Happy New Year to all our readers! Before the ball drops in Times Square, catch up on five of our most read blogs of the year: Continue reading
Guest blog by Michael Totzke, 3M data analyst.
At the AMIA 2014 convention in Washington D.C., we showcased some of our processes for mapping and maintaining RxNorm drugs into the Healthcare Data Dictionary (HDD). Our poster and podium presentations emphasized the fact that with clinical data, accurate and consistent mapping of terminology standards over successive versions is critical. With the selection of RxNorm as the drug terminology standard required to meet Meaningful Use criteria, it has become necessary for the HDD to maintain RxNorm’s drug data from a longitudinal perspective. Our former process for maintaining RxNorm dealt solely with the mapping of the current version, with limited regard to managing changes in RxNorm’s data over time. However, it’s not just the initial mapping that is important; having a long term strategy for maintaining that terminology within a larger terminology server is crucial for ensuring data quality. Medical terminologies change over time, and there is no algorithm yet that can alone guarantee the level of accuracy required for exchange of clinical data. Continue reading
Blog post by Krysten Brooks, RN, BSN, MBA
Hospitals across the country have launched a wide-range of initiatives to reduce hospital-acquired conditions (HACs), but despite their efforts, a quarter of the nation’s hospitals face reimbursement penalties according to a preliminary analysis released in June by CMS that scored hospitals based on rates of acquired conditions and patient complications. While Medicare’s HAC Reduction Program plans to release final scores later this year, the healthcare organizations facing penalties can expect to lose approximately one percent of each Medicare payment from October 1, 2014 through September 30, 2015, translating into billions of dollars in lost reimbursement.
The Medicare penalties will undoubtedly hit some organizations hard, and these hospitals are moving quickly to analyze avoidable complications and intervene to improve quality. Facilities are also auditing clinical documentation for completeness and accuracy and examining documentation workflow to analyze process breakdowns and problems. Continue reading
Blog post by Senthil Nachimuthu
I had the opportunity to talk about 3M’s open source HDD Access at the 2014 OSEHRA Open Source Summit in the Washington D.C. area (Bethesda, to be precise) earlier this month. This was my first time attending OSEHRA; I enjoyed the conference and I hope to be back to learn and contribute more. The title of my talk was “Enabling Interoperability between Standard and Local Terminologies using HDD Access.” The two other speakers in the session talked about the difficulties encountered when trying to achieve interoperability. This turned out to be a good introduction to my talk, which focused on how HDD Access can help to achieve interoperability. Continue reading
Blog post by Barbara DeBuono and Rich Keller
Over 85 attendees at 3M’s healthcare conference in New York City heard from the payer, government and provider speakers on how the ground is shifting from underneath us all. Value-based care is no longer the new frontier; it is right where we are standing. Linking payment to performance is here to stay. Financial incentives that reward high volume are going away; they are part of a model that is on its way to becoming the exception rather than the rule. Consider that:
Blog by Sue Belley
This blog has been updated. You can view the update here.
A man from a small village in Guinea, West Africa, presented to his village health clinic with a severe headache, vomiting, diarrhea and severe pains in his back. He was initially thought to have malaria, but upon transfer to a special unit at a hospital in Conakry he was diagnosed with Ebola. The patient went on to develop disseminated intravascular coagulopathy, SIRS and septic shock. The patient was treated with intravenous fluid and electrolytes, vitamin K, oxygen and blood pressure support. He eventually succumbed. Assign codes for this inpatient encounter and sequence appropriately. Continue reading
Blog by Julia Palmer
A patient presented to outpatient surgery for laser treatment of scars from third-degree burns. The patient had a large scar on her neck, one on her chest, and a third one on her abdomen. Laser treatment of the skin of each area was performed successfully.
The codes for last month’s scenario are as follows:
L90.5 Scar conditions and fibrosis of skin
T21.32XS Sequela of third degree burn of abdomen
T21.31XS Sequela of third degree burn of chest
T20.37XS Sequela of third degree burn of neck Continue reading
Blog by Julia Palmer and Sue Belley
The results are in for the final ICD-10 Coding Contest! While the contest ends this week, participants have been loud and clear about how much they learn from the ICD-10 scenarios and feedback: “Let’s keep this going!” Sign up to be notified each month about new ICD-10 scenarios and commentary from 3M experts.
Identical twin baby girls, who shared the same amniotic sac and placenta and were holding each others hand at delivery, were delivered just in time for Mother’s Day via low cervical cesarean section at 33 weeks and 2 days.
What diagnosis and procedure codes should be reported for the mom? Continue reading
The results are in for the latest scenario in the ICD-10 coding challenge! Check out the correct ICD-10 codes and an explanation for the scenario from 3M consultants.
A patient with multiple extensive skin lesions of the labia determined to be condyloma acuminata had cauterization performed. Here is the pertinent portion of the operative report: Bovie electrocautery was then used to remove the multiple condyloma taking care to achieve meticulous hemostasis throughout the course of the procedure. After all visible condylomas were removed, the area was washed with acetic acid solution. Residual condylomas were then cauterized at this time. The area was examined for any residual bleeding and there was none.
What is the ICD-10-PCS code for the procedure performed? Continue reading
Guest blog by Amy Sheide, Clinical Analyst with 3M Health Information Systems’ Healthcare Data Dictionary (HDD) team
The ICD-10 delay announcement is over a month old but there still are a lot of Health Information Technology (HIT) regulatory changes to keep up with. The new 2015 Electronic Health Record (EHR) Technology Certification Criteria Proposed Rule and implementation of the 2014 Meaningful Use requirements remain top priorities across the industry. The unfortunate take away is that the amount of change in the HIT landscape is not going away and the amount of effort required by organizations to keep up with and successfully implement these requirements is becoming more and more difficult to maintain. For example, look at the trends in EHR certification criteria. Vendor readiness was stated as a serious concern in meeting the 2014 stage two certification requirements and many organizations were held captive to the promise from their vendor that the EHR technology would be ready in time to meet the 2014 requirements. The release of the 2015 EHR certification requirements supports the goal of the Office of the National Coordinator (ONC) to provide more frequent releases of certification criteria that were less cumbersome for EHR vendors to meet. Despite the goal of more nimble updates and requiring changes to EHR technology in smaller increments, nearly half of the 2015 certification criteria are new or revised (Figure 1). Continue reading