Posts Tagged ‘HIM Circle’

What a Year in HIM!

November 11, 2010

Happy HIT Week!  The past year has been a tough one!

We thought it would be great to take a moment and consider all the issues we’ve dealt with  together over the last year.  We tackled RAC’s, dealt with the new HITECH and HIPAA rules, handled coding changes, many of us continued mastering our EMR projects, and we’re all starting to learn about and prepare for ICD-10.

The nice thing is that over the last year, we haven’t had to do it alone.  Through the HIM Circle, we’ve answered more than 200 peer questions on our free peer support forums on facebook, Linkedin, and twitter.  It’s been amazing!

Thank you for being a part of the HIM Circle, and we can’t wait to see what the next year has in store for us all. 

Enjoy the week!

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An Abridged Guide to ICD-10

August 13, 2010

As you probably have heard by now, on October 1, 2013, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets.  We’ve compiled information directly from the CMS website to help provide a basic introduction and some steps to help prepare for ICD-10. 

In the future, we’ll be posting more updates.  If you’d like to have those updates sent to you, simply subscribe on the right side of blog’s home page (Click the word “Clear” above to get there).

ICD-10

ICD-10-CM/PCS (International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System) consists of two parts:

  1. ICD-10-CM for diagnosis coding
  2. ICD-10-PCS for inpatient procedure coding

ICD-10-CM is for use in all U.S. health care settings. Diagnosis coding under ICD-10-CM uses 3 to 7 digits instead of the 3 to 5 digits used with ICD-9-CM, but the format of the code sets is similar.

ICD-10-PCS is for use in U.S. inpatient hospital settings only. ICD-10-PCS uses 7 alphanumeric digits instead of the 3 or 4 numeric digits used under ICD-9-CM procedure coding. Coding under ICD-10-PCS is much more specific and substantially different from ICD-9-CM procedure coding.

 

Why?  The transition to ICD-10 is occurring because ICD-9 produces limited data about patients’ medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated terms, and is inconsistent with current medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full. 

 

Steps to Prepare for Version ICD-10

  • Begin preparing now for the ICD-10 transition to make sure you are ready by the October 13, 2013, compliance deadline. The following quick checklist will assist you with preliminary planning steps.
  • Identify your current systems and work processes that use ICD-9 codes. This could include clinical documentation, encounter forms/superbills, practice management system, electronic health record system, contracts, and public health and quality reporting protocols. It is likely that wherever ICD-9 codes now appear, ICD-10 codes will take their place.
  • Identify potential changes to work flow and business processes. Consider changes to existing processes including clinical documentation, encounter forms, and quality and public health reporting.
  • Assess staff training needs. Identify the staff in your office who code, or have a need to know the new codes. There are a wide variety of training opportunities and materials available through professional associations, the HIM Circle, online courses, webinars, and onsite training. If you have a small practice, think about teaming up with other local providers. You might be able, for example, to provide training for a staff person from one practice, who can in turn train staff members in other practices.
  • Coding professionals recommend that training take place approximately 6 months prior to the October 1, 2013 compliance date.
  • Budget for time and costs related to ICD-10 implementation, including expenses for system changes, resource materials, and training. Assess the costs of any necessary software updates, training and related expenses.
  • Conduct test transactions using ICD-10 codes with your payers and clearinghouses. Testing is critical. Check to see when they will begin testing, and the test days they have scheduled.

See the “Compliance Timeline” below for important stages of implementation for ICD-10 and the Version 5010 that goes with it.

 

DECEMBER 31, 2010

  • Internal testing of Version 5010 must be complete to achieve Level I Version 5010 compliance

JANUARY 1, 2011

  • CMS begins accepting Version 5010 claims
  • Version 4010 claims continue to be accepted

DECEMBER 31, 2011

  • External testing of Version 5010 for electronic claims must be complete to achieve Level II Version 5010 compliance

JANUARY 1, 2012

  • All electronic claims must use Version 5010
  • Version 4010 claims are no longer accepted

OCTOBER 1, 2013

  • Claims for services provided on or after this date must use ICD-10 codes for medical diagnosis and inpatient procedures

  

To discuss ICD-10 with your peers, visit http://www.HIMfacebook.com

Feds propose stronger patient privacy rights

July 11, 2010

We just saw this on the HIM Circle facebook page (http://www.facebook.com/HIMCircle):

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The U.S. Department of Health and Human Services (HHS) proposed a new federal healthcare information privacy rule yesterday that would expand patients’ rights to access their information and restrict certain types of disclosures of protected health information to health plans, according to InformationWeek.

The proposed rule is part of the Obama administration’s plan for every citizen to have an electronic medical record by 2014.

The changes are also a response to the Health Information Technology for Economic and Clinical Health (HITECH) Act, which requires HHS to change the Health Insurance Portability and Accountability Act of 1996 (HIPAA) rules by strengthening the privacy and security protections for health information.

The proposed rule would strengthen and expand HIPAA privacy, security and enforcement rules by:

• Expanding individuals’ rights to access their information and to restrict certain kinds of disclosures of protected health information to health plans;
• Requiring business associates of HIPAA-covered entities to follow most of the same rules as the covered entities;
• Setting new limitations on the use and disclosure of protected health information for marketing and fund raising; and
• Prohibiting the sale of protected health information without patient authorization.

For more information check out the new HHS Website:
http://www.hhs.gov/healthprivacy/

Update: Submitting Notice of a Breach to HHS

February 19, 2010

The breach notification interim final rule requires covered entities to provide the Secretary with notice of breaches of unsecured protected health information (45 CFR 164.408).  The number of individuals affected by the breach determines when the notification must be submitted to the Secretary.

Please review the instructions below for submitting breach notifications.

Breaches Affecting Fewer than 500 Individuals

For breaches that affect fewer than 500 individuals, a covered entity must provide the Secretary with notice annually.  All notifications of breaches occurring in a calendar year must be submitted within 60 days of the end of the calendar year in which the breaches occurred.  Notifications of all breaches occurring after the effective date in 2009 must be submitted by March 1, 2010.  This notice must be submitted electronically by following the link below and completing all information required on the breach notification form.  A separate form must be completed for every breach that has occurred during the calendar year.  

If a covered entity that has submitted a breach notification form to the Secretary discovers additional information to report, the covered entity may submit an additional form, checking the appropriate box to signal that it is an updated submission.

Breaches Affecting 500 or More Individuals

If a breach affects 500 or more individuals, a covered entity must provide the Secretary with notice of the breach without unreasonable delay and in no case later than 60 days from discovery of the breach.  This notice must be submitted electronically by following the link below and completing all information required on the breach notification form.

If a covered entity that has submitted a breach notification form to the Secretary discovers additional information to report, the covered entity may submit an additional form, checking the appropriate box to signal that it is an updated submission. 

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For consulting help or free peer support, visit http://www.HIMCircle.com to learn how we can make a difference, together.


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