The Impact Of ICD-10 On Health Care

In today’s society, the accuracy of health information, the availability of health records, and the professional resources in which one live are vital in decision making for health conditions. Meaningful Use (MU) is a program developed by CMS Medicare and Medicaid that awards, incentives in the health care industry in which the certified electronic health records (EHRs) are used to improve patient care (Practice Fusion, 2016). These incentives are for professionals that care for about 30% of their adult patient volume or 20% of their children’s volume for Medicare and Medicaid patients (CMS, 2016). In addition, adjusting from paper charts to electronic charts of patient’s information is beneficial for MU. Furthermore, the American

Radley, D., Wasserman, M., Olsho, L., Shoemaker, S., Spranca, M., & Bradshaw, B. (2013). Reduction in medications errors in hospitals due to adop

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.

Are you and your staff anywhere near ready for ICD-10’s October 1st deadline? Maybe you’ve been overwhelmed just trying to implement all of the other changes happening in healthcare thanks to the Affordable Care Act, EMR mandates, increased Medicare audits, and value-based purchasing penalties; you’ve hardly had time to prepare for this latest coding switch.

A few things are happening soon and for us to be excited about. One is for this Saturday's picnic we will close at 4:30pm as the email stated yesterday. I do hope to see all of you there to enjoy a nice evening by of the family and shorebirds and of course the food!!! We also will be starting to use ICD-10. This is being used all over. From the billing prospective this is a wonderful way of documenting. When we first start this it may take us a few extra minutes with our time patients that have been here before, however; once we do this we will not have to do it again since the codes will then be ICD-10. More information is coming on this.

The SCHC addressed meaningful use by recording patient demographics, maintaining an active medication lists and incorporating clinical lab test results into the HER, as apart of their meaningful use objectives. For recording patient demographics, they maintained data for accurate billing and ensured that the practice workflow was adjusted to capture all of the necessary patient data. They addressed active medication lists by following the requirements for e-prescribing. Patients were able to review their active medication list during their visit. Changes to the medication list were reviewed with the nurse and adjusted within the EHR system by the doctor. They communicated information for the care coordination process by making test results efficient and safe to access. Physicians were able to make real time decisions when they receive the test results from LabCorp, Quest, and other health

Physicians and other facilities are paid by insurance companies, including Medicare and Medicaid, based on the procedure (CPT) code they submit. These codes must be accompanied by the correct diagnosis or ICD-10 codes.There must be a valid reason for a medical encounter for the physician to be paid, such as pain, refills for medications, or a follow-up for such diseases as diabetes or any chronic condition. If you just submit the CPT or ICD-10 code separately then you will not be paid as both support each other. So it is vital that a medical biller and coder be aware of these rules and how to complete the claim forms properly.

The United States implemented the current version (ICD-9) in 1979. ICD-10- CM is the mandated code set for diagnoses under the HIPAA Electronic Health Care Transactions and Code Sets standard starting on October 1, 2014. While most countries moved to ICD-10 several years ago, the United States is just now transitioning into ICD-10 and has to be compliant by October 1, 2015. ICD has been revised a number of times since the coding system was first developed more than a hundred years ago.

It took a long process to convert to ICD-10, ICD-9 was a huge thing and was commonly used in the 1980's. It was until October of 2013 when they decided to convert to ICD-10 would happen and be implemented. It took over 20 years just to move to another move.

I think one of the biggest challenges transitioning from ICD-9 to ICD-10 will me the amount of codes the ICD-10 book has. I think at first it will be a little hard getting used to but once we get used to it, I think it's going to be fine.

A thorough knowledge of medical terminology is extremely important in order to code. If you cannot find the term you are looking for, you will need to know where the term is located in the body in order or the exact problem you are looking for to find the term.

The goal of Discounted MEDS is to reduce readmission rates to show that patients are healthier (Gagnon, personal communication, March 23, 2015). According to the statistics, CRH’s best readmissions percentages occurred after the program’s implementation. Nurses are giving more Discounted MEDS education in groups, which encourages patient-centered care. Therefore, patients are informed and can ask about medication costs in geographic areas. The first quarter comparison exceeded the staff’s expectations. The manager and staff analyzed and adjusted to the program needs by using the plan, do, study, and act (PDSA).

For example, one of the current gaps in data is how long a patient should be on DAPT after stent placement. This is confusing to patients and providers because there is conflicting data on how long a patient should uphold this medication regimen. Another gap identified is affordability of medications. A cohort study used data from a French health insurance reimbursement database to identify and monitor DAPT compliance (Latry, Lafitte, Peter, Couffinhal, & Martin-Latry, n.d.). It found that patients were noncompliant because they did not submit for reimbursement of their medications or patients filled their prescriptions but did not pick them up. It also identified patients who were not prescribed DAPT upon discharge (Latry, Lafitte, Peter, Couffinhal, & Martin-Latry,

Health Information Technology (HIT) Medicare databases are valuable tools to extract healthcare data because they store comprehensive sources of health information. Medicare collects information on all its beneficiaries and those providers that receive payments from Medicare. The data that Medicare collects can be used to identify the variations in cost, utilization and quality. Most Medicare beneficiaries are in traditional fee-for-service (FFS), therefore, spending per beneficiary should be the same throughout the country but, it is not. Numerous studies have shown there are differences in cost and the quality of health care with Medicare beneficiaries, with the biggest spending difference being post-acute services. As explained, by the

Every executive in the hospital should be concerned about patient safety. Adverse drug events (ADEs) are costly, both in human terms and money. The cost of each ADE is significant, according to The Leapfrog Group (2014), each “ADE adds more than $2,000 on average to the costs of hospitalization.” As CFO, I need to balance the cost of new technology with patient safety. As CFO, I would like to have some incentives to implement these costly CPOE systems; however, these incentives may not help Suburban hospital improve quality of care. Lee et al. (2012). Found that the CMS policy to decrease payments to providers based on in-hospital infection rates “had no measurable effect on infection rates in U.S. hospitals.”