Tag Archives | ICD-10

Reimbursement, Billing in Radiology: Updates and Issues

Radiology, as a business, has become increasingly complex as regulatory demands grow and revenues, both on the hospital and physician side decrease. Doing more with less has become a common theme and both the commoditization of billing as well as the implementation of ICD-10 codes have played an important role over the past year, according […]

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Healthcare Reform Can Create Confusion Over Compliance for Providers

In 2016, the federal government recovered more than $3.3 billion in healthcare fraud judgments and settlements. On Monday, TeamHealth agreed to pay $60 million to settle allegations that a company it acquired, IPC Healthcare “knowingly and systematically encouraged false billings by its hospitalists.” The settlement is the latest in a string of False Claims Act […]

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Navigating ICD-10: Tips For Hospitals and Coders

More than one year after the ICD-10 go-live on Oct. 1, 2015, CMS has ended the ICD-10 claims auditing and quality reporting leniency period. Guidelines now require providers to code to reflect clinical documentation in as much specificity as possible. Therefore, hospital and health system leaders must ensure both new and experienced coders are prepared […]

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Everything Doctors Should Know About ICD-10 Glitch

CMS has announced a glitch in the quality reporting measures brought upon by the changes in the ICD-CM (Clinical Modification) and ICD-PCS (Procedural Coding System) updates that went into affect Oct. 1. While CMS is a bit unclear as to exactly what the problem is, there are a few things we know: This glitch only […]

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Top 5 Tips for Combating 2017 Coding Concerns

The calendar may say the ICD-10 transition is long gone, but practices still will likely feel its repercussions in 2017 in terms of payer requests, denials and the new code set’s influence on value-based care. Looking to next year, practices should start being proactive with these coding opportunities now to consider how the following five […]

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Experts Say ICD-10 Codes Don’t Go Far Enough

When CMS switched from ICD-9 to ICD-10 last year, the new diagnosis classification list allowed coders to translate additional elements of doctors’ language to billers’ language. In a sense, ICD-10 added “adjectives” to coders’ vocabularies: oncology coders now have the ability to describe additional aspects of a tumor, such as whether it resides in the […]

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Computer Assisted Coding Can’t Replace Competent Coders

Are you familiar with IBM’s supercomputer Watson? IBM’s stated aspiration is to make it “the world’s best diagnostician,” because it can store way more medical information than a human doctor and makes decisions based on evidence, free of cognitive biases. It is consistent, and, according to the company, “given the same inputs, Dr. Watson will […]

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5 Findings From Nationwide ICD-10 Coding Contest

Central Learning’s national 2016 ICD-10 coding contest highlighted the converse relationship between coding accuracy and productivity across inpatient, ambulatory and emergency settings. Central Learning is a web-based coding assessment application, belonging to AVIANCE’s suite of health information and revenue cycle management solutions. More than 550 coders registered with Central Learning to code 1,859 cases in […]

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Careful Planning Can Reduce Vaccine Associated Losses

Vaccine administration is an important element of primary care practice, and a critical contribution to preventive care public health. But as vaccine and overhead costs continue to rise—particularly for private practices—physicians can have a difficult time aligning expenses with revenues. A decade-old paper published in Vaccine sought to estimate the expense practices face from administering […]

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ICD-10 Specificity Has Providers Bracing for Denials

A year after the much-hyped switch to the ICD-10 diagnostic coding library, healthcare providers now face pressures to assign codes with the right degree of specificity or risk claim denials. While the Centers for Medicare and Medicaid Services ended its grace period for unspecified codes on Medicare fee-for-service claims on Oct. 1, commercial insurers are […]

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CMS ICD-10 Coding Grace Period Comes to a Halt October 1, 2016

Since the update from ICD-9 to ICD-10, has your business successfully made the transition to the new coding system, or are you still struggling to keep up? If it’s the latter, very little time remains! According to CMS, October 1, 2016, will be the cutoff date for the use of unspecified or less specific codes […]

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ICD-10 Pre-Bill Auditing a Growing Area of Concern

Given the massive number of new ICD-10 codes and the Oct. 1, 2016 compliance date, HRS and ICD10monitor are producing a special-edition Internet broadcast that will focus on the imperative of pre-bill auditing. The free broadcast will air live at 1:00 p.m. on Thursday, Aug. 4. The 60-minute live event is being sponsored by HRS. […]

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Reducing Your Risk and Staying the Course

One thing always remains the same in healthcare: change. With the implementation of ICD-10 we found out how disruptive some of these changes can actually be, and it appears that this was only a precursor to even more change in healthcare, with the implementation of new quality payment initiatives. During the ICD-10 implementation, we began […]

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Good News, Bad News: The Saga Continues

The long-awaited update to the CT lung screening national coverage determination (NCD) was finally released this month. As you may recall, current smokers who were otherwise eligible were omitted from the NCD-covered codes released last year. That is the really good news. The really bad news is that at least one Medicare Administrative Contractor (MAC) […]

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CDC Releases 2017 ICD-10-CM Codes

Since the release of the 2017 ICD-10-PCS codes, the healthcare vendor community has been waiting with bated breath for the 2017 ICD-10-CM codes. Now they’re here.

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The State of ICD-10 Implementation: Calm, and Qualms

Now at almost the 9-month mark, the implementation of the new ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision) diagnostic codes by physician practices resembles a calm, glassy stretch of ocean broken by a solitary shark fin.

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