2012 CPT Code Changes: Integumentary Changes for Dermatology

Lisa Eramo February 29th, 2012

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Wound debridement, wound repairs, and skin replacement surgery are among several procedures in the integumentary system subsection of the CPT® Manual for which there are 2012 CPT code changes

Wound debridement, wound repairs, and skin replacement surgery are among several procedures in the integumentary system subsection of the CPT® Manual for which there are new guidelines in 2012. Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC, director of education at the AAPC in Salt Lake City, provided an overview of the changes and explained what coders and physicians should keep in mind.

Wound debridement

Wound debridement (11042-11047) is always a tricky area of coding because it requires explicit physician documentation of the following:

  • Depth of the tissue removed
  • Surface area of the wound

In general, physicians receive greater reimbursement for debridement of larger and deeper wounds, which is why accurate documentation—and subsequent code assignment—is crucial.

New guidelines for 2012 remind coders that when physicians debride a single wound, they should report depth using the deepest level of tissue removed. For example, if a physician debrides a wound down through the fascia and into the bone, coders should report a code for a wound debrided into the bone. This includes debridement of the fascia.

Be careful when reporting debridement of multiple wounds, however. When physicians debride multiple wounds of the same depth, report one code that includes a summation of the surface area of those wounds. For example, when a physician debrides bone from a 10 square centimeter heel ulcer as well as an 8 square centimeter ischial ulcer, report 11044 (debridement, bone [includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed]; first 20 square centimeters or less. This code denotes the depth of the wound (i.e., into the bone) as well as the summation of the surface area both wounds (i.e., 10 square centimeters + 8 square centimeters).

However, when physicians debride multiple wounds of different depths, do not sum the surface area of those wounds. For example, a physician debrides subcutaneous tissue from a 10 square centimeter heel wound and bone from a 5 square centimeter thigh wound. Do not sum the total surface area because the depth of each wound differs. Instead, report 11042 and 11044.

Wound repairs

New CPT guidelines for wound repairs state coders should report modifier -59 (distinct procedural service) when physicians repair more than one classification of wounds. Coders should list the more complicated repair as the primary procedure followed by the less complicated repair as the secondary procedure. They should append modifier -59 to the less complicated procedure.

For example, a physician performs a simple repair of a 2.6 cm wound on the neck as well as an intermediate repair of a 2.7 wound on the scalp. Coders should report 12032 followed by 12002-59.

Prior to 2012, coders reported modifier -51 (multiple procedures) to distinguish between different classifications of wound repairs. Like modifier -51, modifier -59 is important because it may help override certain payer systems that normally bundle these services. Reporting the modifier will ensure correct payment for these services.

Skin replacement surgery

New CPT guidelines remind coders that in general, skin replacement surgery includes surgical preparation (15002-15005) as well as the topical placement of either an autograft/tissue cultured autograft (15040-15261) or a skin substitute graft (15271-15278). CPT provides detailed definitions for each type of graft as well as an explanation of how physicians surgically prepare a clean and viable wound surface. These definitions and explanations can assist coders in reviewing physician documentation to better understand surgical procedures and ensure correct code assignment.

New codes for skin substitute grafts are also more simplified. Previously, codes for skin substitute grafts distinguished between specific types of skin substitute (e.g., allograft, acellular dermal allograft, and tissue-cultured allogeneic dermal substitute). As of 2012, these more specific codes were deleted and replaced with new codes based on anatomic site and size. Coders are no longer required to specify the type of skin substitute. Coders should remember to separately report a HCPCS code for the supply of the skin substitute in conjunction with a code from the 15271-15278 range.

As always, coders should encourage physicians to document as thoroughly as possible to ensure compliant coding and accurate reimbursement. Physicians should document the following information for skin replacement surgery:

  • Anatomic site
  • Type of graft (autograft vs. skin substitute)
  • Size of the graft

Lisa A. Eramo is a freelance writer and editor specializing in medical coding, health information management, and other healthcare regulatory topics. Visit her website at http://lisaeramo.wordpress.com/.

For additional information on 2012 CPT code changes, read our recent articles Getting Paid in 2012: 2012 CPT Code Changes and More, CPT Changes for 2012: An Overview, 2012 CPT Code Changes: Reporting Procedures Related to Pacemakers and Cardioverter-Defibrillators, 2012 CPT Code Changes: Billing Prolonged Services, Part I and 2012 CPT Code Changes: Billing Prolonged Services, Part II.

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What You Need to Know About Selecting the Right EHR: Key Components of EHRs

Kathy McCoy, MBA February 28th, 2012

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What You Need to Know About Selecting the Right EHR
Selecting the right electronic health record can seem like a daunting task. If given the choice, many medical providers would prefer to continue using paper charts indefinitely because that is the system they know and have always used. However, with Medicare requiring that claims be submitted electronically—and with many payors now following suit—staying paper-based forever is not an option.

To help those providers who are currently in the throes of selecting an EHR, Kareo asked health information systems expert Ron Sterling of Sterling Solutions, LTD to walk participants through the process. Kareo frequently sponsors informational webinars to help practitioners through their most difficult practice management issues. Ron is a nationally acknowledged expert on the selection of EMRs and practice management systems. He authored the Book of the Year, Keys to EMR/EHR Success, according to the Healthcare Information and Management Systems Society (HIMSS). We have posted a series of blogs that summarize the key points from Ron’s webinar, entitled What You Need to Know About Selecting the Right EHR. You can read the previous posts now: What You Need to Know About Selecting the Right EHR: EHR Selection Strategies and What You Need to Know About Selecting the Right EHR: EHR Relationships with PMSs and Patient Portals. This post focuses on five key components of EHRs that most practices will need to manage patients appropriately.

Document manager and patient service tools

According to Ron, most practices will want a document manager that allows clinicians to monitor and view images such as x-rays, images from MRI studies or medical reports. Be sure your EHR can handle the types of images you view most in your specialty. Another important component is the bundle of patient service tools that comes with your EHR. Functionality such as triage tools, refill tracking, coordinating care, messaging, and issuing reports to patients can help manage patients more smoothly while documenting the care provided.

Workflow tools and patient portals

Workflow tools are important as well. They support patient services within the office and collaboration among doctors and staff. They also provide a way to facilitate the tracking of messages and issue resolution, the routing of incoming outgoing items and overall patient interactions. Patient portals are another component that will also help manage patients. They allow patients to proactively contact the practice with refill requests and questions for their practitioner, and enable the office to contact patients with reminders, messages, access information, test results and more.

Clinical content

Clinical content, another component, will of course vary by specialty. It should be detailed enough to support the other components yet offer the flexibility to alter it to the practice’s needs. Some EHRs offer toolkits that allow practitioners to tailor how the clinical record will look. But Ron advises caution with toolkits, since changing the order of how information appears may affect interoperability with other EHR components.

Check back soon for more articles on EHR selection and management by Ron in our monthly enewsletter. And feel free to review our complimentary webinar archives for other informative videos that may interest you. Kareo regularly sponsors webinars that feature industry experts discussing ways to improve your medical billing and reimbursement. You can also receive notice of upcoming webinars by signing up on our notification list. If you’d like to know which EHRs Kareo integrates with, please visit the EHR page on our site.

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Complimentary Webinar: Government Incentives for Medical Practices – Tips and Tools to Qualify, Participate and Get Paid

Kathy McCoy, MBA February 27th, 2012

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Thursday, March 22, 2012
1:00 PM EST/10:00 AM PST
Speaker: Elizabeth W. Woodcock, MBA, FACMPE, CPC

Elizabeth Woodcock will speak on Government Incentives for Medical Practices: Tips and Tools to Qualify, Participate and Get Paid in this complimentary webinar

As the national economy continues to bump along in the doldrums – likely dragging down your practice’s revenue prospects along with it – you need to take advantage of every opportunity that comes your way. Today’s opportunities include several federally based incentive programs that can mean extra cash for physicians. In this webinar, you’ll learn how to participate – and succeed – in qualifying for reimbursement-based bonuses through the array of government incentives for medical practices offered to eligible providers who treat Medicare or Medicaid patients.

Topics include:

  • Meeting the multi-year criteria for electronic health record (EHR) incentive funds now available to eligible providers treating Medicare and Medicaid patients
  • Qualifying for Medicare’s electronic prescribing (eRx) program
  • Achieving the measures to collect from Medicare’s pay-for-performance -program (Physician Quality Reporting System, or PQRS)
  • Acting to meet the eligibility requirements for incentive bonuses through the Medicare Primary Care Incentive Program (PCIP) and General Surgery Incentive Program (GSIP)
  • Understanding how the Medicaid / Medicare Rate Parity provisions of the federal Affordable Care Act may affect your medical practice

With so many programs competing for your attention, it would be all too easy to overlook a vital detail or miss a deadline. Attend this webinar to learn how to gain the money now – and avoid the reimbursement penalties later! You’ll get the low-down on what you need to do to track, register and successfully participate in federally based government incentive programs for physicians.

Learn how to qualify, participate and get paid in government incentive programs for medical practices in this complimentary webinar

You can download the handout for the webinar on Government Incentives for Medical Practices – Tips and Tools to Qualify, Participate and Get Paid now. You can also download two handouts for the webinar now: Handout for Kareo Govt Incentives Webinar – MCD-MCR Rate Comparison and Handout for Kareo Govt Incentives Webinar – Appendix 3-12.

Question-and-Answer Session — Ask your tough questions and get answers about qualifying for government incentive programs

Who Should Attend
Private practice owners, office managers, billing managers, billers, billing service owners and others concerned about benefiting from for government incentive programs will benefit from this informative session.

CEU Credit
“Government Incentives for Medical Practices” meets the criteria of the Professional Association of Health Care Office Management and is approved for 1.0 CEU(s).“Government Incentives for Medical Practices” meets the criteria of the Professional Association of Health Care Office Management and is approved for 1.0 CEU(s).

The American Medical Billing Association (AMBA) will award 1 CMRS CEU for participation in this webinar.The American Medical Billing Association (AMBA) will award 1 CMRS CEU for participation in this webinar.

About Your Speaker:
Elizabeth W. Woodcock, MBA, FACMPE, CPC

Elizabeth W. Woodcock, MBA, FACMPE, CPC will discuss how to qualify for and get paid goverment incentives for medical practices

Elizabeth Woodcock is a speaker, trainer and author who is passionately dedicated to helping physician practices achieve and sustain patient satisfaction, practice efficiency, and profitability. An expert at practice operations and revenue cycle management, she is nationally recognized for her outstanding presentations and writings aimed at improving the business of medicine. Her education and expertise, combined with her humor and an engaging delivery, make her popular with physicians and administrators alike.

With rich experience in consulting, training, and industry research, Elizabeth has led educational session for the nation’s most prominent health care professional associations, specialty societies, and medical societies. She consults for many clients including Kareo medical billing software.

Learn how to qualify, participate and get paid in government incentive programs for medical practices in this complimentary webinar

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2012 CPT Code Changes: Billing Prolonged Services, Part II

Lisa Eramo February 22nd, 2012

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Here’s the second part of the overview of 2012 CPT code changes and new CPT guidelines for 2012 related to prolonged services

When providers render prolonged services—i.e., services that go beyond those associated with the usual evaluation and management (E/M) services—they may qualify for additional reimbursement. That’s because coders can capture these services using certain CPT® codes (99354-99359) when documentation reflects the added time and effort spent with patients and when certain other criteria are met. We recently wrote an introductory post on 2012 CPT code changes related to prolonged services

Here’s the second part of the overview of 2012 CPT code changes and new CPT guidelines for 2012 related to prolonged services we received from Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC, director of education at the AAPC in Salt Lake City.

Indirect prolonged services are more difficult to capture because providers often perform these services after the patient has left the office. Providers may forget to document the details of the services entirely, or coders may not be aware that providers rendered these services on a different date than the primary E/M service to which it is related.

New CPT guidelines state that prolonged services without direct patient contact must relate to a service or patient for which face-to-face care has occurred or will occur and relate to ongoing treatment management. For example, indirect prolonged services may include extensive record review related to a previous E/M service.

Coders should note that codes 99356-99357 have been revised for 2012 to include the observation setting. These codes also denote the inpatient setting. Codes 99354-99355 should be reported when services are rendered in the office or other outpatient setting.

In summary, it’s worth it to take the time to understand these codes and report them when appropriate. Coders should encourage providers to clearly document the total time spent with the patient, the services rendered to the patient, and why the additional time was necessary.

Lisa A. Eramo is a freelance writer and editor specializing in medical coding, health information management, and other healthcare regulatory topics. Visit her website at http://lisaeramo.wordpress.com/.

For additional information on 2012 CPT code changes, read our recent articles Getting Paid in 2012: 2012 CPT Code Changes and More, CPT Changes for 2012: An Overview and 2012 CPT Code Changes: Reporting Procedures Related to Pacemakers and Cardioverter-Defibrillators.

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Medical Billing Video Update: Three Tips to Improve Reimbursements

Kathy McCoy, MBA February 21st, 2012

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If you perform minor surgeries or medical procedures within your office, you should know that they can be very lucrative because of their high RVUs. But in order to maximize your reimbursement, you need to pay attention to three critical details.

Those details were the subject of a video recently produced by Kareo and featuring Codapedia.com founder and author Betsy Nicoletti, M.S., CPC. Kareo often sponsors informative videos on coding and reimbursement to help medical billing professionals and the practitioners they work for to maximize their cash flow. Our blog here will encapsulate Betsy’s three tips. For more detail, especially on coding specifics, be sure to view the video below.

According to Betsy, it’s important to have a set-up that doesn’t slow you down. That means having all the necessary instrumentation, forms and personnel on hand in the room to quickly and efficiently perform the patient’s procedure. Repeatedly leaving the room or being interrupted during a procedure only takes precious time—and that’s time for which you aren’t getting reimbursed.

Her second tip is: Burn your encounter form. She means this figuratively, since most basic encounter forms do not provide enough detail which adequately justifies the higher reimbursement. In Betsy’s experience, so many of these forms have wrong or missing CPT definitions. She recommends creating procedure-specific encounter forms with full descriptions of every procedure you do in your office, and use those to submit your claims.

And last but not least, she recommends that you pay meticulous attention to the codes and corresponding descriptions for procedures you normally perform in your office. It would be helpful to have your CPT book on hand when you view this portion of the video. Betsy provides greater detail on how to code common office procedures such as lesion destruction, wound care, incision and removal of a foreign body, and biopsies. In the latter case, you would need to code differently for a benign lesion that you remove, as opposed to a malignant one. Why? Because the follow-up care for a patient with a malignancy would be longer than for a patient with no malignancy; so the global period for that patient would be 10 days and thus be reimbursed at a higher rate.

Betsy Nicoletti, M.S., CPC, is the founder of Codapedia.com, a wiki for physician reimbursement. She is a nationally known speaker and consultant, and can be reached at www.mpconsulting.org. You can watch an informational video by Betsy Nicoletti on Better Collections Through Improved Medical Coding now. She has also written recently on What You Need to Know About Annual Wellness Visits for Medicare Patients and Preventive Services: How Practices Can Benefit from the Mandate.

Join Betsy on Thursday, Feb. 23, 2012 for a complimentary webinar on Optimizing Office Visits for Preventive Services.

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2012 CPT Code Changes: Billing Prolonged Services, Part I

Lisa Eramo February 16th, 2012

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An overview of 2012 CPT code changes and new CPT guidelines for 2012 related to prolonged services as well as what physicians and coders should keep in mind

These days, who wouldn’t want to be paid a little extra for spending more time caring for patients? This question may particularly resonate with providers who spend a significant amount of time counseling and coordinating care for critically ill patients, those working in an inpatient setting, or those in a variety of specialties.

When providers render prolonged services—i.e., services that go beyond those associated with the usual evaluation and management (E/M) services—they may qualify for additional reimbursement. That’s because coders can capture these services using certain CPT® codes (99354-99359) when documentation reflects the added time and effort spent with patients and when certain other criteria are met.

Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC, director of education at the AAPC in Salt Lake City, provided an overview of 2012 CPT code changes and new CPT guidelines for 2012 related to prolonged services as well as what physicians and coders should keep in mind.

Take it step by step

New CPT guidelines for 2012 remind coders that physicians as well as other qualified healthcare professionals (e.g., nurse practitioners or physician assistants) may perform prolonged services, permitted the services are within the provider’s scope of practice. This is important to remember when ensuring that all providers receive credit for the work they perform.

Like other E/M codes, codes that denote prolonged services are time-based CPT codes. When reporting prolonged services, coders must first note the total time the provider spends with the patient. Does it exceed the time included in the description for the primary E/M code? If so, a prolonged service code may be warranted.

Coders should encourage providers to clearly document either the total time spent with the patient or a start and stop time for the duration of the session. Documentation of start and stop times may be clearer in the event of an audit, although this format is not required.

Keep in mind that codes 99354-99357 are add-on codes. This means coders must report them in conjunction with the appropriate E/M code. The caveat to this is that the prolonged service must exceed 30 minutes in order to separately report it. Any prolonged services performed for fewer than 30 minutes are reimbursed as part of the E/M code and should not be separately reported.

For example, a provider spends 45 minutes performing a level one, face-to-face office visit for a new patient. Coders should report 99201 (which captures the first 10 minutes) and 99354 (to capture an additional 35 minutes). However, if a provider spends 25 minutes performing a level one, face-to-face office visit for a new patient, coders should only report 99201, as the additional 15 minutes does not meet the prolonged service threshold for separate reporting.

Note that the time providers spend rendering prolonged services may not be continuous. New CPT guidelines state coders should report one prolonged services code per date to capture the total duration of time spent regardless of whether it was continuous.

Next, determine whether the provider has direct contact with the patient when providing the prolonged service. Report a code(s) from the 99354-99357 range (for direct patient contact) or a code(s) from the 99358-99358 range (for indirect patient contact), depending on the total time spent and the setting in which the service is provided.

In Part II of this post, we’ll review how CPT defines direct patient contact and how to capture indirect prolonged services, a more challenging task.

Lisa A. Eramo is a freelance writer and editor specializing in medical coding, health information management, and other healthcare regulatory topics. Visit her website at http://lisaeramo.wordpress.com/.

For additional information on 2012 CPT code changes, read our recent articles Getting Paid in 2012: 2012 CPT Code Changes and More, CPT Changes for 2012: An Overview and 2012 CPT Code Changes: Reporting Procedures Related to Pacemakers and Cardioverter-Defibrillators.

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Breaking News: Compliance Deadline for Implementation of ICD-10 WILL Be Delayed

Kathy McCoy, MBA February 15th, 2012

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Update: HHS has now removed the press release they posted yesterday regarding the initiation of the rulemaking process to postpone the compliance deadline for implementation of ICD-10. Today a new release was posted entitled “HHS announces intent to delay ICD-10 compliance date.”

Health and Human Services Secretary Kathleen G. Sebelius announced late today that HHS will initiate the rulemaking process to postpone the compliance deadline for implementation of ICD-10-CM/PCS.

“ICD-10 codes are important to many positive improvements in our health care system,” said HHS Secretary Kathleen Sebelius. “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead. We are committing to work through the rulemaking process, with the provider community, to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.”

The statement did not contain any indication of a new deadline or when the rulemaking process would begin.

Earlier today, speculation about a delay set off a firestorm among industry watchdogs.

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The Importance of Documentation for Medicare and Medicaid Claims: Part 2 of 2

Kathy McCoy, MBA February 15th, 2012

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Dr. Julie Taitsman, Chief Medical Officer for OIG, gave a presentation recently as a part of OIG’s award-winning HealthCare Fraud Prevention and Enforcement Action Team (HEAT) entitled, The Importance of Documentation. The information in Dr. Taitsman’s presentation can help you to better understand the issues surrounding proper medical records documentation in patient medical records and in Medicare claims and bills. This blog post is the second of a two-part series on the topic. You can read The Importance of Documentation for Medicare and Medicaid Claims, Part I now.

Accurate Records Protect Providers

If your medical records are selected for review, clear records will help you to withstand scrutiny. Stiff fines are paid for upcoding and providers can be sentenced to probation and/or house arrest if convicted. An endocrinologist recently paid almost $500,000 in fines for upcoding routine blood draws to higher-paying, critical-care blood draws. A dermatologist paid almost $3,000,000 in fines for falsifying diagnosis codes for a condition covered by Medicare when the patient’s actual condition was not covered. This same doctor was sentenced to two years of probation and six months’ house arrest.

Here are a few good tips to keep in mind when the OIG reviews the legitimacy of your claims and services:

  • If it wasn’t documented, it didn’t happen.
  • Clear information showing your rationale for performing a diagnostic test helps demonstrate why a medical test was necessary and will help you meet the medical necessity requirement.
  • Clear recording of test outcomes helps substantiate that the test was completed and can also prove the need for subsequent care that may be billed later.

In one of the OIG’s ongoing studies, they have reviewed a number of records documenting medical imaging and found most of them to be complete and legible, with detailed histories, test results and explanation of treatment plans. Those records fully support the services claimed and those providers don’t have to worry about Medicare knocking on their doors to request that money be repaid.

However, the OIG has also reviewed imaging records that contain little more than the patients’ names, a chief complaint and some vital signs. In one example, no information was recorded about the service performed that Medicare was billed for, other than the letters CXR, indicating that the patient got a chest x-ray. Nothing was recorded to state that anyone read the chest x-ray or used it in any subsequent treatment. In a post-payment review of claims not supported by documentation of the medical record, CMS may, at the very least, require that the provider repay Medicare and Medicaid for the money that was received.

Enforcing Documentation

Most claims are processed automatically, but CMS does not have to automatically pay claims. If necessary, claims can be subject to:

  • Post-payment/retrospective review – CMS will review suspected records already billed and may require that a provider repay Medicare for services not covered.
  • Prepayment review – Suspicious providers can be placed on prepayment review and payment of claims will be subject to approval by the OIG.

In the future, there will continue to be an increase in the enforcement of documentation requirements and fraud enforcement:

  • The Administration is attempting to cut the improper payment rate for Medicare fee-for-service in half by 2012.
  • The OIG has recommended that CMS and contractors focus on error-prone providers.
  • CMS is increasingly tasking contractors to review medical records to prevent improper payments.

Pitfalls when Adopting Electronic Medical Records

Currently, many healthcare providers are adopting electronic medical health records (EMR) and this can be a great thing. They can be great for providers, increasing practice efficiency, and for patients, improving patient care. However, as providers adopt these new technologies, users should understand that there are vulnerabilities:

  • Cloning – This is the cutting and pasting of information across multiple patient records or for the same patient from visit to visit. This practice is too easy with many EMR systems and must be discouraged.
  • Over-documentation – These are default EMR settings that automatically fill-in full history, full exam and full review of systems info for all patients and/or for every patient visit. These systems require the provider to manually uncheck a box to delete the services not provided, often resulting in overbilling.

Keep in mind that it’s just as dishonest to allow a computer to record provided services inaccurately is as it is for a human to do it deliberately.

EMR Systems’ Security Issues

EMRs allow multiple users to access records simultaneously in different locations. However, security is as important with an EMR as it is with manual record keeping. OIG auditors may test providers by attempting to access providers’ networks from laptops in the parking lot. Providers are responsible to provide for their systems’ security.

  • Remote access of patient information– Some systems allow staff to access medical information from their homes or other remote sites, and some utilize PDAs, such as smartphones or iPads. Providers must provide security for data if these features are implemented.
  • Good integrity functions and change documentation– Date, time and author stamps for all data entry and changes should be a part of the system and users should not be allowed to disable these features.
    • A means to make legitimate changes should be provided for.
    • All changes must be signed and dated so that changes made to an original record by another author do not reflect inaccurately on the original author.
    • Backdating and postdating should not be enabled if allowed by your system.
    • Use of systems or features that allow patient notes to be left open for long periods of time (and backdated to the time the note was opened) should be discouraged.

Cover-ups of lack of documentation always make matters worse.

This concludes the two-part blog series entitled The Importance of Documentation. Watch Dr. Taitsman’s complete video presentation now. You can also read The Importance of Documentation for Medicare and Medicaid Claims, Part I now.

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ICD-10 To Be Delayed Indefinitely, Says Trusted Blog; Not So, Counter Others

Kathy McCoy, MBA February 15th, 2012

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A catfight has erupted over whether CMS is delaying ICD-10 implementation

A catfight has erupted over whether CMS is delaying ICD-10 implementation, and how healthcare professionals should respond to the announcement yesterday.

According to Robert Laszewski’s post today in The Health Care Blog entitled, “Oops! ICD-10 To Be Delayed Indefinitely. Never Mind!” CMS has announced today that the ICD-10 implementation deadline is going to be delayed indefinitely.

Not so, according to Carl Natale of ICD-10 Watch, in his post entitled, “The ICD-10 Timeline: It’s up for revision not destruction.”

Laszewski wrote that “After years of telling us they are serious this time and everyone in the health care system had better be ready on time to implement the new disease coding system, CMS said today the whole project is going to be delayed indefinitely.”

Laszewski quoted Marilyn Tavenner, acting CMS Administrator, as saying, “There is a concern that folks cannot get their work done around meaningful use [of information technology], ICD-10 implementation, and be ready for [insurance] exchanges. So we decided to listen and be responsive.”

Laszewski’s reaction to Tavenner’s comments? “Fine, but that has not been the message for months now and lots of people have spent lots of money for apparently no good reason.”

He added: “Apparently, a new timeline will be developed through a ‘rule making process.’”

Stopping ICD-10 in its tracks would literally take an act of Congress

Natale writes, “Stopping ICD-10 in its tracks would literally take an act of Congress. It’s a federal law, and would require more than Tavenner’s support or opposition. Which may be the reason why she’s willing to re-examine timelines. This could be an attempt to appease the medical community so ICD-10 doesn’t become a part of attempts to repeal President Obama’s healthcare reform.”

In a comment on The Health Care Blog, Lorraine Schnelle, EVP of educational company BridgeFront, says: “Your statement ‘…CMS said today the whole project is going to be delayed indefinitely’ is inaccurate. Marilyn Tavenner, acting CMS Administrator, stated the ICD-10 timeline is being re-evaluated. At this time there has been no official delay in implementing ICD-10.

“It is important that people be made aware that AMA’s concerns with the October 1, 2013 implementation date have been heard and are being evaluated by CMS…however, no delay decision has been made as of today, she concludes.”

In the last few weeks, the American Medical Association has been sounding the alarm, saying their people wouldn’t be ready. The American Health Information Management Association (AHIMA), has of course encouraged healthcare professionals to continue their implementation plans, and yesterday issued a press release in response to the CMS announcement. The statement said AHIMA encouraged the healthcare community to continue to prepare for the ICD-10 transition and not delay or suspend efforts to meet the ICD-10 current compliance deadline of Oct. 1, 2013.

“This is a promise from CMS to examine the timeline, not to change it,” said Dan Rode, MBA, CHPS, FHFMA, vice president for advocacy and policy at AHIMA.

Laszewski  adds, “It was obvious a year ago that the docs (ACP and AMA) weren’t going to be ready yet CMS kept telling everyone to keep spending big money on all of this.”

Natale’s bottom line: “Don’t cancel your next ICD-10 steering committee meeting.”

I agree.

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Breaking News: Tavenner Says CMS Will Re-Examine ICD-10 Timeline

Kathy McCoy, MBA February 14th, 2012

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The acting head of the CMS today signaled that the agency will extend the timeline on ICD-10 implementation, according to an article on ModernHealthcare.com this morning.

Marilyn Tavenner, acting CMS Administrator, told reporters that the CMS will “re-examine the timeframe” for ICD-10 through a rulemaking process after speaking to attendees at the American Medical Association Advocacy Conference in Washington. She did not say when that rulemaking 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.”

This is particularly interesting following the 5010 enforcement delay, the MGMA’s letter to Tavenner requesting another enforcement delay, and the AMA’s call on Congress to block the ICD-10 mandate.

Experts in the field are cautioning against delaying implementation plans too much; the entire industry will be watching to see what this means to practices. What do you think it will mean? Will your plans change in response to this?

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Improve patient care with electronic charting, electronic prescribing and medical labs interfaces.

Medical Billing & Collections

Streamline your entire medical billing and collections process from charge entry to reporting.

Clearinghouse Services

Integrated electronic claims, electronic remittance advice and insurance eligibility services.

Analytics & Data

Store and access data with insightful reports, document management and faxing, and an integration