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By Laurie Desjardins, CPC-I for For The Record Vol. 27 No. 11 P. 6 The Social Security Act defines medical necessity as follows: “Notwithstanding any other provisions of this title, no payment may be made under Part A or Part B for any expenses incurred for items or services, which are not reasonable and necessary for the diagnosis…
By Mike Miliard for Healthcare IT News Hospital IT departments have a lot on their proverbial plates these days, as they work to help their health systems manage the minutia of meaningful use attestations, deal with the nuts and bolts of the ICD-10 changeover (so far, so good!) and strengthen defenses against data security threats that…
Article by Karen Diop, RN, CDIP. This article was originally published on the Journal of AHIMA website in the “Coding Notes” section in November 2015 and is republished here with permission. Change has become a constant in healthcare. With the introduction of electronic health record (EHR) systems, core measures, the “meaningful use” EHR Incentive Program, value-based purchasing, and the…
By Dr. Jon Elion for ChartWise Medical Systems, Inc. In my blog entry of July 8, 2015, I summarized some of the history of the first international classification of diseases, a process that started in 1853 and was finally approved in 1893. While this was not officially called “ICD-1”, it was in fact the first international…
By Joseph Conn for Modern Healthcare It’s been mostly smooth sailing with a few rough spots one month into the national conversion to the International Classification of Diseases, 10th Revision, of diagnostic and procedural codes, better known as ICD-10. The CMS issued a statement Thursday saying Medicare fee-for-service claims “are processing normally,” with 4.6 million…
Written by Ayla Ellison for Becker’s Hospital CFO CMS released its final 2016 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule on Friday, which finalizes CMS’ proposal to alter its controversial two-midnight rule and implements previously announced modifications to CMS’ medical review strategy. Here are 10 things to know about the…
Sharing documentation best practices is a win-win for healthcare stakeholders. By Bonnie Bakal for Advanced Healthcare for Health Information Professionals One of my all-time favorite song lyrics is from Josh Groban’s You Raise Me Up and goes: “I am strong when I am on your shoulders, You raise me up to more than I can…
Written by John Smithwick for Healthcare Intelligence Network Getting patients diagnosed correctly and treated appropriately depends on providers gathering both quantitative data, which is typically structured, and qualitative data, which is typically unstructured. When comparing both types of data, it’s more challenging to manage and derive value from unstructured data. Structured data is that which…
By Akanksha Jayanthi for Becker’s Health IT & CIO Review After three delays and much industry opposition, the United States’ healthcare industry transitioned Oct. 1 to ICD-10, catching up with the latest version of the international classification of diseases codes. The transition has been compared to the Y2K scare at the turn of the millennium,…
By Niam Yaraghi for Brookings While patients may hugely benefit from having access to their own medical records, many hospitals and physicians are still very reluctant to provide patients with a copy of their records. Although taxpayers have partly paid for the majority of hospitals to adopt electronic health records systems, which reduce the cost…