ICD-10: The road ahead

After decades of development, endless regulatory hurdles and multiple delays, the implementation date for ICD-10 has arrived. If ICD-10 had a theme song, it certainly would be “The Long and Winding Road” by the Beatles. “Don’t leave me standing here” is the lyric that sums up the frustrations of enduring repeated last minute delays. Finally, the healthcare industry will no longer be left standing in the past, chained to the out-of-date and inadequate ICD-9 coding system. Continue reading

You are ready

No more kicking this ICD-10 can down the road. It’s finally here.  We have all been waiting, planning, preparing, training, and yes, worrying. With ICD-10 only 24 hours away, will it be gloom and doom as some suggest? Will the sky really fall when ICD-10 becomes effective? How could it when there have been so many years of effort and dedication by so many from across the healthcare industry?

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ICD-10-PCS: Let it evolve

Ten years ago I had the chance to make my job portable and work from home, so I moved to a small town called Florence that I “discovered” on the Oregon coast—a perfect jewel set down between forest and river and ocean.

It soon became apparent that my definition of “perfect jewel” had strings attached. I loved Florence as it was when I moved there, and I didn’t want it to change. The changes that occurred after I arrived—the new blocky condos right by the riverbank, the new housing developments chewing up more of the forest, the old fish market replaced by a cheap chain restaurant—were all changes for the worse, I thought. How dare they mess up my town! Florence was supposed to stay the way it looked in the snapshots in my head. Continue reading

Working 22.6 hours a day: Alert fatigue, guidelines and “left of boom” opportunities in health care

Where do alerts fit in a physician’s 22.6 hour day?

When I’m travelling around the country interacting with healthcare leaders and health systems, I mostly see valiant efforts to improve outcomes through improved management of diseases. While improving disease management through guideline adherence is certainly a good thing, this is a problematic strategy given the current reality of our tools, the design of our workflow and our ability to recognize and address the multiple non-disease factors that weigh heavily on outcomes. Continue reading

E&M coding: Incident-to vs. shared visit guidelines

I’ve written in the past about how to score the language within an E&M note. There are a number of ways to arrive at the same code, or in fact, a different code. But, there are also different types of providers and coding/billing rules associated with those different types of providers. In past blogs, I’ve written primarily about physicians as providers of care. But there are other health care members that provider E&M services, and can bill for them, but you have to know all the rules associated with each type of provider. Continue reading

ICD-10: Design for change

In Neil Stephenson’s latest novel Seveneves, one of the main characters says, “politics” is a word nerds use when they feel impatient about the human realities of an organization. When I read that sentence, I got a shock of recognition—yes! That is me, exactly! (I didn’t even mind the nerd part, because some nerds are pretty cool. Steve Jobs. Ruth Bader Ginsburg. Dr. Who).

Over the past dozen years, I could have developed some patience with the human realities of getting organizations to prepare for ICD-10. But no, the closer the implementation date gets, the more impatient I become. Continue reading

HIMagine That! ICD-10: Bringing it home

Donna: Sue, can you believe it? We’re going live with ICD-10 in less than two weeks – this has to be the longest pregnancy in history!

Sue: I know. You and I have been blogging about ICD-10 for what is it – three years now? What are we going to talk about after October 1st?

Donna: Plenty! But let’s not worry about that right now. I’m wondering what people are talking about in these last few weeks leading up to go-live. Continue reading

More changes contemplated for short stays

As we all focus on the looming deadline for the ICD-10 go-live, CMS is quietly floating more changes to short stay requirements.

CMS reiterated its goals of “respecting the judgment of physicians, supporting high quality care for beneficiaries, providing clear guidelines for hospitals and doctors and incentivizing efficient care to protect the Medicare trust funds.” So, what’s new? Continue reading

Is the accountable care community the next evolution of the ACO?

The move to accountable care is ultimately about achieving better health outcomes at lower cost while creating a better experience for the patient. This is the Triple Aim. A narrow view of health focuses on health care, which is understandable in the United States, since a wide range of health-related expenditures are funneled through the medical system. The United States has long been the leader among industrialized countries in healthcare spending, while other nations have led in health outcomes, such as lower infant mortality rates, lower mortality amenable to health care and longer life expectancy. Continue reading

20 days, 12 hours, 8 minutes, and 21 seconds….

That’s the current countdown to ICD-10, ticking away as I sit and write this blog post. By the time it’s posted, we’ll be even closer. And for every day, in every minute of each of those remaining hours, all of us at 3M Health Information Systems are working to help you, our customers, succeed as you make the transition.

Like you, we have worked for years to prepare for what will finally happen on October 1. Our mission has always been to develop ICD-10 products and services that would be ready when our customers needed them. Virtually every department within HIS has contributed to what has been a massive undertaking, and the work reflects thousands of hours invested by 3M HIS employees. Continue reading