Sep 20, 2013 | Uncategorized
Todd Welter laughs about it now. When first approached about offering his “Fundamentals of Managed Care” course online for students in Regis’ Division of Health Services Administration, he admits he was resistant.nn”Back then – it seems kind of silly nowadays – I thought teaching online was just a fad,” said Welter, an affiliate faculty member. “It’s amazing how fast that has taken off.”nnNow more than 10 years into teaching his signature course and more than 75 percent of that time teaching it online, he can’t imagine it any other way.nnWelter’s teaching philosophy is simple: Engage online students no differently than those in a campus-based class. He maintains regular contact by jumping online frequently throughout the day, responding promptly to questions and making himself available away from the computer – whether by phone or even in-person to work through material face to face.nnClass discussions are still energetic. Personal attention is still a focal point. And everyone, Welter included, comes away from each session learning something new.nnStudents also gain the benefit of his more than 25 years of health care industry experience. He is president and founder of Welter Healthcare Partners, Inc., which works with providers, hospitals, public health agencies and other facilities around the world on the business side of health care. Welter, who earned a Master of Science in Organization Leadership and Management, credits his own Regis education with helping him see the big picture, think outside the box and find solutions. Those skills are what give Regis graduates an edge in the job market and help them excel in a field that is exploding with opportunity, including the ability to join in efforts to move health care forward, he said.nn”I am part of changing health care,” he said. “And I want to drag students into it. I want to tell them, ‘Get in the storm and be part of the change.'”nnConnect and find out how Regis can position you as a change agent in health care.n
Click Here To Learn More
nSource: www.regis.edu; 2013.
Sep 12, 2013 | Uncategorized
The U.S. Health and Human Services (HHS) Centers for Medicare and Medicaid (CMS) announced on Thursday that Medicare will begin accepting a revised CMS-1500 form (version 02/12) on January 6, 2014.nnEmbedded in this is a requirement for some healthcare IT vendors to start supporting a component of the International Classification of Diseases version 10 (ICD-10) earlier than the anticipated October 1, 2014 date.n
Starting April 1, 2014, Medicare will accept only the revised version of the form. The revised form will give HIPAA Covered Entities who are health care providers the ability to indicate whether they are using ICD-9 or ICD-10 diagnosis codes, which is important as the October 1, 2014, transition approaches. Effectively this means that any healthcare IT system that adjudicates, submits, or reports on claims data that was scheduled to be compliant as of October 1, 2014 with ICD-10 must actually comply with a component of the ICD-10 requirements related to claims data as early as of April 1, 2014.
nICD-9 codes must be used for services provided before October 1, 2014, while ICD-10 codes should be used for services provided on or after October 1, 2014. The revised form also allows for additional diagnosis codes, expanding from 4 possible codes to 12. ICD-10 CM must be used for all diagnosis for both inpatient and outpatient claims. ICD-10 PCS must be used for all inpatient procedures.nnOnly providers who qualify for exemptions from electronic submission may submit the CMS-1500 Claim Form to Medicare. For those providers who use service vendors, CMS encourages them to check with their service vendors to determine when they will switch to the new form.nnICD-10 promises to introduce better information to improve the quality of healthcare by providing more granular data on the condition of the patient, how the patient acquired a condition, how the patient was treated for the condition and why. This in turn it is hoped, will improve population health management and other components of healthcare.nnAt the same time ICD-10 is viewed as disruptive because it requires a re-write of healthcare IT systems, processes, and substantial re-training of medical coders, billing personnel, physicians, and other clinical staff.nnFrom a financial perspective ICD-10 introduces a new payment paradigm including opportunities for improved reimbursement and potential risks of decreased reimbursement for HIPAA Covered Entities who do not carefully examine the nuances of the ICD-9 to ICD-10 transition.nnHIPAA Covered Entities and healthcare IT vendors who are building test plans must take this into consideration as they plan for the ICD-10 transition.n
Online ICD-10 specialty-specific provider training modules coming soon!nContact us for more details.
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On-site, custom ICD-10 training for staff and providers – book your ICD-10 trainer now!
nSource: www.govhealthit.com; Michael F Arrigo; September 6, 2013.
Sep 12, 2013 | Uncategorized
S93.411A – Sprain of calcaneofibular ligament of right ankle, initial encounter.nnW03.XXXA – Other fall on same level due to collision with another person, initial encounter.nnY93.61 – Activity, American tackle football.nnY92.126 – Garden or yard of nursing home as the place of occurrence of the external cause.
Sep 4, 2013 | Uncategorized
For the ICD-10 transition to be successful, there will need to be a huge effort on the part of medical coders, IT staff, and physicians to put all the pieces together. However, the new code set also presents an opportunity for healthcare organizations to make some big-picture decisions about the future of data governance and the role of healthcare analytics. 2011 AHIMA President Bonnie Cassidy, MPA, RHIA, FAHIMA, FHIMSS, Senior Director of HIM Innovation for Nuance, sat down with EHRintelligence to explain how the ICD-10 decisions you make now can affect your organization in the months and years after October 1, 2014.n
What are you seeing right now as providers work towards ICD-10 readiness?
nOne of the things I’m seeing a lot is a focus on contingency planning. In the work plans or roadmaps, if the organization didn’t allow for contingency planning, they’re now realizing that it’s really something that’s very important. There’s a domino effect. If you find out that you didn’t address something that is critical to the mission or there’s a wrinkle in the plan, they must ask themselves: what did you do to allow for a contingency? It’s like business disaster planning. Maybe one of the vendors went out of business. Or maybe you never approached all of your payers. Whatever the case may be, good contingency planning is an important element to building a strong ICD-10 transition plan.nnProviders are also finding out about all of the challenges of working with payers or working with the vendors while they’re addressing everything that has to do with making sure that all their ducks are in a row for ICD-10 readiness. If one of those is out of alignment, it can disrupt your whole plan. Business partners, business associate agreements, IT vendors, contracts…all of those things need to be built in and accounted for in your contingency plan.n
What are some of the things providers and hospitals need to focus on right now?
nThe whole concept of information technology (IT) testing is going to be significant. It’s been announced that CMS will not be conducting testing for providers and payers, so I think there’s a renewed energy around the concept of testing. A lot of organizations are delaying it because they have underestimated the amount of time that it will take to thoroughly and properly evaluate and test their systems. It is a huge effort and many organizations haven’t even gotten to the point of thinking about it. But if you think about all of the systems and all of the databases that have to convert from ICD-9 to ICD-10, you have to test everything because you need to see if the data will flow. You need to prioritize what those systems are, and build separate test databases so you’re not disrupting your actual live transactions.nnDo you have a Clinical Documentation Improvement (CDI) program? If you do, what is the goal and focus of the program? You need to do an evaluation, a gap analysis, of your current CDI program –what is your ideal result, and what’s falling in between? You should really look at your specialties, your physician population, and your patient population to see what you need to focus on. You have to get laser focused on your own patient population so you know what your top 25 DRG codes are, and you know what’s missing in your education and documentation. You already know what areas are going to be important to you. If you had to switch to ICD-10 today, you can predict where the trouble spots will be. That’s what CDI programs need to shift to right now.nnYou most likely also need to have more physician champions to get your physicians practicing the behaviors they need for ICD-10. That means you’re either hiring or contracting with physician consultants or finding physician champions in your organization. In order to do that education in your CDI program, you’ll need to think about what each specialty really needs to know. Physicians communicate best with each other, so physician-to-physician communication is your best strategy for enhancing your CDI program.nnThe other thing to focus on is your own staff. Have you really thought about what happens if one of your key players leaves the organization? The employee retention program is important. Be certain that you’ve really worked with human resources and established a program to retain your talented resources. Who are your critical success individuals?nnIf you spend all that investment in getting your coders educated and trained, as well as your clinical documentation improvement (CDI) staff, but you didn’t make the investment in an employee retention program, with the law of supply and demand, we’re going to have major capacity concerns. If those people leave, you might be left without the right staff to get the job done.n
Is there anything that looks like it might be forgotten in the implementation rush?
nICD-10-PCS coding for ambulatory surgery. Have you made a decision in your organization about what you’re going to do with ambulatory surgery? Are you going to code ICD-10-PCS for your procedures even though we know we only have to code CPT? The reason I introduce that under clinical documentation improvement is that CDI traditionally is not in the ambulatory setting.nnBecause of the need for very specific documentation in ambulatory surgery, if you’re going to use that for ICD-10 on the diagnosis side or the PCS side, you will then have clinical documentation requirements that are far more specific in ICD-10 than they are in CPT. You will probably need a CDI effort in that regard, because otherwise you won’t have enough information to code in ICD-10. You’ll have enough for CPT, but you won’t get the specificity necessary for ICD-10.nnMany people ask, “Well, why would I want to do that if the only thing that’s required is CPT?” But that connects to the overarching goal of analytics. If you want to be a progressive organization, you need to embark on something that allows you to have better information for analytics. You then will be a step ahead of the game because you’ll have that ICD-10 data in addition to your CPT data.nnAs we know, the world’s going to go from inpatient to ambulatory with the focus on outcomes and chronic disease management. So that’s going to be another push for CDI, but it’s also a huge organizational decision. It’s very much a strategic decision if you’re focused on your own data analytics in the future.n
Online ICD-10 specialty-specific provider training modules coming soon!nContact us for more details.
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On-site, custom ICD-10 training for staff and providers – book your ICD-10 trainer now!
nSource: www.ehrintelligence.com; Jennifer Bresnick; August 26, 2013.
Sep 4, 2013 | Uncategorized
T20.16XA – Burn of first degree of forehead and cheek, initial encounternnX03.0XXA – Exposure to flames in controlled fire, not in building or structure, initial encounternnY93.G2 – Activity, grilling and smoking foodnnY92.017 – Garden or yard in single-family (private) house as the place of occurrence of the external cause.nnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
