Almost a year after the world of coding was transformed by the implementation of ICD-10-CM/PCS, CMS released the 2017 ICD-10-CM Official Guidelines for Coding and Reporting along with more than 5,000 diagnosis and procedure code changes. The new codes and guidelines went into effect October 1, but not without some controversy. Many of the changes were praised for the increased clarity and level of detail they allow providers to capture. Other changes, though, raised questions and eyebrows and left some wondering what the Cooperating Parties may have intended.
Most healthcare systems already have a proven process in place to monitor revenue integrity and ensure correct reimbursement. Beyond the day-to-day revenue cycle staff involved in revenue integrity, more than 60% of hospital executives believe revenue integrity is essential to their organization’s financial stability and sustainability, according to a survey by Craneware, Inc.
Today’s HIM professional needs to understand the various programs and the impact that coding and documentation may have on an organization’s performance. By 2018, 50% of Medicare payments will be tied to value-based alternative payment models.
As HIMB’s 30th year comes to a close, we look back on a year of exciting developments and new challenges. Both HIMB and the HIM profession have seen their share of changes over the past 30 years, and this year was no exception.
Most of us are familiar with ICD-10-CM through picking codes from a list in our EHRs or perusing a printed code book. Allow me to suggest that unless we understand the coding rules in the ICD-10-CM Official Guidelines, we may mistakenly pick the wrong code, leading to a potential false claim.
The recent adoption of a refined version of the Patient Safety Indicator (PSI) 90 composite by the Agency for Healthcare Research and Quality (AHRQ) has a significant impact on what discharges are included in PSI 15 (Unrecognized Abdominopelvic Accidental Puncture Laceration Rate).