Tag Archives | ICD-10

14 Things To Know About Medical Coding

Medical coders play a crucial role in the revenue cycle process, as they help ensure health systems, hospitals and physicians are properly reimbursed for the services they provide. Here are 14 things to know about medical coding. 1. AAPC describes medical coding as “the transformation of healthcare diagnosis, procedures, medical services and equipment into universal […]

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Key ICD-10 Changes That Impact Pathology/Lab Coding in 2017

Have you updated your reporting of malignant carcinoid tumors, viral hepatitis, GIST or ovarian cyst coding? You haven’t had to deal with annual ICD-10-CM updates until Oct. 1, 2016. Now that the changes are effective, ensure your lab is on top of the latest changes. Take a look at how the first annual update in […]

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ICD-10 Codes Aren’t Oppressive After All

Alexander Miller, M.D., a dermatologist in Yorba Linda, Calif., has a simple message for colleagues grappling with the new ICD-10 codes: Don’t panic! “It’s just a matter of restructuring one’s thinking,” Dr. Miller tells Dermatology Times. “It was no problem for us to handle these codes,” he says, even in his office that continues to […]

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Contact with Nonvenomous Frog, Subsequent Encounter

EDITOR’S NOTE: This article focuses on physician engagement and ICD-10 education. However, the term “physician” includes everyone licensed and credentialed to record a patient diagnosis, such as wound care and other clinical staff. St. Joseph’s Healthcare System (SJHS)in Paterson and Wayne, N.J. is truly an ICD-10 success story. Under a new administration and clinical documentation […]

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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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