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It’s Another Part of HIPAA the ADA Won’t Discuss
By D. Kellus Pruitt DDS
A couple of days following the heads up I posted concerning the imminent upgrade from the tedious ICD-9 coding system to the ICD-10 that is said to be exponentially more complicated, informatics specialist Tom Sullivan posted a signal to fellow coders nationwide: “7 tactics for making ICD-10 urgent.”
http://www.healthcareitnews.com/blog/7-tactics-making-icd-10-urgent
If you are fed up with unfunded, non-productive and ineffective mandates like I am, I imagine an alert to coders to create urgency in your practice makes your ear lobes burn bright red as well.
Tedious Administrative Tasks
According to Sullivan, the ICD-10 presents providers with new requirements for “care management protocols, clinical and financial databases and reports, reimbursement, registries, quality management and research.” These requirements do not promote patients’ best interests. These tedious administrative tasks only enable HIPAA-covered entities to get paid.
ADA
If you are a HIPAA-covered dentist with a voluntary but permanent 10-digit NPI number which is required for ICD-10 compliancy, are you aware if ADA leaders have yet described the ICD-10 coding system any better than they described the NPI number that Delta Dental, BCBSTX, as well as the ADA aggressively promoted years ago?
Who knows? The ICD-10 may not even apply to dentistry. Somewhere deep in the HIPAA Rule, there might be a footnote that says “except in dental practices.”
Department of Dental Informatics
This isn’t the first time I’ve heard rumors about HIPAA’s nasty surprises for dentists. Five years ago this month, “quality” control through dental informatics was enthusiastically but perhaps prematurely revealed to me by an excited spokesman for the ADA Department of Dental Informatics. It was his email that equipped me with everything I needed for this 5 year adventure.
Shortly afterwards, the topic of HIPAA became so poisonous for ADA officials to discuss that the misled leaders who unwittingly signed on to promote digital fantasies in dentistry only rarely appeared in print and never on the internet – leaving the responsibility of informing naïve and trusting ADA members about the downsides of EHRs to those who sell EHRs.
Nevertheless, following three years of official silence about HIPAA from the ADA, in the last 14 months there have been two commentaries published in the JADA which promote quality control in dentistry. The first was written by James Bader DDS and appeared in the December 2009 edition of the JADA titled “Challenges in quality assessment of dental care.”
http://jada.ada.org/cgi/content/full/140/12/1456
Quality Control
The second commentary concerning quality control was written by Editor Michael Glick DMD titled ““When good may not be good enough — The need for clinical performance measures in dentistry.” (I’m no longer able to access JADA online).
EBD
HIT stakeholders Bader and Glick, who are both fervent supporters of Evidence Based Dentistry as well as paperless dental practices, carefully tiptoe around what looks to me like an oppressive, micromanaged future for dentists. They both argue what must be a desperate committee-approved talking point – that quality assessment is critically important for ADA members so that fully-licensed dentists will have digital, Evidence-Based proof that their care is better than dental therapists’ who work for much less money.
Are ADA leaders sitting around a big table in ADA Headquarters when they think up this crap?
In addition, the cloistered committee concludes that patients’ opinions of their dentists is too difficult to collect and less reliable than algorithms based on dental claims and other data provided by the ICD-10 (?).
In fact, Dr. Bader is so confident in Evidence-Based digital results, he dismisses the need for any patient involvement in quality assessment: “Patient satisfaction has been shown to be associated only weakly with other assessments of quality of care, which means that it cannot be used as a surrogate for measures of technical quality.” Try telling that to a formerly satisfied dental patient who suddenly must pick his or her next dentist from a “preferred” provider list of strangers.
Assessment
You mean like Ingenix’s measures of technical quality, Dr. Bader? In 2008, NY Attorney General Andrew Cuomo spanked the UnitedHealth subsidiary for selling algorithmic excuses to insurers to be used to cheat out-of-network physicians.
Conclusion
If you are a small business owner who reasonably asks to be paid no more and no less than what one is owed as quickly as possible – if not immediately like all other businesses in the land of the free – I’m pretty sure Sullivan’s 7 pearls intended to make ICD-10 more urgent for doctors will light up the lobes again. And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
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Filed under: Information Technology, Practice Management, Pruitt's Platform | Tagged: ADA, BCBSTX, Darrell Pruitt, delta dental, evidence based dentistry, HIPAA, ICD-10, ICD-9, James Bader DDS, Michael Glick DMD |
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Medicare Taps 3M For ICD-10 Conversion
Darrell – The Centers for Medicare and Medicaid Services just licensed 3M software to help translate old ICD-9 codes to the much more specific ICD-10 labels.
http://www.informationweek.com/news/healthcare/policy/231601125
Mary
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CMS Issues ICD-10 Transition Guide
The CMS has issued new guidance on implementing the International Classification of Diseases, 10th Revision, procedure and diagnostic codes that healthcare providers are mandated to adopt as of Oct. 1, 2013.
The seven-page guide includes direction on terminology to use on claims that span the days just before and after the Oct. 1, 2013 transition from the currently used ICD-9 codes to the new, expanded ICD-10 codes.
Source: Joseph Conn, Modern Healthcare [9/16/11]
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AMA Opposes ICD-10
The American Medical Association’s House of Delegates voted to work vigorously to stop implementation” of the International Classification of Diseases 10th Revision family of diagnostic and procedural codes, citing the healthcare industry’s already full plate for changes and reforms, including the federal push for physicians to adopt electronic health-record systems.
Unlike the federal Medicare and Medicaid EHR incentive payment programs under the American Reinvestment and Recovery Act of 2009, the HHS-mandated upgrade to ICD-10 from the currently used ICD-9 family of codes provides no funds to offset conversion costs to providers, payers and claims clearinghouses.
Source: Joseph Conn, Modern Healthcare [11/15/11]
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ICD-10 Specific Preparation Tool Released
Darrell – The Jericho, N.Y.-based Health Care Compliance Strategies, Inc., (HCCS), a provider of online healthcare compliance and competency training courses, just announced the release of the ICD-10 Preparation Analyzer, an online ICD-10 knowledge assessment tool.
The ICD-10 Preparation Analyzer will test providers’ knowledge of the CM and PCS guidelines and identify knowledge gaps for physicians, coders and other healthcare staff.
http://www.healthcare-informatics.com/ME2/dirmod.asp?type=news&mod=News&mid=9A02E3B96F2A415ABC72CB5F516B4C10&tier=3&nid=483D3F1D2F11446F846BA9182DFEEE8F
Mary
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The only part of my profession that is becoming increasingly more complicated and very expensive has nothing to do with actually treating diseases in patients’ mouths.
It’s the intricate, stakeholder-friendly regulations and expensive hoops that dentists must heed – just to get paid what is owed them by 3rd parties which have the power to capriciously retain payment. This is tyranny.
Darrell DK
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The Challenges and Opportunities Surrounding ICD-10
[A Video from Physician Nexus TV]
Source: http://physiciannexus.com/video/the-challenges-and-opportunities-surrounding-icd10
Dr. David Edward Marcinko MBA
[Member Physician Nexus Medical Advisory Board]
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Doctors lobby urges GOP to halt new insurance codes
The largest physicians lobby [AMA] has sent House Speaker John Boehner (R-Ohio) a letter urging him to halt a federal requirement forcing doctors to switch to new insurance CPT codes in 2013.
http://thehill.com/blogs/healthwatch/medicare/206871-doctors-lobby-urges-gop-to-halt-new-insurance-codes
Dr. David Edward Marcinko MBA
http://www.BusinessofMedicalPractice.com
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Who’s in charge of healthcare?
[AHIMA: AMA Stance on ICD-10 Should Not Slow Down Work]
http://www.healthdatamanagement.com/news/american-medical-association-ama-ahima-icd-10-43951-1.html
Even though physicians almost universally complain that ICD-10 is an oppressive, demanding regulatory idea, informatics stakeholders with careers to consider, like the American Health Information Management Association (AHIMA), don’t really care what physicians think.
“If health care providers stop their ICD-10 planning and implementation now and wait to see if Congress will take action, they will not be ready in time for the compliance date”
-Dan Rode
[AHIMA vice president for advocacy and policy]
Who is running healthcare anyway? Stakeholders or principals?
D. Kellus Pruitt DDS
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CMS Will Re-examine ICD-10 Timeline
The acting head of the CMS just signaled that the agency will extend the timeline on ICD-10 implementation. After speaking to attendees at the American Medical Association Advocacy Conference in Washington, acting CMS Administrator Marilyn Tavenner told reporters that the CMS will “re-examine the timeframe” through a rule-making process.
Tanner did not say when that rule-making process will begin but said the CMS would send details about the process in the coming days. “There’s concern that folks cannot get their work done around meaningful use, their work around ICD-10 implementation, and be ready for exchanges,” Tavenner said. “So we’re trying to listen to that and be responsive.”
Source: Jessica Zigmond, Modern Healthcare [2/14/12]
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CMS
“So we’re trying to listen to that and be responsive.”
Why start now?
More: http://www.medscape.com/viewarticle/758657
Darrell DK
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HHS to put off ICD-10 implementation
[It’s official]
The Department of Health and Human Services (HHS) has announced it will delay implementation of the ICD-10 diagnostic code set beyond Oct. 1st, 2013.
http://www.fiercehealthit.com/press-releases/hhs-announces-intent-delay-icd-10-compliance-date?utm_medium=nl&utm_source=internal
But, today’s announcement did not specify for how long ICD-10’s starting date would be postponed.
Ann Miller RN MHA
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The New Countdown
The timeline for healthcare organizations to convert to the ICD-10 coding system will likely be delayed one year–to Oct. 1, 2014–U.S. Department of Health & Human Services Secretary Kathleen Sebelius announced today.
The delay is part of a proposed rule, set to be published next week in the Federal Register, that would create a unique health plan identifier that HHS estimates could save doctors and insurers $4.6 billion over the next decade.
Stay tuned.
Ann Miller RN MHA
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AMA Renews Call for ICD-10 Delay Until 2015
The American Medical Association has renewed its call to hit the pause button on the national adoption of the ICD-10 diagnostic and procedural codes. In a letter to CMS acting Administrator Marilyn Tavenner, AMA Executive Vice President Dr. James Madara referenced a November 2011 House of Delegates policy vote in which that body called for a “repeal” of the move to ICD “so that physicians and other stakeholders could assess an appropriate alternative to such a costly, burdensome regulatory requirement. The AMA has since pressed the case for a second look at ICD-10 overall.
Physicians need the delay because they are “overwhelmed with the simultaneous implementation of multiple health IT programs,” Madara said. He asked for a two-year extension to Oct. 1, 2015, with the caveat that “if stakeholders cannot reach consensus on this matter during this two-year period, then the move to ICD-10 should be postponed indefinitely.”
Source: Joseph Conn, Modern Healthcare
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