Documenting Autism in ICD-10
Written by Kathy Pride, CPC, RHIT, CCS-P | Monday, 17 November 2014 00:00
Comedian Jerry Seinfeld shocked the nation recently when he announced he “might be on the autism spectrum” and subsequently created an uproar in the autism community.
Many have viewed his statement as a play for attention and as an insult to those who are severely autistic. However, one must look at the context of the statement before rushing to judgment. Mr. Seinfeld did not claim to have autism; his reflective words implied he may have what John Elder Robison referred to in a recent article in Psychology Today as the Broader Autism Phenotype (BAP)—people who have traits of autism, but not to the degree that they would be diagnosed autistic. According to Robison, millions of people are in this BAP group.
What do we know about autism? According to the National Institutes of Health, autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. Autistic disorder, sometimes called autism or classical ASD, is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger syndrome, and childhood disintegrative disorder and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS). Although ASD varies significantly in character and severity, it occurs in all ethnic and socioeconomic groups and affects every age group. Experts estimate that one out of 88 children aged eight will have an ASD (Centers for Disease Control and Prevention: Morbidity and Mortality Weekly Report, March 30, 2012). Males are four times more likely to have an ASD than females. Children whose language skills regress early in life (before age three) appear to have a higher than normal risk of developing epilepsy or seizure-like brain activity.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
11/18/14
To Shift or Not to Shift, That is the Question #ICD10 #ICDRemediator #ICD10Matters #HealthIT
To Shift or Not to Shift, That is the Question
Written by Maria T. Bounos, RN, MPM, CPC-H | Monday, 17 November 2014 05:00
It’s that time of year again: now that all of the major 2015 Federal Register Final Rules are published, many of us find ourselves scurrying to assess how these payment systems, Inpatient, Outpatient, and Physician, just to name a few, are going to affect our business. Although the Inpatient Prospective Payment System for 2015 did not change much from a code-set perspective, the ICD-10 implementation date is right around the corner and will be here before we know it. It is imperative not to lose focus and assure that you are ready to not only answer the question of payment systems shifts but know the cause and how to remediate.
THIS IS IT. We are in our last year of preparation and organizations need to understand the financial shift from ICD-9 to ICD-10, how it impacts the bottom line, and what you need to do NOW to prepare prior to the implementation date. Understanding that from a reimbursement perspective, organizations have a lot going on right now, with a long list of to-dos that seems never-ending. It is our understanding that historically, providers struggle, as it is not always clear if they should start by analyzing the impact from a facility perspective, focus on the providers in their organization, or isolate specific service lines. In order for an organization to be successful, it will get the most mileage by analyzing patient claims data.
The impact of ICD-10 for organizations can be looked at from three different perspectives: True financial risk, potential financial risk, and low financial risk, and are defined as follows:
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
Written by Maria T. Bounos, RN, MPM, CPC-H | Monday, 17 November 2014 05:00
It’s that time of year again: now that all of the major 2015 Federal Register Final Rules are published, many of us find ourselves scurrying to assess how these payment systems, Inpatient, Outpatient, and Physician, just to name a few, are going to affect our business. Although the Inpatient Prospective Payment System for 2015 did not change much from a code-set perspective, the ICD-10 implementation date is right around the corner and will be here before we know it. It is imperative not to lose focus and assure that you are ready to not only answer the question of payment systems shifts but know the cause and how to remediate.
THIS IS IT. We are in our last year of preparation and organizations need to understand the financial shift from ICD-9 to ICD-10, how it impacts the bottom line, and what you need to do NOW to prepare prior to the implementation date. Understanding that from a reimbursement perspective, organizations have a lot going on right now, with a long list of to-dos that seems never-ending. It is our understanding that historically, providers struggle, as it is not always clear if they should start by analyzing the impact from a facility perspective, focus on the providers in their organization, or isolate specific service lines. In order for an organization to be successful, it will get the most mileage by analyzing patient claims data.
The impact of ICD-10 for organizations can be looked at from three different perspectives: True financial risk, potential financial risk, and low financial risk, and are defined as follows:
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
Autism – Self-Care vs. Right Reimbursement #ICD10 #ICDRemediator #ICD10Matters #HealthIT
Autism – Clinical Documentation for Autistic Patients: Self-Care vs. Right Reimbursement
Written by Ellen VanBuskirk | Monday, 17 November 2014 00:00
I have written several articles for ICD10monitor over the years as we as an industry grapple with ICD-10 compliance. Like many of you, I have become a bit ICD-10-weary, but I have found a new breath of energy in the topic of autism and ICD-10.
Autism is a vague diagnosis to many, and the fact that there is a spectrum of symptoms complicates the clinical picture, and thus could complicate how ICD is applied. I am not going to attempt to be an expert on how to code a complicated diagnosis like autism, but I want to present the importance of the diagnosis to the 1-88 or 1-66 families of children, whichever statistic one chooses. I think it is important to look at where the World Health Organization (WHO) placed the ICD-10 code for autism more than 10 years ago, when the I-10 code was developed. It was a part of the mental health disorders, not a neurological diagnosis. ICD-10 was endorsed by the 43rd World Health Assembly in May 1990 and came into use in WHO member states as of 1994.
Obviously, there has been considerable research, and it continues today around the cause and symptoms and treatment for the children properly diagnosed with autism. Thus, it is critical to ensure the clinical record is documented in detail so the proper ICD-10/Diagnostic and Statistical Manual (DSM) codes are applied.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
Written by Ellen VanBuskirk | Monday, 17 November 2014 00:00
I have written several articles for ICD10monitor over the years as we as an industry grapple with ICD-10 compliance. Like many of you, I have become a bit ICD-10-weary, but I have found a new breath of energy in the topic of autism and ICD-10.
Autism is a vague diagnosis to many, and the fact that there is a spectrum of symptoms complicates the clinical picture, and thus could complicate how ICD is applied. I am not going to attempt to be an expert on how to code a complicated diagnosis like autism, but I want to present the importance of the diagnosis to the 1-88 or 1-66 families of children, whichever statistic one chooses. I think it is important to look at where the World Health Organization (WHO) placed the ICD-10 code for autism more than 10 years ago, when the I-10 code was developed. It was a part of the mental health disorders, not a neurological diagnosis. ICD-10 was endorsed by the 43rd World Health Assembly in May 1990 and came into use in WHO member states as of 1994.
Obviously, there has been considerable research, and it continues today around the cause and symptoms and treatment for the children properly diagnosed with autism. Thus, it is critical to ensure the clinical record is documented in detail so the proper ICD-10/Diagnostic and Statistical Manual (DSM) codes are applied.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
Where Obamacare and ICD-10 Collide #ICD10 #ICDRemediator #ICD10Matters #HealthIT
Where Obamacare and ICD-10 Collide
Posted on November 17th, 2014
The Affordable Care Act, or more commonly known as ACA or “Obamacare”, continues to put pressure on providers and employers with respect to insurance coverage’s, quality of care standards, cost controls, and overall coverage. A significant component of ACA is the enforcing governmental entity, which is the IRS. Yes – the same IRS that is in charge of tax collection, has a reputation for making rules completely unintelligible, enforcing large fines against the “little guys” while big offenders and bazillion-aires pay little or nothing, targeting and auditing those they politically disagree with, and running their own court system with practically no due process for the accused.
The IRS continues to put out memos regarding the ACA’s 501(r) rules that affect non-profit hospitals and the collection of what is owed to them. There are a number of items to be considered, but for the sake of this Post lets take a look at the discussion regarding “extraordinary collection efforts” as defined by the 501(r) rules and enforced by the IRS. A non-profit hospital, among other things, MUST create a financial assistance policy and make that policy known in their community. Within the first 120 days of the date of service a patient has, the provider is prohibited from taking any “extraordinary collection efforts”, which include credit reporting, filing a lawsuit, and a few other actions. The rules go on to extend to another 120 days if the hospital has not correctly created and communicated their financial assistance policy, OR the patient asks for a financial assistance form. If the patient asks for one, then all “extraordinary collection efforts” must cease and/or be reversed, indefinitely. Or until the hospital has reviewed their application for assistance. So – no credit reporting, lawsuit, garnishments for up to 240 days after date of service.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
Posted on November 17th, 2014
The Affordable Care Act, or more commonly known as ACA or “Obamacare”, continues to put pressure on providers and employers with respect to insurance coverage’s, quality of care standards, cost controls, and overall coverage. A significant component of ACA is the enforcing governmental entity, which is the IRS. Yes – the same IRS that is in charge of tax collection, has a reputation for making rules completely unintelligible, enforcing large fines against the “little guys” while big offenders and bazillion-aires pay little or nothing, targeting and auditing those they politically disagree with, and running their own court system with practically no due process for the accused.
The IRS continues to put out memos regarding the ACA’s 501(r) rules that affect non-profit hospitals and the collection of what is owed to them. There are a number of items to be considered, but for the sake of this Post lets take a look at the discussion regarding “extraordinary collection efforts” as defined by the 501(r) rules and enforced by the IRS. A non-profit hospital, among other things, MUST create a financial assistance policy and make that policy known in their community. Within the first 120 days of the date of service a patient has, the provider is prohibited from taking any “extraordinary collection efforts”, which include credit reporting, filing a lawsuit, and a few other actions. The rules go on to extend to another 120 days if the hospital has not correctly created and communicated their financial assistance policy, OR the patient asks for a financial assistance form. If the patient asks for one, then all “extraordinary collection efforts” must cease and/or be reversed, indefinitely. Or until the hospital has reviewed their application for assistance. So – no credit reporting, lawsuit, garnishments for up to 240 days after date of service.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
ICD-10 Updates #ICD10 #ICDRemediator #ICD10Matters #HealthIT
LONG TERM CARE LEADER: ICD-10 Updates
ICD-10 Updates
Dianne De La Mare
As reported previously, the US Department of Health and Human Services (HHS) has released a final rule setting Oct. 1, 2015, as the new compliance date for health care eproviders, health plans and health care clearinghouses to transition to ICD-10. During the upcoming MLN Connects National Provider call on Nov. 5, 2014, CMS subject matter experts will discuss ICD-10 implementation issues, opportunities for testing and federal government developed resources.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
ICD-10 Updates
Dianne De La Mare
As reported previously, the US Department of Health and Human Services (HHS) has released a final rule setting Oct. 1, 2015, as the new compliance date for health care eproviders, health plans and health care clearinghouses to transition to ICD-10. During the upcoming MLN Connects National Provider call on Nov. 5, 2014, CMS subject matter experts will discuss ICD-10 implementation issues, opportunities for testing and federal government developed resources.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
ICD Ebola and How We Talk about It #ICD10 #ICDRemediator #ICD10Matters #HealthIT
ICD | Johns Hopkins University Press Blog
Ebola and How We Talk about It
Guest post by Annemarie Goldstein Jutel
Diseases are much more than the viruses which cause them. Even in the presence of well-defined physical illness, social and cultural beliefs and behaviors have a strong impact on how we can understand the disease and mitigate its impact. The Ebola virus provides us with an excellent example. A source both of fascination and fear, this virus highlights just how the words we use to discuss it influence its impact on the ground.
Classifying disease has roles which go beyond simply helping someone to get better. The whole process of classifying diseases formally and maintaining public health records emerged at the same time as the modern state, with disease tracking part of how nations sought to identify and protect their citizenry. Nineteenth-century epidemics such as influenza and cholera were constrained in their spread by the length of time it took for sick people to travel; the slowness of transport meant that the sick normally died before they could travel far enough to spread the disease. Today, however, because of the increasing efficiency of travel, germs can travel from country to country, spreading disease across national borders: disease victims have a chance of surviving long enough to pollute a second nation. Classifications therefore had to be able to cross national boundaries with the germs.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
Ebola and How We Talk about It
Guest post by Annemarie Goldstein Jutel
Diseases are much more than the viruses which cause them. Even in the presence of well-defined physical illness, social and cultural beliefs and behaviors have a strong impact on how we can understand the disease and mitigate its impact. The Ebola virus provides us with an excellent example. A source both of fascination and fear, this virus highlights just how the words we use to discuss it influence its impact on the ground.
Classifying disease has roles which go beyond simply helping someone to get better. The whole process of classifying diseases formally and maintaining public health records emerged at the same time as the modern state, with disease tracking part of how nations sought to identify and protect their citizenry. Nineteenth-century epidemics such as influenza and cholera were constrained in their spread by the length of time it took for sick people to travel; the slowness of transport meant that the sick normally died before they could travel far enough to spread the disease. Today, however, because of the increasing efficiency of travel, germs can travel from country to country, spreading disease across national borders: disease victims have a chance of surviving long enough to pollute a second nation. Classifications therefore had to be able to cross national boundaries with the germs.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
11/17/14
ACA releases 2nd edition ICD-10 Toolkit featuring updated resources #ICD10 #ICDRemediator #ICD10Matters #HealthIT
ACA releases 2nd edition ICD-10 Toolkit featuring updated resources
November 14, 2014
The American Chiropractic Association (ACA) has released a 2nd edition ICD-10 Toolkit to prepare doctors of chiropractic for a seamless transition to ICD-10 coding beginning Oct. 1, 2015.
Beginning Oct. 1, 2015, the ICD-9 codes currently used to describe diagnoses and treatment plans can no longer be used by HIPAA-covered entities. The conversion to ICD-10 will enable U.S. healthcare providers to report greater specificity and clinical information.
The new coding system includes updated healthcare terminology and provides higher quality data for processing claims and making clinical decisions. It may also enhance the ability to provide data that proves the effectiveness and positive outcomes achieved by chiropractic services.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
November 14, 2014
The American Chiropractic Association (ACA) has released a 2nd edition ICD-10 Toolkit to prepare doctors of chiropractic for a seamless transition to ICD-10 coding beginning Oct. 1, 2015.
Beginning Oct. 1, 2015, the ICD-9 codes currently used to describe diagnoses and treatment plans can no longer be used by HIPAA-covered entities. The conversion to ICD-10 will enable U.S. healthcare providers to report greater specificity and clinical information.
The new coding system includes updated healthcare terminology and provides higher quality data for processing claims and making clinical decisions. It may also enhance the ability to provide data that proves the effectiveness and positive outcomes achieved by chiropractic services.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
Accurate ICD-10 Implementation Critical for Claims Payments #ICD10 #ICDRemediator #ICD10Matters #HealthIT
Georgia Health Care Association – Accurate ICD-10 Implementation Critical for Claims Payments
As the October 1, 2015 implementation date gets closer, GHCA, along with AHCA/NCAL, encourages long term and post-acute care providers to start now to educate and train staff; make the required software changes to submit accurate assessments or claims with ICD-10 CM code sets; and monitor any state Medicaid policy changes that may be required by ICD-10-CM code sets. Although CMS has provided numerous tools and resources for certain health care providers – – it has not very successfully provided tools for long term and post-acute care providers. GHCA has training planned; and AHCA/NCAL is currently planning its own series of webinars especially for our sector (mark your calendars for Dec. 5th and 11th), which will be advertised shortly. In the meantime, to obtain more general information regarding ICD-10 implementation information go to:
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
As the October 1, 2015 implementation date gets closer, GHCA, along with AHCA/NCAL, encourages long term and post-acute care providers to start now to educate and train staff; make the required software changes to submit accurate assessments or claims with ICD-10 CM code sets; and monitor any state Medicaid policy changes that may be required by ICD-10-CM code sets. Although CMS has provided numerous tools and resources for certain health care providers – – it has not very successfully provided tools for long term and post-acute care providers. GHCA has training planned; and AHCA/NCAL is currently planning its own series of webinars especially for our sector (mark your calendars for Dec. 5th and 11th), which will be advertised shortly. In the meantime, to obtain more general information regarding ICD-10 implementation information go to:
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
ICD-10 — Are You Ready? #ICD10 #ICDRemediator #ICD10Matters #HealthIT
Narhc – National Association of Rural Health Clinics ICD-10 — Are You Ready?
ICD-10 — Are You Ready?
Although October 1, 2015 seems like a long way off, you should be taking this time to be sure you, your vendors and your payers are ready! The best way to know you are ready is to engage in end-to-end testing with your vendors and health plans. Contact the health plans you work with most frequently and ask them if they plan to do full end-to-end ICD-10 testing and if so, when? If the Health Plans says they have no plans to test, let them know that this is unacceptable! The last thing you want is to have your claims denied or kicked back beginning on October 1, 2015 because something in the Plans EDI system won’t allow your claims to process correctly. When it comes to ICD-10, test early, test often….
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
ICD-10 — Are You Ready?
Although October 1, 2015 seems like a long way off, you should be taking this time to be sure you, your vendors and your payers are ready! The best way to know you are ready is to engage in end-to-end testing with your vendors and health plans. Contact the health plans you work with most frequently and ask them if they plan to do full end-to-end ICD-10 testing and if so, when? If the Health Plans says they have no plans to test, let them know that this is unacceptable! The last thing you want is to have your claims denied or kicked back beginning on October 1, 2015 because something in the Plans EDI system won’t allow your claims to process correctly. When it comes to ICD-10, test early, test often….
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
BCBSM | Coalition for ICD-10 #ICD10 #ICDRemediator #ICD10Matters #HealthIT
BCBSM | Coalition for ICD-10
The Coalition for ICD-10 presents the third installment of its Member Spotlight series with the focus on Blue Cross Blue Shield of Michigan (BCBSM).
By Dennis Winkler, Director of Technical Program Management and ICD-10 for BCBS of Michigan
When news of the ICD-10 implementation delay came, we at BCBSM had two thoughts: First, what do we have to do to accommodate the delay and secondly, how do we help to avoid another delay. It was similar to questions that entities around the country were asking themselves. The first question was relatively easy to answer – we simply executed the contingencies we had defined as we started our ICD-10 program. The second question required a lot more thought and consideration.
When looking at how to avoid another delay, you have to understand the reason for the initial delays. The predominant reason for delaying ICD-10 was lack of industry readiness. As we looked around our landscape we saw that certain entities were having a more difficult time getting ready for ICD-10 than others. One area of focus that we decided to concentrate was the smaller professional health care provider practice.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
The Coalition for ICD-10 presents the third installment of its Member Spotlight series with the focus on Blue Cross Blue Shield of Michigan (BCBSM).
By Dennis Winkler, Director of Technical Program Management and ICD-10 for BCBS of Michigan
When news of the ICD-10 implementation delay came, we at BCBSM had two thoughts: First, what do we have to do to accommodate the delay and secondly, how do we help to avoid another delay. It was similar to questions that entities around the country were asking themselves. The first question was relatively easy to answer – we simply executed the contingencies we had defined as we started our ICD-10 program. The second question required a lot more thought and consideration.
When looking at how to avoid another delay, you have to understand the reason for the initial delays. The predominant reason for delaying ICD-10 was lack of industry readiness. As we looked around our landscape we saw that certain entities were having a more difficult time getting ready for ICD-10 than others. One area of focus that we decided to concentrate was the smaller professional health care provider practice.
Click the link above for access to the article
#ICD10 #ICDRemediator #ICD10Matters #HealthIT
Get Remediator to assist in your readiness for the ICD-10 switchover www.icdremediator.com
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