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For The Record Magazine - eNewsletter
December 2009
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Other News

Kansas Investigates Medical Records Disposal
According to a Topeka television station, the Kansas Department of Aging may have illegally disposed of medical records.

Changes Needed in Medical Error Tracking, Reporting?
According to the Connecticut Post, attorney general Richard Blumenthal has called for “sweeping” changes to how the state reports medical errors and holds doctors and hospitals responsible.

Editor’s E-Note

Solarity IndexingMany variables factor into making a successful transition to an electronic record environment, not the least of which is securing capital. In this month’s E-News Exclusive, an industry expert surmises that old paper records may be able to help with funding.

— Lee DeOrio, editor

E-News Exclusive

EHR Money Could Lie Within Paper Records
By Ed Santangelo

U.S. hospitals spend billions of dollars annually to store and manage both paper and electronic medical records, placing a major strain on the national healthcare infrastructure. The American Recovery and Reinvestment Act (ARRA) hopes to rectify this by allocating more than $30 billion for the implementation and use of healthcare technology, including $17 billion aimed at EHR adoption.

While this promise of financial assistance and incentives will help healthcare providers begin the transition to electronic records, it likely will not be enough to support the massive investment required to complete this migration. What’s more, healthcare providers must implement an EHR system and demonstrate its effectiveness before they’re eligible for federal funding. This limited access to federal aid, combined with overextended hospital budgets and resources, requires hospitals to manage paper and film records more efficiently so they can find savings to apply to EHR transition.

Most of the dollars necessary to support the transition to an EHR already exist in the budget of large multifacility health systems. By focusing on their paper and film records —the way they are stored, accessed, and managed—healthcare systems can reduce their records management workflow to a single coherent strategy for building an EHR-ready infrastructure. This, in turn, frees existing capital for funding the EHR transition or other initiatives.


Recently in For The Record...

The Lure of EHR Incentives
Healthcare organizations in a hurry to implement an EHR system to take advantage of federal stimulus money may be in for a fall.
Read more

Transcription Technology Wars
Application service provider and automatic speech recognition solutions are changing the landscape of the medical transcription industry.
Read more

Dealing With Downtime
Learn the steps that need to be taken to ensure operations are kept in running order the next time your EHR system fails. Read more

Signs of the Times
Digital signature technology has helped healthcare organizations get more out of their EMRs and curtail chart deficiencies. Read more

Industry Insight

Healthcare Innovative Solutions Partners With Misys

Healthcare Innovative Solutions, a full-service clinical consulting firm, recently announced a partnership with Misys Open Source Solutions to provide the healthcare community with the consultancy services and open source technology necessary to build health information exchanges (HIEs).

“HIEs are important because they provide the healthcare community with immediate access to patient data coming from many different sources, like labs, hospitals, physician offices, pharmacies, radiology centers, and payers, giving healthcare providers the essential information to improve the quality and efficiency of healthcare in America today,” says Tim Elwell, vice president of Misys Open Source Solutions–Healthcare.


Ask the Expert

Have a coding or transcription question?
Get an expert answer by sending an e-mail to

A patient comes in (to the facility) with ankle pain after an injury, but the injury is not specified. The final diagnosis is soft tissue swelling of the ankle. Would the correct code be 729.99 plus E928.9 or just the injury code and E code?

This is a good question. Coders deal with the issue of how far does one need to go on diagnostic findings. According to the Official Coding Guidelines, for patients receiving diagnostic services, you should first sequence the diagnosis shown to be chiefly responsible for the encounter and if the diagnostic test has been interpreted by the physician and is available at the time of coding, you can add the definitive diagnosis documented in the interpretation. In this case, the reason for the visit is the ankle injury with the E code. The findings on this care are a condition of the injury, and we do not have a definitive diagnosis.

With this information, I would code injury and the E code only; however, I do not feel that it would be wrong if a coder wanted to code the findings. In this case, 729.81, Swelling of limb, would be the best code for the described condition, soft tissue swelling of the ankle.

— Cathy Brownfield, RHIA, CCS, is director of coding operations at HealthPort.

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