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In this Issue
Other News
State Looks at Digital Health Records
Alabama plans to launch a statewide EMR initiative this April, according to the Montgomery Advertiser.

Family Denied Final Farewell
While enforcing HIPAA, a hospice denied a dying patient’s family the right to be by his side, The Morning Journal reported.
Ask the Expert
Have a coding or transcription question? Get an expert answer by sending an e-mail to edit@gvpub.com.

This month’s selection:
We have an endocrinologist on staff who wants to start management training for her diabetic patients. I am not finding that many insurance carriers cover the CPT code 98960, Education/training patient for self-management. Medicare is reimbursing for G0108, Diabetes self-management/individual, and G0109, DSMT, 2 or more. Now that Medicare is recognizing this care, is there a reason commercial insurance carriers are not embracing this self-management for diabetes patients? Is there another code I should be using?

Darlene Earl, CCS-P
Tallahassee Primary Care Associates
Tallahassee, Fla.

It’s nice that Medicare does pay for this, but commercial carriers don’t have to do anything they don’t want to.

I’d recommend taking the issue to the facility’s contract management department and encourage them to aggressively negotiate their next contract with commercial carriers to include coverage of services/codes that are covered by Medicare—especially if they can convince them to pay better than Medicare! Read more »
Tech & Tools
Sunlight Health Mobile App
The Sunlight Foundation has launched a new series of national data apps, the first of which helps patients and their families make informed decisions about healthcare services and prescription drug options. Read more »

drchrono iPad App
drchrono’s free iPad app has received official government certification that will result in doctors receiving $44,000 in incentives when they use drchrono as an EMR platform. Read more »

Gaiam Health and Wellness Mobile Apps
Gaiam’s Mayo Clinic Wellness Solutions apps include integrated health action plans for 10 everyday ailments.
Read more »
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Editor's E-Note
Nearly everyone in coding circles these days is talking about ICD-10 and its enormous impact on the healthcare industry as a whole. As this month’s E-News Exclusive points out, getting lost in the shuffle is the need for coders to continue to be well versed in the nuances of ICD-9.

Follow us on TwitterAlso in this issue, a veteran HIM professional explains why this is a wonderful time to take advantage of the numerous educational opportunities being afforded to RHIAs.

Lee DeOrio, editor
E-News Exclusive
No ICD-9 Left Behind
By Shelly Cronin, CPC, CPMA, CANPC, CGSC, CGIC

The interest in ICD-10-CM training is at a fever pitch with most coders, which is not going to stop until well after the October 1, 2013, implementation date. We are constantly seeing the drive for education careening to ICD-10-CM; however, it makes me wonder why ICD-9-CM is being left behind.

Coders should be intimate with their coding manuals; outpatient coding is not only about CPT coding, but rather it is about abstracting the entire picture through a combination of CPT and ICD-9-CM codes. ICD-9-CM has a complete listing of guidelines just like the CPT manual. Glossing over ICD-9-CM knowledge inhibits coders from fully understanding why diagnosis codes are used or sequenced in a particular way to produce complete claims. A coder should have a well-rounded knowledge of CPT, HCPCS, and ICD-9-CM. This will ensure fewer denials due to ICD-9-CM mismatches with the CPT codes selected.

The basics of ICD-9-CM should be well known; however, let’s review the important steps coders need to take to properly report the diagnosis for the following example.

Full Story »

The Evolution of a Profession
By Wendy Coplan Gould, RHIA

While attending the 83rd Annual AHIMA Convention & Exhibit in Salt Lake City in October, I began reminiscing about the HIM profession. Two things quickly came to mind: Wow, we have really come a long way in 83 years, and wow, I have been doing this for a long time.

Almost the entire convention was focused on ICD-10. Not to date myself (assume I was a child prodigy), but the chaos from the ICD-8 transition to ICD-9 was not as traumatic in 1979 as will be our move to ICD-10. Back then, reimbursement based on prospective payments and diagnosis-related groups were not in place nationally. Coding was conducted for statistical purposes and was not the foundation for revenue.

Despite this major difference, I believe the RHIAs of today can learn a few important lessons from the registered record administrators of yesterday. This article takes a look back and, in doing so, provides practical ideas to help coders take the leap forward.

Full Story »
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Industry Insight
Future of Health Technology Award Presented
Craig Feied, MD, of Microsoft Health Solutions Group and Georgetown University, has been named the recipient of the 2011 Future of Health Technology Award for his pioneering work in medical software.

Today's Diet & NutritionFeied, a specialist in emergency medicine, is a pioneer in medical informatics, which combines the disciplines of computer science, information science, and healthcare to optimize the use of information in patient services and research.

He conceived and was instrumental in the development of Amalga software architecture for the real-time integration of medical data. And, through the EROne Institutes for Innovation in Medicine, which he helped found, he has brought hundreds of innovative ideas to life. Read more »
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