Posts Tagged ‘ICD-10’

Guest Post: 5 Ways to Use CDI to Smooth ICD-10 Implementation

July 30th, 2015 by Deborah Neville, Elsevier

Clinical documentation is far from an add-on or afterthought. Without it, ICD-10 implementation will fail to achieve its full potential. Instead of taking clinical documentation for granted or moving it down the executive to-do list, healthcare organizations (HCOs)—hospitals, health systems, physician practices and medical groups—must address clinical documentation fully and in parallel to the implementation and optimization of electronic medical record (EMR) systems’ fulfillment of meaningful use (MU) requirements and the transition to ICD-10.

Clinical documentation is in a state of crisis. HCOs continue to copy and paste or pull forward irrelevant and incomplete patient information. By failing to accurately record a diagnosis's specific severity, HCOs can alter decisions over medical necessity, quality and mortality risk. By neglecting to precisely document each diagnosed condition or treatment, HCOs may see inaccurate patient outcome comparisons and may also face losses in revenue. They’re far less able, for example, to minimize denials and suspended claims because payers may question whether services are medically necessary and request additional information.

The challenge of clinical documentation demands that clinicians and healthcare leaders launch initiatives focused on clinical documentation improvement (CDI). Only with CDI can HCOs enhance communication and care decision-making, improve quality reporting and minimize financial risk.

CDI enhances an HCO’s operational efficiency, and minimizes clinicians’ frustration over having to sacrifice time usually spent with patients to address queries. Industry-wide trends toward team-based coordination and collaboration in the interests of value-based care and population health management also call for CDI to enhance patient evaluation, diagnosis and treatment.

Fortunately, CDI is already at the core of many HCOs’ efforts to enhance outcomes, streamline workflows, boost financial performance and achieve full compliance. In doing so, these HCOs have the chance to document the status of populations, integrate quality and outcomes measures and minimize gaps in documentation as part of the transition to ICD-10.

CDI Aids ICD-10 Implementation

Following are several suggestions for how HCOs can use CDI as a platform to aid in ICD-10 implementation:

  • Engage clinicians in CDI. By engaging clinicians—physicians, nurses and allied healthcare professionals—in CDI, HCOs can minimize long-term effects of poor documentation that leads to poor data. CDI initiatives provide a template and launch pad for information sharing, reporting, partnership and collaboration among individual healthcare professionals and care teams. As clinicians discover, discuss and analyze available patient data, they’ll be better able to provide complete, timely, evidence-based clinical care. To that end, HCOs should offer clinicians opportunities—both online and face-to-face—to dialogue over possible improvements.
  • Zero in on workflow. Offer clinicians the opportunity to document, analyze, evaluate and re-engineer clinical workflow—perhaps in partnership with a CDI specialist. By reviewing the thought processes that underlie clinical workflows, clinicians can more easily integrate technologies like mobile devices, speech recognition or natural language processing to enhance patient care.
  • Focus on enhanced outcomes. Help clinicians understand how and why more detailed, timely patient data enhances accuracy and promotes consistent communication, resulting in improved outcomes. By linking documentation to clinical workflows, HCOs can help clinicians discover how to collaborate as they zero in on patients with possible complications, initiate early interventions, facilitate discharge planning and control readmissions.
  • Show them the money. Remind clinicians how CDI will improve revenues. Through CDI, HCOs can secure more appropriate, timely reimbursement from payors, make the best use of specialists and develop risk-adjusted outcome profiles that ensure accurate payment. Equally important is that they can avoid the audits, penalties and fines that sometimes accompany lackluster compliance.
  • Go for the long haul. Remind clinicians that while they may still care for individual patients, they must also care for populations and communities. Focus on how CDI benefits overall patient care across lifestyles and lifecycles and why clinicians need documentation of previous diagnoses and treatments to properly care for consumers and patients over time.
  • Beyond ICD-10

    CDI creates a solid foundation for any regulatory change that might emerge in the years ahead. In the short-term, CDI will help HCOs ease the transition to ICD-10 and enhance clinicians’ engagement in patient care improvement, revenue generation, error reduction and operational efficiency.

Resources

AHRQ Quality Indicators Toolkit Facilitates Process Improvement Work at Cedars-Sinai Medical Center

Clinical Documentation in the 21st Century Executive Summary of the Policy Position Paper from the American College of Physicians

Guidance for Clinical Documentation Improvement Programs

Certified Documentation Improvement Practitioner

Clinical Documentation Excellence Program: Tackling ICD-10 challenges

About the Author: Deborah Neville manages Elsevier's development of an integrated system of on-line curricula and tools spanning clinical documentation, compliance, coding, finance and CDI. She has BS degrees in management/human resources and social psychology. She is a registered health information management administrator and holds a certified coding specialist: physician-based credential. Prior to joining Elsevier, Deborah held positions such as revenue cycle analyst for Mayo Clinic; corporate compliance officer; educator; coding manager; and senior consultant.

As an active member of AHIMA, she has participated in the Quality Initiatives & Secondary Data Practice Council, chaired the Coding Policy and Strategy Committee and Board member for the Society of Clinical Coding. She has authored journal articles, been a presenter of audio conferences and often speaks at national and state conventions.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

Infographic: Bizarre ICD-10 Codes

June 15th, 2015 by Melanie Matthews

ICD-10 codes will provide a more robust classification system, providing vastly more detail for diagnoses and procedures, revealing more about quality of care and allowing data to be used to better track outcomes.

However, according to a new infographic by CureMD, some of the new codes border on the bizarre in their specificity.

ICD-10-CM/PCS Implementation Action PlanOf all the tapes and books on the market about ICD-10, this important book by an Approved ICD-10 CM-PCS Trainer is a standout. Hospital, physician practice, ambulatory surgery center, freestanding clinics, and long-term care staff who are primary or secondary users of medical coding data will want it as their constant companion as they begin the implementation of ICD-10 at their facility.

ICD-10-CM/PCS Implementation Action Plan goes beyond its comprehensive coverage of ICD-10 CM/PCS to provide you with training tools, as well. This 135-page book also includes an 81-page customizeable document, as well as a customizeable spread sheet log.

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Infographic: Should You Outsource Healthcare Billing to Prepare for ICD-10?

April 13th, 2015 by Melanie Matthews

As the deadline to ICD-10 approaches, some physician practices may decide to outsource healthcare billing, according to CureMD.

CureMD has created an infographic to highlight the expected impact of ICD-10 and help physician practices determine if they'll need to outsource their billing for the code changes.

ICD-10-CM/PCS Implementation Action PlanOf all the tapes and books on the market about ICD-10, this important book by an Approved ICD-10 CM-PCS Trainer is a standout. Hospital, physician practice, ambulatory surgery center, freestanding clinics, and long-term care staff who are primary or secondary users of medical coding data will want it as their constant companion as they begin the implementation of ICD-10 at their facility.

ICD-10-CM/PCS Implementation Action Plan goes beyond its comprehensive coverage of ICD-10 CM/PCS to provide you with training tools, as well. This 135-page book also includes an 81-page customizeable document, as well as a customizeable spread sheet log.

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Infographic: ICD-10 Industry Readiness

January 5th, 2015 by Melanie Matthews

Nearly 75 percent of health plans have completed their ICD-10 impact assessment, while only 50 percent of providers have completed theirs, according to results from the Workgroup for Electronic Data Interchange (WEDI), August 2014 ICD-10 Industry Readiness Survey, depicted in a new infographic by Healthsomely, a healthcare communications firm.

The infographic also looks at vendor readiness and testing by both providers and health plans.

ICD-10-CM/PCS Implementation Action PlanOf all the tapes and books on the market about ICD-10, this important book by an Approved ICD-10 CM-PCS Trainer is a standout. Hospital, physician practice, ambulatory surgery center, freestanding clinics, and long-term care staff who are primary or secondary users of medical coding data will want it as their constant companion as they begin the implementation of ICD-10 at their facility.

ICD-10-CM/PCS Implementation Action Plan goes beyond its comprehensive coverage of ICD-10 CM/PCS to provide you with training tools, as well. This 135-page book also includes an 81-page customizeable document, as well as a customizeable spread sheet log.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

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Infographic: CMS’ Quality Improvement Programs

December 31st, 2014 by Melanie Matthews

Ninety-two percent of eligible hospitals and 75 percent of eligible healthcare professionals have received an incentive payment for meaningful use, according to an infographic by CMS.

The infographic also examines the progress on other CMS' quality improvement programs, including: ACOs; physician quality reporting system; ICD-10; and electronic funds transfer.

Physician Quality Rewards for Population Health ManagementHumana recently distributed $76.8 million in quality awards to approximately 4,700 physician practices through Humana's Provider Quality Reward programs. The program is designed to support providers where they are in their practices as they move through the continuum of care programs focused on the Triple Aim.

Physician Quality Rewards for Population Health Management a 45-minute webinar on December 16th, now available for replay, Chip Howard, Humana's vice president of payment innovation in the provider development center of excellence, shares how Humana's program supports physicians' transition from volume to value and helps them become successful population health managers.

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Infographic: Using ICD-10 To Track Ebola Outbreak

October 20th, 2014 by Melanie Matthews

With the exception of the United States, all industrialized nations use ICD-10 to code morbidity and report disease data to the World Health Organization.

The following infographic below created by Coalition for ICD-10 illustrates the public health impact of ICD-10 in supporting the biosurveillance of the eBola outbreak.

Using ICD-10 To Track Ebola Outbreak

ICD-10-CM/PCS Implementation Action Plan ICD-10-CM/PCS Implementation Action Plan goes beyond its comprehensive coverage of ICD-10 CM/PCS to provide you with training tools, as well. This 135-page book also includes an 81-page customizeable document, as well as a customizeable spread sheet log.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

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Infographic: Healthcare in the Cloud

June 9th, 2014 by Jackie Lyons

Security, agility and accessibility are among the top healthcare benefits of cloud computing. Furthermore, cloud storage could potentially reduce health IT costs by $11 billion, according to a new infographic from MBAHealthcareManagement.org.

This infographic also identifies the three types of cloud computing, additional benefits of cloud storage, types of information that can be stored in the 'cloud,' and more.

Remote monitoring is another crucial healthcare technology utilized by organizations to obtain patient information and reduce costs. 2014 Healthcare Benchmarks: Remote Patient Monitoring delivers a comprehensive set of metrics from more than 100 healthcare organizations on current practices in and ramifications of remote monitoring for care management of chronic illness, the frail elderly and remote populations.

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Infographic: How the Healthcare Industry Is Reacting to the ICD-10 Delay

April 23rd, 2014 by Jackie Lyons

On April 1, 2014, President Obama signed a law that included the delay of ICD-10 implementation until at least October 1, 2015. Fifty-eight percent of respondents to the Deloitte Center for Health Solutions Live from the Center Webcast Poll expressed disappointment because their organizations wanted the shift to occur as scheduled, according to a new infographic from Deloitte.

This infographic also provides responses from approximately 1,250 healthcare industry professionals regarding optimal ICD-10 scenarios, areas most impacted by the delay and actions that will be taken in response to the delay.

How should your organization be preparing for ICD-10? Learn more in A Best Practice Roadmap to ICD-10 Readiness. This 24-page report documents the process BCBSM has established to resolve discrepancies between ICD-9 and ICD-10 codes, a milestone that has allowed the payor to complete its version of the General Equivalence Mappings (GEMs) — referred to as the Blue GEM Encyclopedia.

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Infographic: The Pros, Cons and Costs of ICD-10

March 7th, 2014 by Jackie Lyons

The shift from ICD-9 to ICD-10 that will occur on October 1, 2014 will transition 14,000 codes to more than 68,000 codes.

Ninety-two percent of physicians are concerned with the overall cost of converting to ICD-10, according to a new infographic from Greenway. This infographic shows the pros, cons and costs of ICD-10 as well as the specific problems it presents.

You may also be interested in this related resource: A Best Practice Roadmap to ICD-10 Readiness. Want to learn more about how to make ICD-10 simple? This 24-page report documents the process BCBSM has established to resolve discrepancies between ICD-9 and ICD-10 codes, a milestone that has allowed the payor to complete its version of the General Equivalence Mappings (GEMs) — referred to as the Blue GEM Encyclopedia.


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Infographic: Healthcare Organizations Adjusting to New Healthcare Mandates for Maximum Productivity

January 29th, 2014 by Jackie Lyons

In the evolving healthcare industry, physicians must constantly implement new technology and processes to meet new mandates. Practices that do not update with new electronic medical record (EMR) codes in ICD-10 risk losing money associated with cost of programs and lowered productivity.

Compared to ICD-9, ICD-10 contains 55,000 longer codes for more exact clinical documentation, according to a new infographic from Capson Physicians Insurance. This infographic illustrates the variable effects of ICD-10 and EMR implementations on physician practices.

Adjusting to New Healthcare Mandidates for Maximum Productivity

You may also be interested in this related resource: ICD-10-CM/PCS Implementation Action Plan. With these new implementations, it is important to be informed concerning ICD-10. This 135-page resource goes beyond its comprehensive coverage of ICD-10 CM/PCS to provide you with training tools, as well. It also includes an 81-page customizable document, as well as a customizeable spread sheet log.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you'd like featured on our site? Click here for submission guidelines.