CMS UPDATE FOR HIM PROFESSIONALS


Here is some great information and access to some useful resources via CMS:

Latest News

MLN Connects™ National Provider Call: Transitioning to ICD-10
Wednesday, November 5; 1:30-3pm ET
To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.
HHS has issued a rule finalizing October 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. During this MLN Connects™ National Provider Call, CMS subject matter experts will discuss ICD-10 implementation issues, opportunities for testing, and resources. A question and answer session will follow the presentations.Register or visit the November 5 call web page for more information.
Agenda:

• Final rule and national implementation
• Medicare Fee-For-Service testing
• Medicare Severity Diagnosis Related Grouper (MS-DRG) Conversion Project
• Partial code freeze and annual code updates
• Plans for National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)
• Home health conversions
• Claims that span the implementation date

Target Audience: Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers
Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.

Deadline for ICD-10 Allows Health Care Industry Ample Time to Prepare For Change
The U.S. Department of Health and Human Services (HHS) has issued a rule finalizing Oct. 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. This new deadline gives providers, insurance companies, and others in the health care industry time to ramp up their operations to ensure their systems and business processes are ready to go on Oct. 1, 2015.
For more information read the rule or view the press release.
New Medscape Education Resources
CMS has released three new Medscape Education modules to help providers prepare for ICD-10. The new resources are available on the Provider Resources page. Continuing medical education (CME) and nursing continuing education (CE) credits are available to health care professionals who complete the learning modules, but anyone can take them and receive a certificate of completion.  If you are a first-time visitor to Medscape, you will need to create a free account to access these resources.
• Video: ICD-10: Getting From Here to There -- Navigating the Road Ahead
• Video: ICD-10 and Clinical Documentation
• Expert Column: Preparing for ICD-10: Now Is the Time
Road to 10:  CMS Online Resource for Small Practices
CMS has released “Road to 10,” an online resource built with the help of providers in small practices. This tool is designed to help small medical practices jumpstart their ICD-10 transition.
“Road to 10” includes specialty references and gives providers the capability to build ICD-10 action plans tailored for their practice needs.
Successful Results from CMS ICD-10 Acknowledgement Testing Week
In March 2014, the Centers for Medicare & Medicaid Services (CMS) conducted a successful ICD-10 testing week. Testers submitted more than 127,000 claims with ICD-10 codes to the Medicare Fee-for-service (FFS) claims systems and received electronic acknowledgements confirming that their claims were accepted. Read more about the results of the testing in this CMS eHealth blog.
CMS eHealth University
CMS eHealth University, a resource to help providers understand, implement, and successfully participate in ICD-10 and other CMS eHealth programs, features a full curriculum of materials and information, all in one location. The education modules are organized by level, from beginner to advanced, and simplify complex information in a variety of formats, including fact sheets, guides, videos, checklists, webinar recordings, and more.
Visit eHealth University website to find resources to help you prepare for the compliance date.
CMS/WEDI Implementation Success Initiative
The Workgroup for Electronic Data Interchange (WEDI) is partnering with CMS and other public and private organizations to develop the ICD-10 Implementation Success Initiative. The first phase of the Initiative, a searchable database of ICD-10 issues, is open to the public to submit questions.  WEDI, CMS, and industry partners will update the database with information and resources to help health care organizations who submit issues understand how the new codes and standards will affect reporting of diagnoses and inpatient procedures.
The goal of this initiative is to ensure a successful ICD-10 transition for all stakeholders, including health care providers, payers, clearinghouses, and vendors.
Stay up to date on ICD-10!
Sign up for CMS ICD-10 Email Updates and follow us on Twitter.

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• Page last Modified: 10/08/2014 10:18 AM

J.J. WATT QUOTE

I typically ignore the myriad of quotes and quips that saturate social media these days but this one caught my eye:


"SUCCESS ISN'T OWNED, IT'S LEASED. AND THE RENT IS DUE EVERY DAY"


Wouldn't it be great if everyone embraced this wisdom? It applies to our personal lives as well as our professional lives. So if you are a Revenue Cycle Leader, HIM Director, Hospital CFO or some other key role player, be sure to pay your rent :)


Hope you enjoyed reading this as much as I enjoyed sharing it. We at Nearterm practice it every day!


Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

Nearterm at the AHIMA 2014

Thank you to everyone who came to the Nearterm booth at the AHIMA 2014 in San Diego. You made our show a great success.

Revenue Cycle DRP

REVENUE CYCLE DISASTER RECOVERY PLANNING (DRP) IS CRITICAL

Most hospitals have highly detailed disaster plans that are mostly focused on direct patient care issues and that is absolutely the appropriate focus. However, we as revenue cycle professionals advocate the reminder that cash flow is a critical when disaster strikes. The following wikipedia link articulates DRP issues fairly well - http://en.wikipedia.org/wiki/Disaster_recovery_plan

Here are a few questions to think about as you review your revenue cycle disaster plan:

• What is the increased volume capacity of the hospital and how would sudden increased volume caused by a disaster and perhaps sustained for several weeks impact registration, coding, billing and collections? For example, if you are accustomed to X OP/ED visits and Y census, what happens if volumes increase to hospital capacity? Is it a 25% increase, 40% or more? If your system is down and staff can't get to work, what is the plan?
• How quickly can EHR's, subsidiary AR ledgers, patient account histories and other data be accessed and what would the process be to do it?
• Is there a resource in the revenue cycle operation that is well versed in securing funds from various agencies that are involved in disaster relief?

Generally, 99% of hospital employees live in the immediate area surrounding the facility. They are therefore in the effected area and most are either dealing with personal trauma or in other cases they are patients. But the work of financial and revenue cycle professionals must continue in order to maintain patient services and to support the viability of the hospital. This includes management and technicians as well.

The contemporary and increasing practice of using remote hospital resources for certain functions is an option to consider, not only during disaster conditions but routinely. This option delivers an experienced labor pool and/or leadership team when the need arises.

Nearterm is in the business of providing interim resources to healthcare providers as part of the business model. Nearterm has clients routinely accessing this model as part of their routine non-disaster operation but it is easily applied when providers face disaster management challenges. Resources might include senior financial leaders, department heads, HIM Directors, Patient Financial Service Managers, Coding Managers, Collectors, Billers, call center personnel and more.

We are always interested in sharing solutions developed by hospitals and colleagues. Please feel free to share your experience by responding to this blog. If you would like to hear more about how we can be of assistance or simply get acquainted, let's talk.

Jim Matthews; Nearterm Corporation

(281) 646-1330

jmatthews@nearterm.com

AHIMA 2014 Conference, San Diego, CA

The AHIMA Convention is not only a great opportunity to access cutting edge education and thought leadership, it is also a great way to meet new healthcare industry friends and strengthen existing relationships. I hope you will stop by the exhibit hall and come see us at BOOTH 1041. We would love to meet you. Be sure to enter the drawing for an iPad 2!

Check it out at the AHIMA website http://www.ahima.org/convention

TxHIMA 2014 Conference

Thank you to everyone who visited Nearterm's HIM Team at TxHIMA. Congratulations to Betty Janak, RHIA for winning the gift card drawing.

THERE'S A CODE FOR THAT!

I found this coding article very entertaining and also provocative. If you are an HIM professional, you are probably already familiar with some of this but the perspective reflected in this blog is amusing nonetheless. If you have similar or new perspectives, please share with us at www.nearterm.com .

Burn Due to Water Skis on Fire? - There's an ICD-10 Code For That

Struck by a Turtle? Walked Into a Lamppost? Hurt While Crocheting? Burn Due to Water Skis on Fire? – There’s a Code for that.
Don’t you hate those burns you get when your water skis catch on fire? Speaking of burning water skis, will your practice sink or swim through the ICD-10 transition? ICD-10 is a massive change and the impact cannot be understated for physicians and the financial health of their practices. GroupOne was there for our clients through 5010, for meaningful use and when they transitioned to paperless EHR systems. GroupOne’s RCM clients will not have to face the ICD-10 challenge alone.
In addition to providing ICD-10 training sessions for its providers, GroupOne’s partner practices will also have access to ICD-10 trained certified coders and reimbursement experts, who will monitor coding and documentation for proper ICD-10 compliance. 
Furthermore, GroupOne will also provide its clients with access to clinical interface terminology technology.  The tool interfaces the standard ICD-9-CM / ICD-10 driven terminology in the EHR search with an improved 260,000+ term search that expresses clinical intent while at the same time providing the correct coding for the intent.  The tool solves the problem of forcing clinicians to remember and use the often awkward and cumbersome ICD-9/ ICD-10 coding language when documenting in an EHR. A client survey shows the 93% of users are more satisfied with EHR when this tool is utilized. The tool also aids with Meaningful Use Compliance and is already mapped to ICD-10. This tool greatly simplifies the transition to ICD-10 for clinicians eliminating much of the need to learn a completely new coding terminology.
Excerpts from an earlier Wall Street Journal article are included below. Some may find this interesting / amusing. ICD-10 is a good reason for medical practice to partner with a professional revenue cycle management (RCM) firm like GroupOne Health Source.

 By ANNA WILDE MATHEWS - Wall Street Journal
Today, hospitals and doctors use a system of about 18,000 codes to describe medical services in bills they send to insurers. Apparently, that doesn't allow for quite enough nuance.
A Code for What Ails You
Search for diagnoses codes from the International Classification of Diseases, 10th Revision, by typing in a keyword. We've provided a few to get you started.
A new federally mandated version will expand the number to around 140,000—adding codes that describe precisely what bone was broken, or which artery is receiving a stent.
It will also have a code for recording that a patient's injury occurred in a chicken coop. (See code.)
Indeed, health plans may never again wonder where a patient got hurt. There are codes for injuries in opera houses (see code), art galleries (see code), squash courts (see code) and nine locations in and around a mobile home (see codes), from the bathroom to the bedroom.
Health insurers, doctors and hospitals are bracing for chaos as they prepare to adopt a new federally mandated format for medical billing. Anna Wilde Mathews has details on Lunch Break.
Some doctors aren't sure they need quite that much detail. "Really? Bathroom versus bedroom?" says Brian Bachelder, a family physician in Akron, Ohio. "What difference does it make?"
The federal agencies that developed the system—generally known as ICD-10, for International Classification of Diseases, 10th Revision—say the codes will provide a more exact and up-to-date accounting of diagnoses and hospital inpatient procedures, which could improve payment strategies and care guidelines. "It's for accuracy of data and quality of care," says Pat Brooks, senior technical adviser at the Centers for Medicare and Medicaid Services.
Billing experts who translate doctors' work into codes are gearing up to start using the new system in two years. They say the new detail is welcome in many cases. But a few aspects are also causing some head scratching.
W61.11XA: A code for injuries related to macaws.
Some codes could seem downright insulting: R46.1 is "bizarre personal appearance (see code)," while R46.0 is "very low level of personal hygiene (see code)."
It's not clear how many klutzes want to notify their insurers that a doctor visit was a W22.02XA, "walked into lamppost, initial encounter" (or, for that matter, a W22.02XD, "walked into lamppost, subsequent encounter").
Why are there codes for injuries received while sewing, ironing, playing a brass instrument, crocheting, doing handcrafts, or knitting—but not while shopping, wonders Rhonda Buckholtz, who does ICD-10 training for the American Academy of Professional Coders, a credentialing organization.
Code V91.07XA, which involves a "burn due to water-skis on fire (see codes)," is another mystery she ponders: "Is it work-related?" she asks. "Is it a trick skier jumping through hoops of fire? How does it happen?"
Much of the new system is based on a World Health Organization code set in use in many countries for more than a decade. Still, the American version, developed by the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services, is considerably more fine-grained.
Y93.J4: A code for injuries received while playing brass instruments.
The WHO, for instance, didn't see the need for 72 codes about injuries tied to birds. But American doctors whose patients run afoul of a duck (see codes), macaw (see codes), parrot (see codes), goose (see codes), turkey (see codes) or chicken (see codes) will be able to select from nine codes for each animal, notes George Alex, an official at the Advisory Board Co., a health-care research firm.
There are 312 animal codes in all, he says, compared to nine in the international version. There are separate codes for "bitten by turtle" and "struck by turtle." (See codes.)
U.S. hospitals and insurers are bracing for possible hiccups when the move to ICD-10 happens on Oct. 1, 2013 (delayed until Oct 1, 2014), even though they've known it was coming since early 2009.
"You have millions of transactions flowing in the health-care system and this is an opportunity to mess them all up," says Jeremy Delinsky, chief technology officer for athenahealth Inc.
Medicare officials say they believe many big insurers and hospital systems are making preparations, but there may be some issues with smaller ones that won't be ready.
With the move to ICD-10, the one code for suturing an artery will become 195 codes, designating every single artery, among other variables, according to OptumInsight, a unit of UnitedHealth Group Inc. A single code for a badly healed fracture could now translate to 2,595 different codes, the firm calculates. Each signals information including what bone was broken, as well as which side of the body it was on.
Some companies hope to grab business from the shift. One medical-coding website operator, Find A Code LLC, has created a series of YouTube videos with the tagline, "Yeah, there's a code for that." Snow White biting the poisoned apple, the firm says, may be a case of T78.04, "anaphylactic shock due to fruits and vegetables (see codes)." On April 1, the company posted a document with the secret "X-codes" to describe medical conditions stemming from encounters with aliens.
Other coding cognoscenti spot possible hidden messages in the real codes. The abbreviation some use for the new system itself, I10, is also a code for high blood pressure. Several codes involving drainage devices end in "00Z." Then there are two of the codes describing sex-change operations that end in N0K1 and M0J0. "You could see it ripple through the room as people said, 'nookie and mojo!'" says Kathryn DeVault, who has been teaching ICD-10 classes for the American Health Information Management Association. "Was it purposeful? We don't know."

AHIMA 2013 Conference

The AHIMA Convention is not only a great opportunity to access cutting edge education and thought leadership, it is also a great way to meet new healthcare industry friends and strengthen existing relationships. I hope you will stop by the exhibit hall and come see us at BOOTH 834. We would love to meet you and we are giving away an iPad 2!

Check it out at the AHIMA website http://www.ahima.org/convention

NEARTERM EXPANDS AS WE KICK OFF 2013!

Thanks to our prestigious clients, successful business strategy and diligent employee owners, Nearterm again expands. We have brought aboard additional professional staff and upgraded offices as we approach 2013 with excitement and confidence. If you would like to learn more about our revenue cycle services and how Nearterm can help you, let's talk.

 

We wish all of our friends and associates a Very Happy and Prosperous New Year!

 

Jim Matthews

jmatthews@nearterm.com

REVENUE CYCLE EFFICIENCY

Most of the 8,700 layoffs this year were non-clinical jobs. The Bureau of Labor Statistics leads to dire projections as we move into 2013. As revenue cycle professionals, we have always been challenged to streamline revenue cycle operations, reduce revenue cycle labor cost and become more efficient. I submit that the challenge is now a mandate. Check this out.......

News in brief - Nov. 5, 2012

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Hospital mass layoffs for 2012 expected to match 2011’s numbers -At-risk teens interested in seeing their medical records online

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Hospital mass layoffs for 2012 expected to match 2011’s numbers

Thirteen mass layoffs occurred in hospitals in September, affecting 817 people, according to a monthly report released Oct. 23 by the U.S. Bureau of Labor Statistics. If numbers hold steady for the remainder of 2012, the industry is on track to have a similar annual count of mass layoffs as it did in 2011.
Ninety-three layoff incidents occurred in the first nine months of 2012, leading 6,529 people to claim unemployment benefits. At this rate, the year would end with about 124 mass layoff incidents with roughly 8,700 people affected. This is comparable to the totals for 2011, which had 121 mass layoffs with 8,098 people losing their jobs.
The BLS does not break numbers down by occupation, but people who hire health workers say administrative rather than clinical staff tend to be most at risk of losing their jobs during mass layoffs.A mass layoff is defined as a minimum of 50 people losing their jobs from one company at the same time. Smaller incidents are not counted. is startling as we consider mass layoff statistics for hospitals in 2011 and 2012.
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At Nearterm, we specialize in assisting provider organizations toward more effective revenue cycle practices through revenue cycle process improvement, better use of revenue cycle technology and revenue cycle management practices.Our revenue cycle consultants, HIM Professionals and interim leaders deliver results. If we can help as you brace for future revenue cycle mandates or if you simply want to share speculation about how the revenue cycle will "morph" in the future, let's talk.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

 

EMR EFFICACY

A practical observation presented in this article and the cited study is that whether medical records are maintained hard copy or electronically, the source is still the same - people. In either environment, providers will continue to be challenged toward improving accuracy and the consequences are far reaching . Check it out;

http://medcitynews.com/2012/12/electronic-medical-records-not-a-panacea-for-patient-safety-problems/

If you are a CFO, HIM Professional or have a role in Health Information Management, you may find this snippet insightful. If you would like assistance with process innovation supporting your HIM, EMR or related revenue cycle objectives, let's talk.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

DRESS FOR SUCCESS

For a lot of hospital employees, dress code is a matter of policy. However, in revenue cycle operations, HIM, hospital finance and other non-clinical work environments, there is greater flexibility regarding attire. Read the article below and think about how your appearance may impact your career.

http://under30ceo.com/4-ways-dress-success-increasingly-casual-workplace/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Under30CEOAll+%28Under30CEO%29

Jim Matthews
Principal; Nearterm Corporation
jmatthews@nearterm.com