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ICD-10 Could Bolster Ebola Bio-Surveillance?

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Forgetting ICD-9 … Moving on to ICD-10

[By Staff Reporters]

According to Tom Sullivan, there is no specific code for the Ebola virus under ICD-9?

And no, this is not a joke: There isn’t a specific one. Instead code number # 078.89 refers to multiple viral diseases. Under ICD-10, however, there is one. It’s A98.4.

***

Ebola

***

The Proponent

That’s according to the Coalition for ICD-10 which, of course, is a proponent of moving to the new code set without further delay.

Assessment

The coalition’s main point is that specific codes can help public health officials better manage bio-surveillance. Do you agree?

Link: Infographic: ICD-10 could bolster Ebola biosurveillance

More: Ascel Bio on Forecasting Infectious Disease Outbreaks

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Medical Provider Readiness for ICD-10?

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And, for Health Plans, too!

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Some Modern Issues Impacting Hospital Revenue Cycles

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By Carol S. Miller RN CPM MHA

By Dr. David Edward Marcinko MBA CMP™

Carol S. Miller “Collectively the healthcare industry spends over $350 Billion to submit and process claims while still working with cumbersome workflows, inefficient processes, and a changing landscape marked by increasing out-of-pocket cost for patients as well as increasing operating costs.”

The Norm Continues Downhill

For many years hospitals and healthcare organizations have struggled to maintain and improve their operating margins.  They continue to face a widening gap between their operating costs and the revenues required to cover not only current costs, but also to finance strategic growth initiatives and investments.

Faced with increased operational costs and associated declines in rates of reimbursement, many healthcare hospital executives and leaders are concerned that they will not achieve margin targets.  To stabilize the internal financial issue, some hospital have focused on lowering expenses in order to save costs – an area they control and an area that will show an immediate impact; however, that is not the best solution.

Beware Cost Reductions

Hospital executives are concerned with the effect that these reductions may have on patient quality and service.  Finding ways to maximize workflow to lower operating costs is vital.  Every dollar not collected negatively impacts short- and long term capital projects, lowers patient satisfaction scores and possibly affects quality of patient care.

Status Today

Hospitals, healthcare organizations and all medical providers are under great pressure to collect revenue in order to remain solvent. And so, here are some of the issues impacting the modern hospital revenue cycle as Obama-Care, or the PP-ACA of 2010, is launched next month?

Issues Impacting the Revenue Cycle

Several of the major leading issues facing the revenue cycle are:

  • Impact of Consumer-driven Health – This process has emerged as a new approach to the traditional managed care system, shifting payment flows and introducing new “non-traditional” parties into the claims processing workflow.  As market adoption enters the mainstream, consumer-driven health stands to alter the healthcare landscape more dramatically than anything we have seen since the advent of managed care.  This process places more financial responsibility on the consumer to encourage value-drive healthcare spending decisions.
  • Competing high-priority projects –Hospitals are feeling pressured to maximize collections primarily because they know changes are coming down the pike due to healthcare reform and they know they will need to juggle these major initiatives along with the day-to-day revenue cycle operations.
  • Lack of skilled resources in several areas – Hospital have struggled to find the right personnel with sufficient knowledge of project management, clinical documentation improvement, coding and other revenue cycle functions, resulting in inefficient operations.
  • Narrowing margins – Declines in reimbursement are forcing hospitals to look at their organization to determine if they can increase efficiencies and automate to save money.  Hospitals are faced with the potential of increased cost to upgrade and adapt clinical software while not meeting budget projections.  There are a number of factors contributing to the financial pressure including inefficient administrative processes such as redundant data collection, manual processes, and repetitive rework of claims submissions.  Also included are organizations using outdated processes and legacy technologies.
  • Significant market changes – Regardless of what happens with the Patient Protection and Affordable Care Act, hospitals will have to deal with fluctuating amounts of insured and uninsured patients and variable payments.
  • Limited access to capital – With the trend towards more complex and expensive systems, industry may not have the internal resources and funding to build and manage these systems that keep pace with the trends.
  • Need to optimize revenue – There are five core areas hospitals have to examine carefully and they are:
    • ICD-10 – This is an entirely new coding and health information technology issue but is also a revenue issues
    • System integration – Hospitals need to look at integrating software and hardware systems that can combine patient account billing, collections and electronic health records.
    • Clinical documentation – Meaningful use will require detailed documentation in order for payment to be made and this is another revenue issue.
    • Billing and claims management – Reducing denials and reject claims, training staff, improving point-of-service collections and decreasing delays in patient billing can improve the revenue cycle productivity,
    • Contract analysis – Hospitals need to focus more on negotiating rates with insurers in order to increase revenue.

Hospital

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About the ICD-10 Hub

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Free Transition Information and News

[By Staff Reporters]

ICD-10 Hub is a leading source of information about ICD-10 news and events.

Sponsored by the AAPC and Navicure, this website is dedicated to being an essential resource to help practices and HIT vendors understand how this transition will impact the entire industry and how every organization can properly prepare.

loop11

Assessment

So, give em’ a click, and tell us what you think?

http://icd10hub.com/

Conclusion

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ICD-10 is Not an Airplane

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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Off Road Touring in Boston with Dr. Marcinko

How Doctors Get Paid

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Just before the Christmas Holidays, I flew up to Boston at the invitation of a pharmaceutical company to lead a managerial workshop entitled: “How Doctors Get Paid” [Treatment is only the beginning in the Changing Billing and Medical Reimbursement Climate].

Our goal was to inform drug representatives, and their regional managers, what value added information physician offices might expect from the pharmaceutical industry of the future.  

Topics of Discussion

The two hour interactive workshop included team projects, flip chart exercises, a mock role-playing session and the customary [hopefully energetic] ppt presentation. Other topics of discussion included:  

  • Health insurance payment evolution
  • Collapse of Medicare
  • Rise of managed care
  • Medical records documentation
  • ICD-9 and 10, HCPCS, DRGs and CPT® coding
  • ABNs, super-bills and HCFA 150 forms
  • Billing methodologies
  • Healthcare fraud, abuse and related policies
  • Capitation, HSAs, concierge medicine and RACs
  • Futuristic health 2.0 payment mechanisms, and more.

Assessment

Rest assured; these folks were a very knowledgeable and aggressive group; not like your father’s “detail men” of yore! They seek to … talk the talk, and walk the walk, of the Health 2.0 era.

Many thanks again to Helen, and Jon D, for the invite.

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ICD-10 Survey Poll

By Ann Miller; RN, MHA

[Executive Director]

The Department of Health and Human Services [DHHS] recently released the final rule for implementing the ICD-10 [International Classification of Diseases] CM [Clinical Modification] and ICD10-PCS [Procedure Coding System] insurance coding initiatives.

Shifting Deadlnes

The compliance deadline was shifted from October 1, 2011; as proposed in the original rule; to October 1, 2013.  And so, how prepared are you for the transition to ICD-10?

Please VOTE:

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