Essay on Converting from Icd 9 to Icd 10

your home, they do not understand what was specifically done because they are not sure what the codes the hospital out of town used

To be certified with AHIMA, the coders will have to take a test of 60 multiple choice questions, six inpatient coding scenarios and seven outpatient coding scenarios, and to maintain this certification the coder is required to provide proof of earning 20 CEU’s (Continuing Education Units) for the past two years. (Ross, K. Oct.30, 2013)

Remember, ICD-9-CM was implemented and in use since 1979, so updating terminology and new classifications were also changed with the upgrade of ICD-10-CM/PCS.

With the new hospital opening in December 2013 patient care will enhance in providing a facility with the most updated technology and allowing compliance with government regulations. For example with the larger patient rooms the hospital is able to have every room comply with HIPAA patient privacy standards. The larger rooms will also allow for modern equipment for advanced care and will allow more processes to occur at the bedside instead of transferring the patient to another department.

"Medical coding professionals provide a key step in the medical billing process. Every time a patient receives professional health care in a physician’s office, hospital outpatient facility or ambulatory surgical center (ASC), the provider must document the services provided. The medical coder will abstract the information from the documentation, assign the appropriate codes, and create a claim to be paid, whether by a commercial payer, the patient, or CMS." (Aapccom, 2015) It is very important that billing coders have a full understanding of how to properly use medical codes to prevent denial of claims submitted.

Health care is growing and demand on our health care system is rising. According to the Administration on Aging of the U.S. Department of Health and Human Services, people 65+ represented roughly 13% of the population in 2011, but are expected to be 21% of the population by 2040. The aging population, as well as increasing technological advances, and improved access to health care reinforce why reimbursement optimization is now essential to cost control and maintaining the quality of our health care system.

As I type these words there are only 20 days until October 1st, AKA, ICD-10 transition day. Most people in the healthcare industry are wondering what that day will be like. What will happen? What will they have to do?

.The purpose of the HCPCs , Level 2 alphanumeric codes are used to report services, supplies and equipment, such as walkers , wheel chairs , oxygen, medicines , provided to Medicare and Medicaid patients , for which no codes exist . HCPCs codes can also be required on non-Medicare and Medicaid patients, because some third-party payer's follow Medicare and Medicaid guidelines and may require that a HCPCs Level 2 code also known as G codes , be assigned. There are also certain HCPCs level 2 codes required by all payer's , such as drug codes also known as j codes. You would find these codes used in out-patient settings , rehabilitation services, doctor's offices , and you would also use them for supplies used , medications and or equipment

The only projects that the organization is currently undergoing is the preparation for the implementation of the new ICD-10 coding. We are hoping that with the new computer coding assistant that it will help the HIM staff transition better and be able to look up the new codes for all the diagnosis and procedures more easily and quickly.

The E/M code's is a big important part in this process. Being a health care professional, using the medical code's. like medicare, medicaid, other private insurance to be reimbursement. If not using the right code, the doctor office, hospital, and urgent care. Will lose a lot of money. So using the right cpt code's insurance companies, office, hospital, and urgent care can be reimbursement correct. Cause CPT code's are formed with 5 digits.

The continue use of ICD-9 codes after the effective date could result in the denial of reimbursement claims. This task can be assigned to the healthcare organization’s management team to determine a solution avoiding a break down in the system. Rahmathulla states, “In instances of an audit, appropriate documentation will make the query process substantially easier while enabling coders to clarify issues without having to query the provider multiple times for answers” (“Migration To The ICD-10 Coding System S187). It is important to accurately document to reduce the amount of claim denials. With the new specificity requirement of the ICD-10 and documentation supporting a claim, lowers the chances of healthcare fraud. The healthcare management team will oversee the process to prevent the risk of exposure.

1. A 54-year-old patient is seen by the physician in the outpatient clinic setting for CLL that is currently in remission. The patient's WBC counts, particularly lymphocytes remain within normal limits

An accurate and specific documentation of universally accepted set of codes are important for the protection of healthcare providers as well as increased reimbursement for services received. These codes are for the validation of which services the patient received from their health care provider ( (Page, 2009). Having the correct codes in place insures the provider with the information needed by the health insurance carrier. Maintained by the AMA (American Medical Association), this universal numeric assignment is also used for developing guidelines for medical care review as well as data collection for medical education and research (Scott, 2013).

Revenue cycle management (RCM) has become increasingly complex thanks in large part to the almost-constant health care reforms and initiatives. As ICD-10 is about to become the new coding standard, hospitals and private practices have begun arming themselves with as many tools and techniques as they can that will help them better manage their revenue cycles.

No change: The cost is increasing every year in the health care industry. There is no way to transfer these costs to patients as the services are already costly. Change is the only constant. Change is inevitable for MGH to survive in this industry. There are no pros with this option and several cons such as having no standards, poor communication and coordination between groups and poor maintenance of patient’s track records.