The 2017 ICD-10-CM updates included a significant number of additions to digestive system diagnoses, especially codes for pancreatitis and intestinal infections. These codes are largely focused in the lower gastrointestinal (GI) tract, and a review of the anatomy of this body system could help improve accurate documentation interpretation and code selection.
The 30-day all cause acute myocardial infarction (AMI) mortality outcome measure has been linked to hospital payments since the inception of the Hospital Value-Based Purchasing Program (HVBP) in fiscal year 2013. In February 2016, CMS announced that 70% of commercial payers have agreed to use this measure as one of the cardiology outcomes linked to payment.
Even though we are set to inaugurate a new president of the United States who vowed to abolish Obamacare, I believe that Donald J. Trump will not touch provisions that address perceived cost inefficiency or quality within our healthcare system. In fact, if you’ve read CMS’ game plan for transforming healthcare published in JAMA in 2014, note that many of these provisions began with George W. Bush and have been embraced by the AMA with the implementation of MACRA.
The implementation of ICD-10 in 2015 was considered an industrywide success. Coders were trained, HIM departments were prepared, and outsourced coding companies expanded their roles. As we enter the second year of ICD-10, what should HIM directors expect from their coding teams and outsourced vendor partnerships?
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.
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.
