partnerships, such as training collaborations with the American Health Information Management Association, or AHIMA, the American Academy of Professional Coders, or AAPC), the Professional Association of Health Care Office Management, or PAHCOM, plus the National Association of Community Health Centers). Green said the purpose of the training arrangement is “to reach small physician practices for information dissemination and ‘boots on the ground’ training.’”



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11/10/14

Half of Providers Unsure of ICD-10 Revenue Impact #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Half of Providers Unsure of ICD-10 Revenue Impact 

by Fred Pennic 11/07/2014 Leave a Comment



ICD-10 Revenue Impact



Nearly half of healthcare providers are unsure of the ICD-10 revenue impact or have yet conducted revenue impact assessments, according to a new eHealth Initiative (eHI)/AHIMA survey. In fact, 35 percent

believed that their organization’s revenue will decrease during the first year of ICD-10 compliance.



The report provides a look at just how prepared healthcare organizations are for the upcoming ICD-10 implementation and how they think ICD-10 will impact their operations. Survey respondents expressed a mix of optimism and concern regarding the impact of ICD-10 indicating that coding (59%), documenting patient encounters (42%) and adjusting reimbursement claims (41%) would be the most difficult under ICD-10. 



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ICD-10 preparation: A checklist for urologists #ICD10 #ICDRemediator #ICD10Matters #HealthIT

ICD-10 preparation: A checklist for urologists | Urology Times 

November 07, 2014 By Lisette Hilton



Mark Painter, CEO of PRS Urology, and Jonathan Rubenstein, MD, a urologist in Baltimore and member of the AUA’s Coding and Reimbursement Committee, recommend this checklist for ICD-10 urology practice transition.



Create a team. If you haven’t already done so, start in November or December 2014 to develop a transition team to look at four practice departments: information technology (IT), clinical, billing and coding, and administration and finance. Small practices might have one champion. Larger practices might have groups of people assigned to analyze readiness in each of these areas.



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Providers Still Lack ICD-10 Testing Plans, Impact Assessments #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Providers Still Lack ICD-10 Testing Plans, Impact Assessments | EHRintelligence.com 

Author Jennifer Bresnick | Date November 7, 2014



ICD-10 preparation is still lagging as providers continue to worry about testing, revenue, and productivity.



A worrying number of providers are still missing some of the basic building blocks of a successful ICD-10 transition plan, AHIMA and the eHealth Initiative found in a new survey, including financial impact assessments and plans for internal and external testing.  As the clock ticks down to the latest ICD-10 deadline of October 1, 2015, the industry continues to be plagued by a lack of education, understanding, and action that puts some organizations at risk for reimbursement troubles and revenue woes.



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ICD-10: Possible fixes #ICD10 #ICDRemediator #ICD10Matters #HealthIT

ICD-10: Possible fixes | Urology Times 

November 07, 2014 By Lisette Hilton



The main problem with ICD-10 in the U.S. is its flawed implementation and huge impact on every aspect of the health care system, according to W. Jeff Terry, Sr., MD. For physicians who have small practices and might still be struggling with EMRs and other government regulations, ICD-10 implementation could be the last straw, he says.



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3 strategies for winning physicians over for ICD-10 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

3 strategies for winning physicians over for ICD-10 - FierceHealthIT 

November 7, 2014 | By Dan Bowman



Physician involvement is an especially crucial element at several levels for hospitals transitioning to ICD-10, according to healthcare IT consultant D'Arcy Guerin Gue, writing in ICD10monitor.com this week.



Not only does accurate physician documentation "drive the production of ICD-10 codes," according to Guerin Gue, executive vice president of corporate services for Richardson, Texas-based Phoenix Health Systems, but physician participation also helps when it comes to navigating hospital politics.



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OASIS C 1 Conference: Gear Up for Jan 1, 2015 #ICD10 #ICDRemediator #ICD10Matters #HealthIT

OASIS C 1 Conference: Gear Up for Jan 1, 2015 

Expert speaker Sharon Litwin will shed light on OASIS C 1 items in an hour-long session at AudioEducator.com



Changes in Home Health often come in clusters and are way more challenging than others; how it will fare in long-term depends on how the home health providers prepares for these challenges. - Sharon Litwin



Durham, NC (PRWEB) November 09, 2014



Apart from CPT 2015 updates, home health providers need to be prepared for the implementation of OASIS C1/ICD-9 (the revised version of the original OASIS C1 data set) effective on January 1, 2015. Previously, OASIS-C1 was expected to arrive in a simultaneous transition with ICD-10 on October 1, 2014; however, with the delay in ICD-10 implementation, CMS has announced a new version referred as OASIS-C1/ICD-9*. This new data set is a blend of all the approved OASIS-C1 modifications; however the ICD-10 items will be restored with their "original" ICD-9 counterparts.



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Why Is Healthcare IT Under Fire? #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Why Is Healthcare IT Under Fire? | CIO 



The Office of the National Coordinator for Health IT has lost several key figures in recent months. An economic report suggests that meaningful use may have been a waste of money. Why is healthcare IT under such duress?



Brian Eastwood By Brian Eastwood  Follow

CIO | Nov 10, 2014 5:00 AM PT



It's been a rough year for the Office of the National Coordinator for Health IT – and it's unclear when things will get better.



On Oct. 23, the Department of Health and Human Services tapped ONC head Dr. Karen DeSalvo as acting assistant secretary for health, primarily to lead its Ebola response team. DeSalvo rose to national prominence helping reshape healthcare in New Orleans following Hurricane Katrina. She's expected to bring valuable (and needed) disaster response know-how to HHS.



However, DeSalvo's departure prompted Deputy National Coordinator Dr. Jacob Reider to resign as well. ONC and HHS later backtracked, saying DeSalvo isn't leaving ONC after all and will serve as HHS acting assistant secretary and "high-level policy" leader at ONC. Lisa Lewis, formerly the ONC's COO, was named acting national coordinator.



Even so, Modern Healthcare notes, ONC has gone through five coordinators since it was established in 2004. Reider's departure also means ONC has lost five key officials in the last six months. That's not good for business. Neither is a rather damning report suggesting that the meaningful use incentive program – ONC's raison d'etre – may prove to be a waste of money.



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Why Big Data and analytics should care about my burning waterskis #ICD10 #ICDRemediator #ICD10Matters #HealthIT

Why Big Data and analytics should care about my burning waterskis 



How you code data in your Big Data project has consequences, just take a look at ICD-10



Network World | Nov 9, 2014 2:20 PM PT



A list friend recently noted that the latest International Statistical Classification of Diseases and Related Health Problems (otherwise called "ICD codes”) is very interesting not to mention that it’s also very amusing. The ICD system, now in its 10th version, was designed and is administered by the World Health Organization and is described as:



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