ICD-10-PCS codes include one digit for the root operation that the provider performs. The root operation is always the third character is the seven-character code. The definitions of these root...
Well, CMS apparently wants to make sure everyone tests the HIPAA Version 5010 transaction sets. CMS previously announced two national testing days, and is adding 5010 testing week. CMS scheduled 5010...
CMS recently posted the 2012 ICD-10-PCS codes and coding guidelines . A summary of the major changes for 2012 states that there are 1,182 new codes, 381 revised titles, and 1,345 deleted codes. In...
You’ve probably heard that it’s too early to start learning ICD-10-CM/PCS codes. After all, the codes are still in draft format. However, it’s not too early to start learning the root operations for...
With 2013 seemingly so far away, many post-acute care organizations, including long-term care facilities, homecare agencies, and hospices, have not started their ICD-10 coding training. Many want to...
The complexity and costs of the switch to IDC-10-CM/PCS will vary by the size of the organization. A large, multi-facility health system needs to review more areas and plan more changes than a five-...
I attended the live portion of the American Health Information Management Association ICD-10-CM training in Baltimore last week. It is definitely not for the faint-hearted! It was a good overview...
As I look at the ICD-10-CM codes and take into consideration some of the possible documentation issues we might face, one of the questions that comes to mind is are we actually taking a step backward...
General Equivalency Mappings (GEMs) are crosswalks between ICD-9-CM and ICD-10-CM codes. They are a helpful way to start looking for a code when you move from ICD-9-CM to ICD-10-CM. But GEMs are not...
Right now only one in five hospital claims is fully paid without a payer request for more information, according to a RAND Corporation report. With the upcoming transition to ICD-10-CM/PCS, providers...
One of the things that I like about the ICD-10-CM manual is use of the vertical gray bars in the Volume II “Alphabetical Listing for Diseases.” This greatly enhances the ability to see how far the...
Certification in this day and age has become a vital part of obtaining and proving proficiency in coding and other related fields. Many years ago, coders did not have to be certified to secure...
Just when I thought that ICD-10 would resolve those annoying coding guideline and definition inconsistencies, I have discovered that some will still exist in ICD-10, too. Oh no—say it ain’t so! The...
Small rural facilities that haven’t yet started planning for ICD-10-CM/PCS shouldn’t panic yet, but they also shouldn’t delay much longer, says Jeff Wieters, RHIA, senior technical advisory...
I have been doing this workout program called P90X. It’s a challenge, and I’m not nearly as faithful to it as I should be. There is one segment called “Ab Ripper X,” during which our fearless leader...
CMS will host a national provider teleconference, "CMS ICD-10 Conversion Activities," on May 18, 1 - 2:30 p.m. EST. Presenters will discuss the ICD-10 conversion process currently taking place within...
When teaching ICD-9-CM coding, I often use a little ditty, “sprains and strains are the same,” to remind myself that when a physician documents “strain,” I need to start with the main term of “sprain...
Many of the speakers at the AHIMA’s ICD-10 Summit April 11-12 in Baltimore stressed the importance of working together. Physicians, coders, and information technology folks all need to work together...
Getting clinicians onboard and trained for the transition to ICD-10-CM/PCS will be one of the biggest challenges for most facilities, according to Patricia A.C. Hildebrand, MSN, RN, AHIMA-approved...
Coding productivity will decrease at least initially with the switch to ICD-10-CM/PCS. But do you know how productive your coders are now? If the answer is no, consider following the example of Mary...
As most people in the healthcare industry know, the conversion to ICD-10-CM/PCS isn’t the only initiative organizations are trying to implement. So where does the ICD-10 conversion fit within your...
When it comes to training staff members for the upcoming transition to ICD-10-CM/PCS, not everyone has the same needs or characteristics. They don’t even belong to the same group of shareholders...
The current versions of the X12 Version 4010/4010A1 transaction standards lack certain functionality that are pertinent to the healthcare industry. By now, health plans, healthcare clearinghouses,...
Coders are discussing whether they need to be trained in ICD-10-CM only or should they also receive training in ICD-10-PCS. Well, the answer may depend on what setting you are currently employed in,...
One of the things I have always liked about ICD-9-CM is that no matter how poor the documentation, if a code requires a fourth and/or fifth digit the manual always gives what I call the “out” by...
The 2011 ICD-10-CM Official Guidelines include several changes relating to the correct coding for neoplasms. Chapter 2 of the ICD-10-CM contains the codes for most benign and all malignant neoplasms...
I saw a question posted recently regarding the inclusion or exclusion of Workers Comp, property, casualty, and auto under the CMS mandate to implement ICD-10. My first reaction was why wouldn’t they...
HCPro is conducting research into how organizations are assessing their ICD-10 readiness. Click the link below to participate. http://www.zoomerang.com/Survey/WEB22C5AE44S33/
The American Health Information Management Association (AHIMA) recently posted on its ICD-10 webpage a Top 10 List: Phase One . In early 2011, Phase I (first quarter 2009–second quarter 2011) of the...
ICD-10-CM/PCS now has guidelines for reporting conditions that are present on admission (POA). As part of the 2011 guidelines updates, CMS and the National Center for Health Statistics added Appendix...
As we work toward the implementation of ICD-10 in 2013, strategic opportunities for change abound. Remember all those items that have remained static on your operational wish list? Perhaps you can...
As a regulatory specialist, I find myself asking my students, fellow coders, and other colleagues (e.g., clinical documentation improvement specialists) where they are in terms of preparation for ICD...
The Centers for Disease Control (CDC) posted the new 2011 guidelines for ICD-10-CM on its website. You won’t find many significant changes to conventions, general coding guidelines, and chapter...
CMS has posted two new frequently asked questions (FAQs) about ICD-10 national provider teleconferences and the partial code freeze. To access these FAQs, please visit the CMS ICD-10 webpage , click...
Before you can think about implementing ICD-10, you need to be sure your numerous Hospital Information Systems (HIS) and Practice Management Systems (PMS) are upgraded for the change. It can be a...
As many of you know, before we switch to ICD-10-CM/PCS, we first will be transitioning to HIPAA Version 5010. In fact, that date is less than one year away. By January 1, 2012, providers need to be...
This series of entries will not follow a random bi-weekly topic but will focus on the chronological transition to ICD-10 readiness. My intent is to dispel myths and compare real-world experience in...
CMS recently posted agendas for what will be the last ICD-9-CM Coordination & Maintenance Committee meeting to address code updates for ICD-9 and ICD-10 before the partial code freeze is...
A common question I have been asked lately is whether coders should receive ICD-10 training now, or should they wait until much closer to the implementation date of October 1, 2013? Comments by some...
I was talking with a friend of mine recently about the transition to ICD-10. He is a very good doctor who prefers to leave the “administrative details” to his capable office manager. Although he...
In previous versions of the ICD-10-CM Draft Manual , we were all under the impression that certain conditions, such as malignant versus benign hypertension and uncontrolled versus not stated as...
CMS included nine topics related to ICD-10-CM/PCS on its tentative agenda for the ICD-9-CM Coordination and Maintenance Committee meeting March 9-10. This is the final meeting to address ICD-9-CM and...
So you still think you have plenty of time before the switch to ICD-10-CM/PCS happens, right? After all it’s still too early to start learning the codes. But what have you done to prepare? According...
Physicians who are part of a practice do go to the hospital to deliver babies, provide consults, and perform surgeries. So does that mean coders in a physician’s office will need to learn ICD-10-PCS...
We should all be in the middle of our plans to transition from ICD-9-CM to ICD-10-CM and ICD-10-PCS. From planning and budgeting to training and auditing to process and technology changes, the...
I know there are some of you out there who missed the recent CMS national provider call. For anyone looking to catch up on this recent information session, CMS posted to its ICD-10 webpage a...
You can expect ICD-10 updates to follow the same timeline that you are already accustomed to for ICD-9—almost. An ICD-9-CM Coordination and Maintenance Committee Meeting was held September 15-16,...
When coders are looking at scenarios in ICD-10-CM/PCS, where the X is located within the code matters. When X is in the fifth and/or sixth character, X is a placeholder. ICD-10-CM codes can be up to...
As many may be aware, laterality has been added in ICD-10-CM to increase specificity. Codes assigned for conditions such as fractures, burns, and pressure ulcers will indicate right side versus left...
On November 23, 2010, the North Carolina Healthcare Information & Communications Alliance (NCHICA) and the Workgroup for Electronic Data Interchange (WEDI) published what they call an "...
Can’t wait to learn more about ICD-10? Want to get some basic training and experience in using ICD-10? Not enough money in the budget to go get training? Take a look at the World Health Organization’...
CMS will host a national provider teleconference January 12 at 1 p.m. that will focus on ICD-10 implementation in 2011. CMS representatives will discuss implementation strategies for this year...
As the New Year starts, where are you at in terms of your ICD-10 implementation plans? This might be a good time to sit down and identify any gaps in your preparation to ensure a smooth transition to...
Expert predictions for industry costs for the upcoming move to ICD-10-CM/PCS vary from $6 billion to $14 billion (Robert E. Nolan Company), to $1.15 billion (RAND Corporation). Regardless of where...
CMS has released the 2011 versions of the ICD-10-CM/PCS crosswalks, also known as the General Equivalence Mappings (GEM) on its ICD-10 website . In addition, CMS also posted a document titled “ICD-10...
It may come as a surprise, but CMS has an excellent website to help with the transitions to 5010 and ICD-10. This site is actually easy to use and fairly comprehensive compared to some of their...
ICD-10. The biggest change to happen in health information management in more than 20 years is on your doorstep. You’ll need a step-by-step plan to educate and train staff across multiple departments...
At the annual American Health Information Management Association's (AHIMA) convention in September, AHIMA practice resources managers Kathy DeVault, RHIA, CCS, CCS-P, and Ann Zeisset, RHIT, CCS, CCS-...
One of the challenges in ICD-9 is teaching the difference between coding for adverse effects and poisonings. You have to understand the difference between the two, and you have to also understand the...
The meanings of the seventh character for ICD-10-CM codes vary across chapters and categories. Fracture codes include additional information that can be provided by the extension. When coding for a...
Neoplasms are a form of new, abnormal growth in organs and tissues. The cells do not develop as an organized part of the site where they form, and they may spread to other parts of the body in a...
The billing department will see plenty of payer ¬policy changes as a result of ICD-10-CM. Billers must know how the new policies affect what can be billed and how they must submit the bills under the...
I have heard and read many discussions that coders will need to get in-depth education on anatomy and physiology (A&P) and pathophysiology before we flip the switch to ICD-10. The more I thought...
What does "x" represent in ICD-10? What seemed like a fairly straightforward question and answer in a recent HCPro ICD-10 Basics Boot Camp™ class I was teaching actually evolved into more of a tricky...
The Commission on Certification for Health Informatics and Information Management (CCHIIM) recently announced ICD-10 recertification requirements for individuals certified by the American Health...
While attending an American Health Information Management Association ICD-10 course, I was surprised to learn that there is a huge change to the coding guidelines regarding neoplasms. Currently in...
Coders and other HIM professionals generally focus on the ways ICD-10-CM is different from ICD-9-CM—the number of codes, the length of the codes, the look of the codes, the level of specificity, and...
Over the past few weeks through e-mail, at conferences, and during class many people have asked myself and my colleagues what makes the HCPro ICD-10 Basics Boot Camp ™ different from the other...
So, once we start using ICD-10 codes, will you still be able to use a super bill? A super bill is a cheat sheet that many facilities and practices develop, on which they list their top diagnostic...
ICD-10 will change more than just the code sets and will impact more than just your coders. The clinical area will face many changes because so many health plan policies are going to change, says...
In ICD-10-PCS, every procedure falls into one of 31 root operations, which define the objective of the procedure. Although some root operations seem self-explanatory (e.g., transplantation or...
Rule 12 of the 2010 ICD-10-CM Official Guidelines for Coding and Reporting reads: Reporting same diagnosis code more than once Each unique ICD-10-CM diagnosis code may be reported only once for an...
CMS will hold a Special Forum to receive input on the development and implementation of its hospital value-based purchasing program, as required by Section 3001 of the Affordable Care Act. The...
By now everyone knows that coders will need more documentation and specificity to assign the correct ICD-10 codes. And everyone knows that increased documentation has to come from the providers—the...
Looking forward to it? Did I really just say that? Yep – I sure did! In July, I attended a preview of HCPro’s ICD-10 Basics Boot Camp ™. I was actually a little surprised that the ICD-10-CM codes,...
CMS posted this week the following ICD-10-PCS files for 2011 to its website: Official ICD-10-PCS Coding Guidelines 2011 Version: What's New Code Tables and Index Code Descriptions ICD-10-PCS...
I often wondered how the ICD-9-CM code set would translate to ICD-10-CM/PCS in regards to MS-DRGs. I couldn’t fathom that along with the costly transition to a new code set, CMS would “double whammy...
The Glasgow Coma Scale provides an objective way of recording the conscious state of a person, for initial as well as continuing assessment. A patient is assessed against the criteria of the scale,...
Sometimes we get really excited about code changes, especially when they have such a huge impact on documentation issues. One such exciting change is in the ICD-10 coding guidelines for Chapter 6:...
If you have taken a peek at a draft ICD-10-PCS Manual , you probably realize that you need to be come familiar with a number of root procedures, some of which you may not even be familiar with. But...
One of the biggest changes in ICD-10-CM is the volume of codes that specify laterality. Providers will need to document which side, right or left, that the injury or diagnosis has occurred for...
I taught the first “official” two-day HCPro ICD-10 Basics Boot Camp™ a couple weeks ago. I was pleasantly surprised that all 50 participants felt the new coding system was easily learned. If I can...
During the ICD-9-CM Coordination & Maintenance Committee Meeting on Sept. 15, CMS representative Pat Brooks, RHIA, announced that the committee had finalized the decision to implement a partial...
One of the things that is not changing between ICD-9 and ICD-10—which often takes hospital coders by surprise—is that coders of professional services cannot code diagnoses documented with the terms “...
When coding with ICD-10, there may be terms that neither your coders nor your physicians are used to using. Now is the time to pass on this knowledge to your medical staff so they can understand what...
The switch to ICD-10-CM will change more than just your code choices. It will also change how physician offices practice medicine. All of your offices' policies will have to be revised to fit ICD-10-...
So, by now you know ICD-10-CM codes contain more specificity than many ICD-9-CM codes. After all, we’re going from 13,000 codes to 68,000 codes. So where will that increased specificity show up? One...
Although I'm sure these great contributors to the field of medicine will live on in many other publications, ICD-10-PCS coding manuals will no longer include eponyms. So you not only need to be...
OK, so maybe your ICD-10-PCS (Draft) Manual doesn't rank up there with your most memorable reads, however, you can't deny that it's a page-turner! Sometimes, it may seem like you can't find the...
Mark your calendars because on August 13, you'll have the opportunity to register for the September 15-16 ICD-9-CM Coordination & Maintenance Committee Meeting in Washington, DC. As required by...
October 1, 2013 is not the only deadline to be concerned with. If you submit electronic claims, you should complete internal testing with Version 5010 by January 1, 2011 so that you are prepared for...
The network of relationships between the ICD-9-CM and the ICD-10-CM code sets is named the General Equivalence Mappings (GEMs) . It’s like trying to translate from one language to another. Sometimes...
Many of the changes to the 2010 ICD-9-CM codes were additions to the external causes of injury and poisoning E codes (E800–E999). Activity codes were added to give context as to what the person was...
If you've been wondering whether the American Hospital Association (AHA) plans to convert guidance it has published in Coding Clinic over the years to include ICD-10 codes, the answer is no. "I am...
The Association of Clinical Documentation Improvement Specialists (ACDIS) recently submitted a comment to CMS explaining its position against the proposed code freeze. ACDIS' comment stated the...
I was reading a recent Medicare Payment Advisory Commission (MedPAC) letter to CMS commenting on the 2011 inpatient prospective payment system proposed (IPPS) rule, specifically their recommendations...
On June 23, CMS issued MLN Matters Special Edition article #SE1019 , which is intended to provide healthcare entities more information about the implementation of ICD-10-CM and ICD-10-PCS. In...
As we continue our journey toward ICD-10 implementation, certified coders will need to show their proficiency in the new coding system. For holders of an American Academy of Professional Coders (AAPC...
Can you believe it has been about 18 months since the Department of Health and Human Services announced in the Federal Register that ICD-10-CM and ICD-10-PCS would be implemented on October 1, 2013?...
At the recent American Health Information Management Association ICD-10 Summit in Washington, DC, several attendees were heard discussing the 3-day rule (sometimes called the 72-hour rule),...
