The Centers for Medicare & Medicaid Services (CMS) has taken its first step toward improving its efforts to ensure the effectiveness, efficiency, economy, and quality of care quality for Medicare beneficiaries in through the Quality Improvement Organization (QIO) Program.nnLast week, the federal agency announced the selection of Livanta LLC and KePRO as Beneficiary and Family Centered Care (BFCC) would be responsible for the program’s case review and monitoring activities at a broader level than the traditional QIO activities taking place at a more local level.nnBetween them, the two BFCC QIOs will oversee five geographic areas — Livanta (Areas 1, 5), KePRO (Areas, 2–3) — of the United States and its territories:n
Area 1: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Puerto Rico, Rhode Island, Vermont, Virgin IslandsnArea 2: District of Columbia, Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West VirginianArea 3: Alabama, Arkansas, Colorado, Kentucky, Louisiana, Mississippi, Montana, North Dakota, New Mexico, Oklahoma, South Dakota, Tennessee, Texas, Utah, WyomingnArea 4: Iowa, Illinois, Indiana, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, WisconsinnArea 5: Alaska, Arizona, California, Hawaii, Idaho, Nevada, Oregon, Washington
nEstablished by statute in 1982, the Medicare Quality Improvement Program Program is currently in its earliest phase of transformation which CMS set in motion back in 2011 with the publishing of the 10th Statement of Work (SOW).nn“One of the most critical roles of CMS is to protect the quality and safety of care delivered to beneficiaries. Care needs to be patient-centered and directly engage patients, families, and caregivers,” Dr. Patrick Conway, Deputy Administrator for Innovation and Quality and CMS CMO, said in a public statement. “The quality of care review is essential to ensure care delivered to all beneficiaries meets professionally recognized standards.”n
nnThe next step for improving the QIO Program is expect to take place this July with the award of contracts to organizations responsible for working directly with providers and communities. Shortly thereafter, CMS will release its 11th SOW on August 1.n
nOn April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, the U.S. Department of Health and Human Services expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015.n
July ICD-10 End-to-End Testing Canceled: Additional Testing Planned for 2015
nCMS planned to conduct ICD-10 testing during the week of July 21 through 25, 2014, to give a sample group of providers the opportunity to participate in end-to-end testing with Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor. The July testing has been canceled due to the ICD-10 implementation delay. Additional opportunities for end-to-end testing will be available in 2015.nnSource: www.cms.gov; May 2, 2014.
J30.1 — Allergic rhinitis due to pollennnJ30.2 — Other seasonal allergic rhinitisnnJ30.81 — Allergic rhinitis due to animal (cat) (dog) hair and dandernnJ30.89 — Perennial allergic rhinitisnnIn 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, 2015 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Successful population health management is not possible without data. The form that information takes depends on the role being played by a particular player in population health management: provider, patient, or payer.nnWith passage of the Affordable Care Act and the movement toward value-based reimbursement, health plans find themselves facing challenges similar to those of the providers they’re working with in the pursuit of accountable care and population health.nn“The landscape is certainly changing and there are many changes. How payers are interacting with providers really depends on the type of structure they have set up,” says the newly-appointed IDC Health Insights Research Director Deanne Primozic Kasim.nn“In the last two to three years in particular, there have been many developments in terms of providers forming patient centered medical homes and accountable care organizations, not just with Medicare but also with some payers doing their own types of ACO arrangements,” she continues. “That has a different dynamic for the types of data being given to payers and the kinds of reimbursement coming back to providers.”nnThe challenge is made harder by the series of healthcare mergers, acquisitions, and partnerships that have an impact on reimbursement for providers and payers. ” You see these hospital systems just eating up provider practices and as their operations are being integrated there are more billing processes are in place in terms of how these groups now get reimbursed,” adds Primozic Kasim.nnIn looking for guidance in the area of accountable care in particular, Primozic Kasim admits that health plans can look to the approach taken by the Centers for Medicare & Medicaid Services (CMS) in its Medicare Shared Savings Program (MSSP) and Pioneer ACO Model, but that does not necessarily provide real clarification.nn“What Medicare has put out there is being used as a guideline, but there is unfortunately not one roadmap,” explains Primozic Kasim. “It is a real challenge for payers in looking at the types of quality metrics they are going to use as different programs pop up, including what they do with the federal government if they choose to play there. There are so many quality metrics that they are challenged to keep up with them.”nnOne thing that is clear to payers is the need to understand individuals as consumers as well as patients where Primozic Kasim sees great potential for improvement.nn“There isn’t one-size-fits-all just like there’s not one type of consumer or patient,” she stresses. “It’s really about trying to reach people by respecting their different healthcare literacy overall, their social use of technology, their access to technology, and what’s going to hit home with them because there are different messages and cultural and demographic concerns as to how to reach people.”nnAccording to the research director, certain payers have a leg up on others in the makeup of their patient populations. “The ones that have more of a target population, such as the Medicaid and Medicare Advantage plans, have an advantage over the larger national plans because their patient population is a lot more focused and more centered geographically as opposed to those plans that are trying to cover everybody in different market segments,” claims Primozic Kasim.nnGetting to know their patient populations is leading payers toward gathering intelligence through business and clinical analytics solutions and services. Given the inchoate of healthcare analytics choosing the right vendor partner or partners is not an easy one.nn“In terms of analytics, there is not one vendor that has a complete, defining market share,” says Primozic Karim. “There are many companies out there doing everything from the backend edge server to some of the more clinical analytics and looking at population health of these exchange populations because clearly setting premiums for this is going to be key to moving forward.”nnFor value to replace volume in healthcare, premiums and reimbursements must be properly configured. Without meaningful insight into the needs of the provider and patient populations, payers will not be able to rise to the requirements of this new era in healthcare.nnSource: www.ehrintelligence.com; Kyle Murphy; April 30, 2014.
Why Should a Practice Outsource Their Billing? Do the Math!
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nThe cost of setting up and maintaining a billing system, including the necessary staff to properly code, scrub, bill, post payments, and pursue denied claims, is a significant expense for any medical practice. Add to that expense the cost of employee turnover (and training), employee benefits, annual support and maintenance of computer equipment, the constant need to remain diligent regarding changes in reimbursement and CPT and ICD-9 coding (soon to be ICD-10!), and the necessity of conforming to meaningful use criteria associated with your electronic medical record, and you have a perfect storm brewing that could cost you a bundle!nnDepending on your specialty and volume, estimates from sources including the Medical Group Management Association (MGMA) and other industry experts peg the average expense of internal billing to be 8 to 15% of your collected revenue.nnOutsourcing your billing will range from 6 to 10% of your collected revenue. However, a number of studies have demonstrated that collections typically improve by as much as 5 to 10% when billing is outsourced due to improvements in the rate of denied claims, timely follow-up and appeals for incorrect or no-pay claims, and familiarity and expertise in correct coding in order to maximize reimbursement. Other intangible benefits of outsourcing include eliminating the administrative hassle of having to manage systems, staff, and expense, which allows you to focus more time and intellect on the practice of medicine.nnA general guide to comparing costs of doing it yourself versus outsourcing, assuming no increase in collected revenue (plug in your own numbers), includes the following:n
Doing it yourself:
n
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A practice of one to three physicians requires a minimum of one and often two full-time equivalent (FTE) staff – cost including salary and benefits – $36,000 to $48,000/FTE/year
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Computer hardware and software expense including support and maintenance – $200/provider/month plus $500 for maintenance and support – $5,300/year
This is just a short delay to the industry’s inevitable transition away from the 30 year old ICD-9 to ICD-10. ICD-10 is coming and Welter Healthcare Partners, Inc. is pulling out all the stops to help our clients prepare for it and be successful. nnICD-10 is a richer data set allowing for more data to be used and transmitted. It will absolutely help the industry document care, document what treatments and modality’s work and how well they work. It will allow providers to better describe their services and why they are necessary.nnICD-10 will also help tremendously as we continue to transition away from a fee-for-service system of reimbursement to a quality and outcomes based reimbursement system like physician centric bundled or episodic payments.nnWe are excited about ICD-10 and the opportunity it will bring to our clients and the industry. We encourage providers, practices, and hospitals to continue training efforts already underway. Determine deficiencies now, as the clinical documentation improvement process and getting your staff proficient with the ICD-10 code set can take time! Take advantage of being ahead of the game! If you haven’t started, we encourage you to do so as this is a huge transition and being completely prepared is the only way to prevent negative impacts on productivity and revenue!n
W56.01XA — Bitten by dolphinnnW56.22XA — Struck by orcannW58.13XA — Crushed by crocodilennW61.09XA — Other contact with parrotnnIn 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, 2015 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
The Senate voted today, (March 31st) to delay the switch to ICD-10 billing codes to October 2015. This is just a short delay to the industry’s inevitable transition away from the 30-year old ICD-9 to ICD-10. ICD-10 is coming and Welter Healthcare Partners, Inc. is pulling out all the stops to help our clients prepare for it and be successful.nnICD-10 is a richer data set allowing for more data to be used and transmitted. It will absolutely help the industry document care, document what treatments and modalty’s work and how well they work. It will allow providers to better describe their services and why they are necessary. ICD-10 will also help tremendously as we continue to transition away from a fee-for-service system of reimbursement to a quality and outcomes based reimbursement system like physician centric bundled or episodic payments. We are excited about ICD-10 and the opportunity it will bring to our clients and the industry.nnWe encourage providers and practices to continue any training efforts already started, as the clinical documentation improvement process and getting your staff proficient with ICD-10 can take time! Take advantage of being ahead of the game! If you haven’t started, we encourage you to do so as this is a huge transition and being fully prepared is the only way to prevent productivity and revenue loss!
The 2014 Medicare Physician Fee Schedule (MPFS) final rule stipulated a negative update to the MPFS that was to be effective January 1, 2014. That reduction was averted for three months with the passage of the Pathway for SGR Reform Act of 2013, which provided for a 0.5 percent update for services paid under the MPFS through March 31, 2014.nnCMS is hopeful that there will be congressional action to prevent the negative update from taking effect on April 1, 2014. CMS has instructed the Medicare Administrative Contractors to hold claims containing services paid under the MPFS for the first 10 business days of April (i.e., through April 14, 2014). This hold would only affect MPFS claims with dates of service of April 1, 2014, and later. The hold should have minimal impact on provider cash flow, because under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 days for paper claims) after the date of receipt. All claims for services delivered on or before March 31, 2014, will be processed and paid under normal procedures, regardless of any Congressional actions.
Z73.1 — Type A behavior patternnnZ73.2 — Lack of relaxation and leisurennZ73.3 — Stress, not elsewhere classifiednnIn 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!
If you’re still banking on an ICD-10 delay, you might want to prepare yourself for yet another disappointment. At HIMSS14 last week, CMS Administrator Marilyn Tavenner stated once again that no such postponement is in the cards, and providers either need to get ready or prepare to stop getting paid. “There are no more delays and the system will go live on October 1,” Tavenner said during her keynote address to attendees of the conference in Orlando, Florida. “Let’s face it guys, we’ve delayed this several times and it’s time to move on.”nnThe deadline has many stakeholders worried about the impact of the hard cut-over from ICD-9 to ICD-10, with some vendors still developing ICD-10 compliant products and many providers and payers deeply concerned about inadequate testing procedures before the new code set goes live. While the Medicare testing week is taking place as we speak, and CMS recently announced a limited end-to-end pilot for some sample providers, the generally lackluster effort to engage the industry in testing has a number of experts on edge.nnAmong the most vocal about the upcoming doomsday is the American Medical Association, which has been advocating for an indefinite postponement of the new codes. In response to Tavenner’s latest remarks, AMA President Ardis Dee Hoven, MD, said, “Many physicians are still waiting for their vendors to deliver updated software they need to use the ICD-10 codes. The later physicians receive this software, the harder it will become to test it out before the October 1ICD-10 deadline.”nn“Testing is needed to discover problems and resolve them prior to the go live date. The slightest glitch in the ICD-10 rollout could potentially cause a billion dollar back-log of medical claims that jeopardizes physician practices and disrupts patients’ access to care,” Hoven continued in a public statement. “The AMA is deeply concerned that Medicare does not have a back-up plan if last minute testing demonstrates anticipated problems with this massive coding transition. At the end of the day sticking hard and fast to the ICD-10 deadline without a back-up plan to address disruptions in medical claims processing will hurt doctors and their patients.”nnTo help providers overcome the big hurdles standing between them and ICD-10 success, CMS has released a flurry of transition tools, such as detailed end-to-end preparation checklists and resources from its eHealth University. Educational sessions at HIMSS14, including a Q&A presentation by the HIMSS ICD-10 Taskforce, also attempted to prepare providers for the upcoming changes.nnTavenner’s assertion is the latest in a series of CMS statements reaffirming the October 1 transition date. As early as August of 2013, Pat Brooks, RHIA, Senior Technical Advisor at CMS, warned providers that there would be no extensions, and urged the industry to listen. “There will be no more delays,” she said during a National Provider Call. “Those who are postponing ICD-10 implementation planning, thinking there might be additional delays, should really begin to plan implementation now. There will be no more delays to the ICD-10 implementation date.”nnSource: www.ehrintelligence.com; Jennifer Bresnick; March 4, 2014.
This ICD-10 Coffee Klatch webinar is an informative review and excellent starting point for physician and hospital coders. Ms. Toni Woods and Ms. Whitney Horton, both AHIMA-Approved ICD-10-CM/PCS Trainers, will give viewers a glimpse of Welter Healthcare Partners’s formal ICD-10 Coder Academies and training, and provide an overview of ICD-10 Coding Conventions, Chapter Guidelines, Code Structures and an introduction to the 31 root operations in the Medical and Surgical sections of ICD-10-PCS.nn
Welter Healthcare Partners is proud to announce the addition of a webinar offering of the ICD-10 Coder Academy! nnThis session will take place July 8–10, 2014 with the registration deadline being May 30th. Registered Participants will have webinar training details emailed to them 72 hours prior to the training. Participant Training Books will be shipped 2 weeks before training. Please provide the address of where books should be shipped on the registration form.nnThis interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. Participants will gain the tools they need to appropriately select ICD-10-CM and ICD-10-PCS codes. These training sessions will be coder centric, and the content will be designed for those staff who will be responsible for applying (or verifying) these codes to documentation. Throughout the academy, participants will be given an assortment of scenarios to code to obtain the proficiency they need for coding in ICD-10.nnParticipants only needing ICD-10-CM training (physician and outpatient coding) should register for the first day of the academy only (Day 1).nnParticipants needing ICD-10-PCS training (hospital/inpatient coding) will need to register for the entire 3-day academy.n
Overview of ICD-10 Academy Agenda:
n(lunch, snacks and drinks will be provided each day)nnICD-10-CM (Day 1)nnnAHIMA-approved ICD-10-CM/PCS trainers will educate coding staff regarding ICD-10-CM with a focus on:n
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Convention changes and additions
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Concept changes and additions
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Chapter specific guideline changes and additions
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Live coding workshop
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n**This training has the approval of 8.0 CEU’s from the American Health Information Management Association (AHIMA) (AAPC members can submit these CEU’s to AAPC for credit)nnICD-10-PCS (Days 2 and 3)nnAHIMA-approved ICD-10-CM/PCS trainers will educate coding staff regarding ICD-10-PCS with a focus on:n
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The structure of ICD-10-PCS text and codes
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The definition and application of each root operation
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The method by which an ICD-10-PCS code is selected
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Live coding workshops
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n **This training has the approval of 16.0 CEU’s from the American Health Information Management Association (AHIMA) (AAPC members can submit these CEU’s to AAPC for credit)n
n[vc_toggle title=”Required Academy Materials:” size=”sm” el_id=””]AHIMA ICD-10-CM Coder Training Manual and/or AHIMA ICD-10-PCS Coder Training Manual – Upon registration participants Training Manuals (CM only, or CM/PCS for 3 day training) will be ordered on their behalf – cost is $75.00 per training manual (discounted from $100.00 per manual) and will be added to the registration fee.nnContexo ICD-10-CM (Draft) and/or ICD-10-PCS (Draft) – Upon registration participants coding manuals (CM only, or CM/PCS for 3 day training) will be ordered on their behalf – cost is $90.00 per ICD-10 book and will be added to the ration fee. ($180.00 for both CM and PCS books for the 3 day training) (Discounted from $110.00 per book)nn**Book Pick-Up: In order for pre-requisites to be completed prior to the actual course date, participants will be required to pick up their books from 8am – 5pm, at Welter Healthcare Partners headquarters at 6870 W. 52nd Avenue, Suite 102, Arvada, CO 80002 on:n
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Friday, February 28, 2014 – for the March Coder Academy
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Friday, May 30, 2014 – for the June Coder Academy
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nIf you need to make alternative arrangements to pick up your books, please contact Jennifer at 303.534.0388.[/vc_toggle]nn[vc_toggle title=”Academy Pre-Requisites:” size=”sm” el_id=””]nnICD-10-CM Only (day 1):nICD-10-CM Coder Training Manual: Pages 2-82; Reading and accompanying section review questionsnnICD-10-CM-PCS (3 day academy):nICD-10-CM Coder Training Manual: Pages 2-82; Reading and accompanying section review questions and ICD-10-PCS Coder Training Manual: Pages 2-83; Reading and accompanying section review questions[/vc_toggle]nn[vc_toggle title=”Academy Dates and Locations:” size=”sm” el_id=””]nnEnglewood, COnREGISTRATION DEADLINE MARCH 4thnMarch 12-14, 2014n8:00am – 5:00pmn(On 3/13/14 training will be held from 9:00am – 6:00pm)nSwedish Medical Center – Pine B & C Conference Roomn501 E. Hampden AvenuenEnglewood, CO 80113[/threecol_one] [threecol_one]Thornton, COnREGISTRATION DEADLINE May 30thnJune 11-13, 2014n8:00am – 5:00pmnSpine Education & Research Instituten9005 Grant Street, Suite 100nThornton, CO 80229[/threecol_one] [threecol_one_last]ONLINE (web-based) Coder AcademynREGISTRATION DEADLINE June 20thnJuly 8-10 2014n8:00am – 5:00pmnRegistered Participants will have webinar training details emailed to them 72 hours prior to the training.nnParticipant Training Books will be shipped 2 weeks before training. Please provide the address of where books should be shipped on the registration form.[/vc_toggle]n
Academy Registration Fee:
nICD-10-CM Only (Day 1) – $275.00 per participant (plus $165.00 for the training manual and the ICD-10-CM book)nnICD-10-CM-PCS (3 Day Academy) – $800.00 per participant (plus $330.00 for the training manuals and the ICD-10-CM/PCS Books)n
Registration Discounts:
nPractices registering 3+ participants will receive $50.00 off each registration.n
Seating is limited, register now to guarantee your spot today!
nToni Woods, CPC and Whitney Horton, CPC, CCCnMs. Woods and Ms. Horton are AHIMA-Approved ICD-10-CM/PCS Trainers. They are educators and trainers in the areas of ICD-10, physician documentation, Medicare coding and documentation guidelines, ambulatory medicine coding, hospital, and other facility coding and documentation. They work with physician practices of all specialties and are experts in analyzing chart documentation and in reengineering practices to enhance their reimbursement systems and processes, and overall increase revenue and profitability. Their goal is to empower physicians and health care professionals and staff to understand the language of the coding and billing world, and to give them the tools they need for successful reporting and reimbursement of their services. Ms. Woods and Ms. Horton are enthusiastic about the future of ICD-10 and are on the forefront of providing ICD-10-CM/PCS education and implementation processes.
S06.0X0A — Concussion without loss of consciousness, initial encounternnW20.8XXA — Struck by thrown object, bouquet of roses, initial encounternnY93.21 — Activity, figure skating (singles) (pairs)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!
I50.21 — Acute systolic (congestive) heart failurennI25.3 — Aneurysm of heartnn746.87 — Malposition of heart and cardiac apexnnR12 — HeartburnnnIn 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!
nThe compliance date for ICD-10 implementation stands firm at October 1, 2014. ICD-10 will bring monumental changes to all physician practices and hospitals, and they face a significant financial impact; including claims denials, cash flow issues, and decreased productivity, if not adequately prepared for the ICD-10 transition.nn[toggle title_open=”Overview of FREE ICD-10 Seminar and Coffee Klatch Webinar” title_closed=”Overview of FREE ICD-10 Seminar and Coffee Klatch” hide=”yes” border=”yes” style=”default” excerpt_length=”0″ read_more_text=”Read More” read_less_text=”Read Less” include_excerpt_html=”no”]nn Welter Healthcare Partners is hosting a “Coffee Klatch” on February 27th, 2014. The session will take place from 1–3 PM, Mountain Time. This FREE “Coffee Klatch” is an excellent starting point for physician and hospital coders, and will provide an overview of ICD-10 including:n
Discuss ICD-10-PCS Guidelines and Code Structure (15 mins)
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Introduce the 31 root operations in the Medical & Surgical Section of ICD-10-PCS (15 mins)
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Discuss Coder Academy Information (15 mins)
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Q&A (15 mins)[/toggle]
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nREGISTRATION IS CLOSED, AS THIS EVENT HAS PASSED.nnNote: Webinar details will be emailed to participants 72 hours before the event.nn[hr]nnThe team at Welter Healthcare Partners has been hard at work, prepping for some exciting and insightful events! Check out some of our upcoming ICD-10 Training opportunities below.n
nRegistration deadline for March Academy is March 4th.nnnThis interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. Participants will gain the tools they need to appropriately select ICD-10-CM and ICD-10-PCS codes. These training sessions will be coder centric, and the content will be designed for those staff who will be responsible for applying (or verifying) these codes to documentation. Throughout the academy, participants will be given an assortment of scenarios to code to obtain the proficiency they need for coding in ICD-10.nn[toggle title_open=”Overview of ICD-10 Coder Academy” title_closed=”Overview of ICD-10 Coder Academy” hide=”yes” border=”yes” style=”default” excerpt_length=”0″ read_more_text=”Read More” read_less_text=”Read Less” include_excerpt_html=”no”](lunch, snacks and drinks will be provided each day)n
[twocol_one]ICD-10-CM (Day 1)nAHIMA-approved ICD-10-CM/PCS trainers will educate coding staff regarding ICD-10-CM with a focus on:n
n
Convention changes and additions
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Concept changes and additions
n
Chapter specific guideline changes and additions
n
Live coding workshop
n
n**This training has the approval of 8.0 CEU’s from the American Health Information Management Association (AHIMA) (AAPC members can submit these CEU’s to AAPC for credit)nn[/twocol_one] [twocol_one_last]ICD-10-PCS (Days 2 and 3)nn
nAHIMA-approved ICD-10-CM/PCS trainers will educate coding staff regarding ICD-10-PCS with a focus on:n
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The structure of ICD-10-PCS text and codes
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The definition and application of each root operation
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The method by which an ICD-10-PCS code is selected
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Live coding workshops
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n **This training has the approval of 16.0 CEU’s from the American Health Information Management Association (AHIMA) (AAPC members can submit these CEU’s to AAPC for credit)[/twocol_one_last]nn[/toggle]n
CHIEF ICD-10 Implementation Plan: 5 Steps to Success!( for Physicians and Outpatient Coding)
nAs your CHIEF trainer for ICD-10, we will guide your practice and providers through the implementation process to help ensure your practice is ready on October 1, 2014! Our AHIMA-Approved ICD-10-CM/PCS trainers will utilize the CHIEF ICD-10 Implementation Plan, and work closely with your providers, coders, billers, and other staff through each step of the implementation and training process.nn
Step 1:Collect data for your top 25 diagnosis codes (50 for Orthopedics!) and review your providers’ (physicians and mid-levels) current documentation to assess ICD-10 readiness. This step will also include forward-mapping of your top diagnosis codes with ICD-10 cheat-sheets for the providers and staff.
Step 2:Highlight areas of needed training for your coding and billing staff. We will utilize your top diagnosis codes data and documentation reviews performed in step 1, and provide a 4 hour intensive, hands-on training and workshop for your coders and billers. We will also formulate a strategic plan for your coders and billers to continue the review and education process with the providers until the implementation date. CEU’s for your certified coders are given for this training!
Step 3:Implement intensive provider training:nnProvider Training #1: A specialty-specific general overview of ICD-10 for all providers (2 hour group training).nnProvider Training #2: One-on-one education with each of the providers (1 hour per provider) to assess their ICD-10 readiness using results from the documentation reviews performed in step 1, and practical tips on how to improve documentation going forward. We recommend that your coding and/or billing staff participate in these one-on-one trainings so they are comfortable continuing the review and education process with the providers until the implementation date.
Step 4:Evaluate EHR, PM, and Clearinghouse readiness. On your behalf we will prepare a “System(s) Readiness Guide” and query vendors on their readiness and routinely provide materials and updates on vendor status to help ensure your revenue stream will not be affected by this transition. We will also provide your staff with a plan to follow up on targeted vendor deadlines.
Step 5:Follow-up provider ICD-10 documentation reviews and additional provider training. Final consultation with your staff on system and vendor readiness.
T68.XXXA — HypothermiannX31.XXXA — Exposure to excessive natural cold, initial encounternnY93.24 — Activity, cross country skiingnnIn 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!
The team at Welter Healthcare Partners has been hard at work, prepping for some exciting and insightful events! Check out some of our upcoming ICD-10 Training opportunities below.n
nRegistration deadline for March Academy is March 4th.nnnThis interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. Participants will gain the tools they need to appropriately select ICD-10-CM and ICD-10-PCS codes. These training sessions will be coder centric, and the content will be designed for those staff who will be responsible for applying (or verifying) these codes to documentation. Throughout the academy, participants will be given an assortment of scenarios to code to obtain the proficiency they need for coding in ICD-10.nn[toggle title_open=”Overview of ICD-10 Coder Academy” title_closed=”Overview of ICD-10 Coder Academy” hide=”yes” border=”yes” style=”default” excerpt_length=”0″ read_more_text=”Read More” read_less_text=”Read Less” include_excerpt_html=”no”](lunch, snacks and drinks will be provided each day)n
[twocol_one]ICD-10-CM (Day 1)nAHIMA-approved ICD-10-CM/PCS trainers will educate coding staff regarding ICD-10-CM with a focus on:n
n
Convention changes and additions
n
Concept changes and additions
n
Chapter specific guideline changes and additions
n
Live coding workshop
n
n**This training has the approval of 8.0 CEU’s from the American Health Information Management Association (AHIMA) (AAPC members can submit these CEU’s to AAPC for credit)nn[/twocol_one] [twocol_one_last]ICD-10-PCS (Days 2 and 3)nn
nAHIMA-approved ICD-10-CM/PCS trainers will educate coding staff regarding ICD-10-PCS with a focus on:n
n
The structure of ICD-10-PCS text and codes
n
The definition and application of each root operation
n
The method by which an ICD-10-PCS code is selected
n
Live coding workshops
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n **This training has the approval of 16.0 CEU’s from the American Health Information Management Association (AHIMA) (AAPC members can submit these CEU’s to AAPC for credit)[/twocol_one_last]nn[/toggle]n
nThe compliance date for ICD-10 implementation stands firm at October 1, 2014. ICD-10 will bring monumental changes to all physician practices and hospitals, and they face a significant financial impact; including claims denials, cash flow issues, and decreased productivity, if not adequately prepared for the ICD-10 transition.nnWe are offering 2.0 CEUs for this session, so make sure to register early!nn[toggle title_open=”Overview of FREE ICD-10 Seminar and Coffee Klatch” title_closed=”Overview of FREE ICD-10 Seminar and Coffee Klatch” hide=”yes” border=”yes” style=”default” excerpt_length=”0″ read_more_text=”Read More” read_less_text=”Read Less” include_excerpt_html=”no”]nn Welter Healthcare Partners is hosting two “Coffee Klatches” on February 11th, 2014. The morning session will take place from 8–10 AM and the afternoon from 2–4 PM. This FREE “Coffee Klatch” is an excellent starting point for physician and hospital coders, and will provide an overview of ICD-10 including:n
CHIEF ICD-10 Implementation Plan: 5 Steps to Success!( for Physicians and Outpatient Coding)
nAs your CHIEF trainer for ICD-10, we will guide your practice and providers through the implementation process to help ensure your practice is ready on October 1, 2014! Our AHIMA-Approved ICD-10-CM/PCS trainers will utilize the CHIEF ICD-10 Implementation Plan, and work closely with your providers, coders, billers, and other staff through each step of the implementation and training process.nn
Step 1:Collect data for your top 25 diagnosis codes (50 for Orthopedics!) and review your providers’ (physicians and mid-levels) current documentation to assess ICD-10 readiness. This step will also include forward-mapping of your top diagnosis codes with ICD-10 cheat-sheets for the providers and staff.
Step 2:Highlight areas of needed training for your coding and billing staff. We will utilize your top diagnosis codes data and documentation reviews performed in step 1, and provide a 4 hour intensive, hands-on training and workshop for your coders and billers. We will also formulate a strategic plan for your coders and billers to continue the review and education process with the providers until the implementation date. CEU’s for your certified coders are given for this training!
Step 3:Implement intensive provider training:nnProvider Training #1: A specialty-specific general overview of ICD-10 for all providers (2 hour group training).nnProvider Training #2: One-on-one education with each of the providers (1 hour per provider) to assess their ICD-10 readiness using results from the documentation reviews performed in step 1, and practical tips on how to improve documentation going forward. We recommend that your coding and/or billing staff participate in these one-on-one trainings so they are comfortable continuing the review and education process with the providers until the implementation date.
Step 4:Evaluate EHR, PM, and Clearinghouse readiness. On your behalf we will prepare a “System(s) Readiness Guide” and query vendors on their readiness and routinely provide materials and updates on vendor status to help ensure your revenue stream will not be affected by this transition. We will also provide your staff with a plan to follow up on targeted vendor deadlines.
Step 5:Follow-up provider ICD-10 documentation reviews and additional provider training. Final consultation with your staff on system and vendor readiness.
With the go-live date rapidly approaching, hospitals and health systems need to make ICD-10 a priority if they want to avoid costly surprises and setbacks.
nThis article appears in the December issue of HealthLeaders magazine.nnDespite the continued objections of some healthcare industry groups, all indications are that the Centers for Medicare & Medicaid Services intends to hold steady with its Oct. 1, 2014, ICD-10 implementation date. With less than a year to go, savvy provider organizations are planning and budgeting for every stage of the conversion process in order to diminish the economic impact wherever possible and to prepare for the expenses they will inevitably incur.nnKaren Testman, chief financial officer at MemorialCare Health System, a Long Beach, Calif.–based six-hospital institution with fiscal year 2012 revenues of $1.8 billion, says her organization is budgeting for five areas related to ICD-10 implementation: computer-assisted coding, comprehensive clinical documentation improvement, HIM training, the systemwide IT component, and training and education.nn”We’ve already had a clinical documentation improvement program in place, but this is really about spending the time and effort and money to build out our Epic electronic medical system and design templates to help physicians document correctly and completely in the system,” she says. “By February, we will be coding everything in ICD-10, and we will be mapping back to ICD-9 to get our bills out.”nnAll told, Testman says MemorialCare expects to spend $24 million to implement ICD-10 in its hospital business and $8 million on the physician side of the organization. Additionally, the system anticipates that ICD-10 will add $800,000 to $850,000 to its annual budget on an ongoing basis.nn”It’s a huge amount of money, and the majority of the cost is operating expenses that can’t be capitalized. You can’t capitalize training,” she says.nnAlthough she believes the system’s early adoption plans will help it mitigate much of the lost staff productivity that many providers are expecting when ICD-10 goes live, she says there will be other staff-related costs.n
Preparing for long-term costs
n”There will be some long-term costs that will never go away. We’ll be adding four coder FTEs on the hospital side, and that will be a permanent cost,” she says, noting she does not expect to add coders on the physician side.n
J09.X1 — Avian Influenza with pneumoniannJ09.X1 — Swine influenza with other respiratory manifestationsnnJ09.X3 — Influenza A with gastrointestinal manifestationsnnIn 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!
The Centers for Medicare & Medicaid Services (CMS) has taken its first step toward improving its efforts to ensure the effectiveness, efficiency, economy, and quality of care quality for Medicare beneficiaries in through the Quality Improvement Organization (QIO) Program.nnLast week, the federal agency announced the selection of Livanta LLC and KePRO as Beneficiary and Family Centered Care (BFCC) would be responsible for the program’s case review and monitoring activities at a broader level than the traditional QIO activities taking place at a more local level.nnBetween them, the two BFCC QIOs will oversee five geographic areas — Livanta (Areas 1, 5), KePRO (Areas, 2–3) — of the United States and its territories:n
ICD-10 Compliance Date
Successful population health management is not possible without data. The form that information takes depends on the role being played by a particular player in population health management: provider, patient, or payer.nnWith passage of the 
“What Medicare has put out there is being used as a guideline, but there is unfortunately not one roadmap,” explains Primozic Kasim. “It is a real challenge for payers in looking at the types of quality metrics they are going to use as different programs pop up, including what they do with the federal government if they choose to play there. There are so many quality metrics that they are challenged to keep up with them.”nnOne thing that is clear to payers is the need to understand individuals as consumers as well as patients where Primozic Kasim sees great potential for improvement.nn“There isn’t one-size-fits-all just like there’s not one type of consumer or patient,” she stresses. “It’s really about trying to reach people by respecting their different healthcare literacy overall, their social use of technology, their access to technology, and what’s going to hit home with them because there are different messages and cultural and demographic concerns as to how to reach people.”nnAccording to the research director, certain payers have a leg up on others in the makeup of their patient populations. “The ones that have more of a target population, such as the Medicaid and Medicare Advantage plans, have an advantage over the larger national plans because their patient population is a lot more focused and more centered geographically as opposed to those plans that are trying to cover everybody in different market segments,” claims Primozic Kasim.nnGetting to know their patient populations is leading payers toward gathering intelligence through business and clinical analytics solutions and services. Given the inchoate of healthcare analytics choosing the right vendor partner or partners is not an easy one.nn“In terms of analytics, there is not one vendor that has a complete, defining market share,” says Primozic Karim. “There are many companies out there doing everything from the backend edge server to some of the more clinical analytics and looking at population health of these exchange populations because clearly setting premiums for this is going to be key to moving forward.”nnFor value to replace volume in healthcare, premiums and reimbursements must be properly configured. Without meaningful insight into the needs of the provider and patient populations, payers will not be able to rise to the requirements of this new era in healthcare.nnSource: www.ehrintelligence.com; Kyle Murphy; April 30, 2014.
This is just a short delay to the industry’s inevitable transition away from the 30 year old ICD-9 to ICD-10. ICD-10 is coming and Welter Healthcare Partners, Inc. is pulling out all the stops to help our clients prepare for it and be successful. nnICD-10 is a richer data set allowing for more data to be used and transmitted. It will absolutely help the industry document care, document what treatments and modality’s work and how well they work. It will allow providers to better describe their services and why they are necessary.nnICD-10 will also help tremendously as we continue to transition away from a fee-for-service system of reimbursement to a quality and outcomes based reimbursement system like physician centric bundled or episodic payments.nnWe are excited about ICD-10 and the opportunity it will bring to our clients and the industry. We encourage providers, practices, and hospitals to continue training efforts already underway. Determine deficiencies now, as the clinical documentation improvement process and getting your staff proficient with the ICD-10 code set can take time! Take advantage of being ahead of the game! If you haven’t started, we encourage you to do so as this is a huge transition and being completely prepared is the only way to prevent negative impacts on productivity and revenue!n
W56.01XA — Bitten by dolphinnnW56.22XA — Struck by orcannW58.13XA — Crushed by crocodilennW61.09XA — Other contact with parrotnnIn 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, 2015 implementation date. Please don’t hesitate to 
The Senate voted today, (March 31st) to delay the switch to ICD-10 billing codes to October 2015. This is just a short delay to the industry’s inevitable transition away from the 30-year old ICD-9 to ICD-10. ICD-10 is coming and Welter Healthcare Partners, Inc. is pulling out all the stops to help our clients prepare for it and be successful.nnICD-10 is a richer data set allowing for more data to be used and transmitted. It will absolutely help the industry document care, document what treatments and modalty’s work and how well they work. It will allow providers to better describe their services and why they are necessary. ICD-10 will also help tremendously as we continue to transition away from a fee-for-service system of reimbursement to a quality and outcomes based reimbursement system like physician centric bundled or episodic payments. We are excited about ICD-10 and the opportunity it will bring to our clients and the industry.nnWe encourage providers and practices to continue any training efforts already started, as the clinical documentation improvement process and getting your staff proficient with ICD-10 can take time! Take advantage of being ahead of the game! If you haven’t started, we encourage you to do so as this is a huge transition and being fully prepared is the only way to prevent productivity and revenue loss!
The 2014 Medicare Physician Fee Schedule (MPFS) final rule stipulated a negative update to the MPFS that was to be effective January 1, 2014. That reduction was averted for three months with the passage of the Pathway for SGR Reform Act of 2013, which provided for a 0.5 percent update for services paid under the MPFS through March 31, 2014.nnCMS is hopeful that there will be congressional action to prevent the negative update from taking effect on April 1, 2014. CMS has instructed the Medicare Administrative Contractors to hold claims containing services paid under the MPFS for the first 10 business days of April (i.e., through April 14, 2014). This hold would only affect MPFS claims with dates of service of April 1, 2014, and later. The hold should have minimal impact on provider cash flow, because under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 days for paper claims) after the date of receipt. All claims for services delivered on or before March 31, 2014, will be processed and paid under normal procedures, regardless of any Congressional actions.
Z73.1 — Type A behavior patternnnZ73.2 — Lack of relaxation and leisurennZ73.3 — Stress, not elsewhere classifiednnIn 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 
If you’re still banking on an ICD-10 delay, you might want to prepare yourself for yet another disappointment. At HIMSS14 last week, CMS Administrator Marilyn Tavenner stated once again that no such postponement is in the cards, and providers either need to get ready or prepare to stop getting paid. “There are no more delays and the system will go live on October 1,” Tavenner said during her keynote address to attendees of the conference in Orlando, Florida. “Let’s face it guys, we’ve delayed this several times and it’s time to move on.”nnThe deadline has many stakeholders worried about the impact of the hard cut-over from ICD-9 to ICD-10, with some vendors still developing ICD-10 compliant products and many providers and payers deeply concerned about inadequate testing procedures before the new code set goes live. While the Medicare testing week is taking place as we speak, and CMS recently announced a limited end-to-end pilot for some sample providers, the generally lackluster effort to engage the industry in testing has a number of experts on edge.nnAmong the most vocal about the upcoming doomsday is the American Medical Association, which has been advocating for an indefinite postponement of the new codes. In response to Tavenner’s latest remarks, AMA President Ardis Dee Hoven, MD, said, “Many physicians are still waiting for their vendors to deliver updated software they need to use the ICD-10 codes. The later physicians receive this software, the harder it will become to test it out before the October 1ICD-10 deadline.”nn“Testing is needed to discover problems and resolve them prior to the go live date. The slightest glitch in the ICD-10 rollout could potentially cause a billion dollar back-log of medical claims that jeopardizes physician practices and disrupts patients’ access to care,” Hoven continued in a public statement. “The AMA is deeply concerned that Medicare does not have a back-up plan if last minute testing demonstrates anticipated problems with this massive coding transition. At the end of the day sticking hard and fast to the ICD-10 deadline without a back-up plan to address disruptions in medical claims processing will hurt doctors and their patients.”nnTo help providers overcome the big hurdles standing between them and ICD-10 success, CMS has released a flurry of transition tools, such as detailed end-to-end preparation checklists and resources from its eHealth University. Educational sessions at HIMSS14, including a Q&A presentation by the HIMSS ICD-10 Taskforce, also attempted to prepare providers for the upcoming changes.nnTavenner’s assertion is the latest in a series of CMS statements reaffirming the October 1 transition date. As early as August of 2013, Pat Brooks, RHIA, Senior Technical Advisor at CMS, warned providers that there would be no extensions, and urged the industry to listen. “There will be no more delays,” she said during a National Provider Call. “Those who are postponing ICD-10 implementation planning, thinking there might be additional delays, should really begin to plan implementation now. There will be no more delays to the ICD-10 implementation date.”nnSource: www.ehrintelligence.com; Jennifer Bresnick; March 4, 2014.
This ICD-10 Coffee Klatch webinar is an informative review and excellent starting point for physician and hospital coders. Ms. Toni Woods and Ms. Whitney Horton, both AHIMA-Approved ICD-10-CM/PCS Trainers, will give viewers a glimpse of Welter Healthcare Partners’s formal ICD-10 Coder Academies and training, and provide an overview of ICD-10 Coding Conventions, Chapter Guidelines, Code Structures and an introduction to the 31 root operations in the Medical and Surgical sections of ICD-10-PCS.nn
Welter Healthcare Partners is proud to announce the addition of a webinar offering of the ICD-10 Coder Academy! nnThis session will take place July 8–10, 2014 with the registration deadline being May 30th. Registered Participants will have webinar training details emailed to them 72 hours prior to the training. Participant Training Books will be shipped 2 weeks before training. Please provide the address of where books should be shipped on the registration form.nnThis interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. Participants will gain the tools they need to appropriately select ICD-10-CM and ICD-10-PCS codes. These training sessions will be coder centric, and the content will be designed for those staff who will be responsible for applying (or verifying) these codes to documentation. Throughout the academy, participants will be given an assortment of scenarios to code to obtain the proficiency they need for coding in ICD-10.nnParticipants only needing ICD-10-CM training (physician and outpatient coding) should register for the first day of the academy only (Day 1).nnParticipants needing ICD-10-PCS training (hospital/inpatient coding) will need to register for the entire 3-day academy.n
S06.0X0A — Concussion without loss of consciousness, initial encounternnW20.8XXA — Struck by thrown object, bouquet of roses, initial encounternnY93.21 — Activity, figure skating (singles) (pairs)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 
I50.21 — Acute systolic (congestive) heart failurennI25.3 — Aneurysm of heartnn746.87 — Malposition of heart and cardiac apexnnR12 — HeartburnnnIn 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 
T68.XXXA — HypothermiannX31.XXXA — Exposure to excessive natural cold, initial encounternnY93.24 — Activity, cross country skiingnnIn 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 
With the go-live date rapidly approaching, hospitals and health systems need to make ICD-10 a priority if they want to avoid costly surprises and setbacks.
J09.X1 — Avian Influenza with pneumoniannJ09.X1 — Swine influenza with other respiratory manifestationsnnJ09.X3 — Influenza A with gastrointestinal manifestationsnnIn 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