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Lin KJ, Schneeweiss S, Pawar A, Singer DE, Liu J, Gagne JJ. Using a Simple Prescription Gap to Determine Warfarin Discontinuation Can Lead to Substantial Misclassification. Thromb Haemost 2022; 122:386-393. [PMID: 33984866 DOI: 10.1055/a-1508-8187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Warfarin remains widely used and a key comparator in studies of other direct oral anticoagulants. As longer-than-needed warfarin prescriptions are often provided to allow for dosing adjustments according to international normalized ratios (INRs), the common practice of using a short allowable gap between dispensings to define warfarin discontinuation may lead to substantial misclassification of warfarin exposure. We aimed to quantify such misclassification and determine the optimal algorithm to define warfarin discontinuation. METHODS We linked Medicare claims data from 2007 to 2014 with a multicenter electronic health records system. The study cohort comprised patients ≥65 years with atrial fibrillation and venous thromboembolism initiating warfarin. We compared results when defining warfarin discontinuation by (1) different gaps (3, 7, 14, 30, and 60 days) between dispensings and (2) having a gap ≤60 days or bridging larger gaps if there was INR ordering at least every 42 days (60_INR). Discontinuation was considered misclassified if there was an INR ≥2 within 7 days after the discontinuation date. RESULTS Among 3,229 patients, a shorter gap resulted in a shorter mean follow-up time (82, 95, 117, 159, 196, and 259 days for gaps of 3, 7, 14, 30, 60, and 60_INR, respectively; p < 0.001). Incorporating INR (60_INR) can reduce misclassification of warfarin discontinuation from 68 to 4% (p < 0.001). The on-treatment risk estimation of clinical endpoints varied significantly by discontinuation definitions. CONCLUSION Using a short gap between warfarin dispensings to define discontinuation may lead to substantial misclassification, which can be improved by incorporating intervening INR codes.
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Affiliation(s)
- Kueiyu Joshua Lin
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Sebastian Schneeweiss
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Ajinkya Pawar
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Daniel E Singer
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Jun Liu
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Joshua J Gagne
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
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Sears JM, Rundell SD. Development and Testing of Compatible Diagnosis Code Lists for the Functional Comorbidity Index: International Classification of Diseases, Ninth Revision, Clinical Modification and International Classification of Diseases, 10th Revision, Clinical Modification. Med Care 2020; 58:1044-1050. [PMID: 33003052 PMCID: PMC7717170 DOI: 10.1097/mlr.0000000000001420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Functional Comorbidity Index (FCI) was developed for community-based adult populations, with function as the outcome. The original FCI was a survey tool, but several International Classification of Diseases (ICD) code lists-for calculating the FCI using administrative data-have been published. However, compatible International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10-CM versions have not been available. OBJECTIVE We developed ICD-9-CM and ICD-10-CM diagnosis code lists to optimize FCI concordance across ICD lexicons. RESEARCH DESIGN We assessed concordance and frequency distributions across ICD lexicons for the FCI and individual comorbidities. We used length of stay and discharge disposition to assess continuity of FCI criterion validity across lexicons. SUBJECTS State Inpatient Databases from Arizona, Colorado, Michigan, New Jersey, New York, Utah, and Washington State (calendar year 2015) were obtained from the Healthcare Cost and Utilization Project. State Inpatient Databases contained ICD-9-CM diagnoses for the first 3 calendar quarters of 2015 and ICD-10-CM diagnoses for the fourth quarter of 2015. Inpatients under 18 years old were excluded. MEASURES Length of stay and discharge disposition outcomes were assessed in separate regression models. Covariates included age, sex, state, ICD lexicon, and FCI/lexicon interaction. RESULTS The FCI demonstrated stability across lexicons, despite small discrepancies in prevalence for individual comorbidities. Under ICD-9-CM, each additional comorbidity was associated with an 8.9% increase in mean length of stay and an 18.5% decrease in the odds of a routine discharge, compared with an 8.4% increase and 17.4% decrease, respectively, under ICD-10-CM. CONCLUSION This study provides compatible ICD-9-CM and ICD-10-CM diagnosis code lists for the FCI.
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Affiliation(s)
- Jeanne M. Sears
- Department of Health Services, University of Washington,
Seattle, WA
- Department of Environmental and Occupational Health
Sciences, University of Washington, Seattle, WA
- Harborview Injury Prevention and Research Center, Seattle,
WA
- Institute for Work and Health, Toronto, Ontario,
Canada
| | - Sean D. Rundell
- Department of Health Services, University of Washington,
Seattle, WA
- Department of Rehabilitation Medicine, University of
Washington, Seattle, WA
- Comparative Effectiveness, Cost, and Outcomes Research
Center; University of Washington, Seattle, WA
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Carlo AD, Corage Baden A, McCarty RL, Ratzliff ADH. Early Health System Experiences with Collaborative Care (CoCM) Billing Codes: a Qualitative Study of Leadership and Support Staff. J Gen Intern Med 2019; 34:2150-2158. [PMID: 31367872 PMCID: PMC6816741 DOI: 10.1007/s11606-019-05195-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/17/2019] [Accepted: 06/13/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although collaborative care (CoCM) is an evidence-based and widely adopted model, reimbursement challenges have limited implementation efforts nationwide. In recent years, Medicare and other payers have activated CoCM-specific codes with the primary aim of facilitating financial sustainability. OBJECTIVE To investigate and describe the experiences of early adopters and explorers of Medicare's CoCM codes. DESIGN AND PARTICIPANTS Fifteen interviews were conducted between October 2017 and May 2018 with 25 respondents representing 12 health care organizations and 2 payers. Respondents included dually boarded medicine/psychiatry physicians, psychiatrists, primary care physicians (PCPs), psychologists, a registered nurse, administrative staff, and billing staff. APPROACH A semi-structured interview guide was used to address health care organization characteristics, CoCM services, patient consent, CoCM operational components, and CoCM billing processes. All interviews were recorded, transcribed, coded, and analyzed using a content analysis approach conducted jointly by the research team. KEY RESULTS Successful billing required buy-in from key, interdisciplinary stakeholders. In planning for CoCM billing implementation, several organizations hired licensed clinical social workers (LICSWs) as behavioral health care managers to maximize billing flexibility. Respondents reported a number of consent-related difficulties, but these were not primary barriers. Workflow changes required for billing the CoCM codes (e.g., tracking cumulative treatment minutes, once-monthly code entry) were described as arduous, but also stimulated creative solutions. Since CoCM codes incorporate the work of the psychiatric consultant into one payment to primary care, organizations employed strategies such as inter-departmental ledger transfers. When challenges arose from variations in the local payer mix, some organizations billed CoCM codes exclusively, while others elected to use a mixture of CoCM and traditional fee-for-service (FFS) codes. For most organizations, it was important to demonstrate financial sustainability from the CoCM codes. CONCLUSIONS With deliberate planning, persistence, and widespread organizational buy-in, successful utilization of newly available FFS CoCM billing codes is achievable.
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Affiliation(s)
- Andrew D Carlo
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
| | - Andrea Corage Baden
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Rachelle L McCarty
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, USA
| | - Anna D H Ratzliff
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
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Yamaguchi M, Inomata S, Harada S, Matsuzaki Y, Kawaguchi M, Ujibe M, Kishiba M, Fujimura Y, Kimura M, Murata K, Nakashima N, Nakayama M, Ohe K, Orii T, Sueoka E, Suzuki T, Yokoi H, Takahashi F, Uyama Y. Establishment of the MID-NET ® medical information database network as a reliable and valuable database for drug safety assessments in Japan. Pharmacoepidemiol Drug Saf 2019; 28:1395-1404. [PMID: 31464008 PMCID: PMC6851601 DOI: 10.1002/pds.4879] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 04/29/2019] [Accepted: 07/14/2019] [Indexed: 12/31/2022]
Abstract
Purpose To establish a new medical information database network (designated MID‐NET®) to provide real‐world data for drug safety assessments in Japan. Methods This network was designed and developed by the Ministry of Health, Labour and Welfare and the Pharmaceuticals and Medical Devices Agency in collaboration with 23 hospitals from 10 healthcare organizations across Japan. MID‐NET® is a distributed and closed network system that connects all collaborative organizations through a central data center. A wide variety of data are available for analyses, including clinical and administrative information. Several coding standards are used to standardize the data stored in MID‐NET® to allow the integration of information originating from different hospitals. A rigorous and consistent quality management system was implemented to ensure that MID‐NET® data are of high quality and meet Japanese regulatory standards (good post‐marketing study practice and related guidelines). Results MID‐NET® was successfully established as a reliable and valuable medical information database and was officially launched in April 2018. High data quality with almost 100% consistency was confirmed between original data in hospitals and the data stored in MID‐NET®. A major advantage is that approximately 260 clinical laboratory test results are available for analysis. Conclusions MID‐NET® is expected to be a major data source for drug safety assessments in Japan. Experiences and best practices established in MID‐NET® may provide a model for the future development of similar database networks.
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Affiliation(s)
- Mitsune Yamaguchi
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices AgencyTokyoJapan
| | - Satomi Inomata
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices AgencyTokyoJapan
| | - Sayoko Harada
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices AgencyTokyoJapan
| | - Yu Matsuzaki
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices AgencyTokyoJapan
| | - Maiko Kawaguchi
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices AgencyTokyoJapan
| | - Mayuko Ujibe
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices AgencyTokyoJapan
| | - Mari Kishiba
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices AgencyTokyoJapan
| | | | - Michio Kimura
- Department of Medical InformaticsHamamatsu University HospitalShizuokaJapan
| | - Koichiro Murata
- Department of RadiologyKitasato University HospitalKanagawaJapan
| | - Naoki Nakashima
- Department of Advanced Information TechnologyKyushu University HospitalFukuokaJapan
| | | | - Kazuhiko Ohe
- Department of Healthcare Information ManagementThe University of Tokyo HospitalTokyoJapan
| | - Takao Orii
- Department of PharmacyNTT Medical Center TokyoTokyoJapan
| | - Eizaburo Sueoka
- Department of Laboratory MedicineSaga University HospitalSagaJapan
| | - Takahiro Suzuki
- Department of Medical InformaticsChiba University HospitalChibaJapan
| | - Hideto Yokoi
- Department of Medical InformaticsKagawa University HospitalKagawaJapan
| | - Fumitaka Takahashi
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices AgencyTokyoJapan
| | - Yoshiaki Uyama
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices AgencyTokyoJapan
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Monestime JP, Mayer RW, Blackwood A. Analyzing the ICD-10-CM Transition and Post-implementation Stages: A Public Health Institution Case Study. Perspect Health Inf Manag 2019; 16:1a. [PMID: 31019430 PMCID: PMC6462880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
On October 1, 2015, the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) was incorporated into the US public health system. Because of significant opposition and reservations expressed by stakeholders, while the proposed rule for ICD-10-CM adoption was issued in 2009, the transition did not occur until October 2015. The purpose of this study was to identify conversion initiatives used by a public health institution during the initial and subsequent stages of ICD-10-CM implementation, to help similar institutions address future unfunded healthcare data infrastructure mandates. The data collection for this study occurred from 2015 to 2018, encompassing 20 semistructured interviews with 13 department heads, managers, physicians, and coders. Research findings from this study identified several trends, disruptions, challenges, and lessons learned that might support the industry with strategies to foster success for the transition to future coding revisions (i.e., ICD-11).
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Bush-Goddard SP, Shaffer VA, Norman KJ. Consolidation of Health Physics Computer Codes: Sustainable Gains in Efficiency, Innovation, and Collaboration. Health Phys 2018; 115:652-656. [PMID: 30260857 DOI: 10.1097/hp.0000000000000964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A decade ago, the nuclear power industry in the United States was on the verge of a nuclear renaissance with the potential to create jobs, funding streams, and great demand for radiation protection personnel. However, based on the high capital investment cost of building and licensing nuclear reactors and declining fossil fuel prices, the renaissance did not reach its full potential. Radiation protection initiatives were developed to bring attention to the profession in order to increase funding for the health physics community during these times of declining resources. It is now essential that the community be innovative in how it uses existing funds and acquires resources. This paper describes a radiation protection computer code program that uses existing resources and international funding to sustain computer codes and tools used in the health physics profession. The program is called the U.S. Nuclear Regulatory Commission's Radiation Protection Computer Code Analysis and Maintenance Program or RAMP. This collaborative, innovative, and transformative model can be followed by others seeking to alleviate the resource issues that exist within the health physics field.
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Al-Hablani B. The Use of Automated SNOMED CT Clinical Coding in Clinical Decision Support Systems for Preventive Care. Perspect Health Inf Manag 2017; 14:1f. [PMID: 28566995 PMCID: PMC5430114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The objective of this study is to discuss and analyze the use of automated SNOMED CT clinical coding in clinical decision support systems (CDSSs) for preventive care. The central question that this study seeks to answer is whether the utilization of SNOMED CT in CDSSs can improve preventive care. METHOD PubMed, Google Scholar, and Cochrane Library were searched for articles published in English between 2001 and 2012 on SNOMED CT, CDSS, and preventive care. OUTCOME MEASURES Outcome measures were the sensitivity or specificity of SNOMED CT coded data and the positive predictive value or negative predictive value of SNOMED CT coded data. Additionally, we documented the publication year, research question, study design, results, and conclusions of these studies. RESULTS The reviewed studies suggested that SNOMED CT successfully represents clinical terms and negated clinical terms. CONCLUSION The use of SNOMED CT in CDSS can be considered to provide an answer to the problem of medical errors as well as for preventive care in general. Enhancement of the modifiers and synonyms found in SNOMED CT will be necessary to improve the expected outcome of the integration of SNOMED CT with CDSS. Moreover, the application of the tree-augmented naïve (TAN) Bayesian network method can be considered the best technique to search SNOMED CT data and, consequently, to help improve preventive health services.
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Affiliation(s)
- Bader Al-Hablani
- King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia
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8
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Baldovino S, Moliner AM, Taruscio D, Daina E, Roccatello D. Rare Diseases in Europe: from a Wide to a Local Perspective. Isr Med Assoc J 2016; 18:359-363. [PMID: 27468531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The European Union defines rare diseases (RDs) as life-threatening or chronically debilitating conditions whose prevalence is less than 5 per 10,000. Moreover, for many RDs, including those of genetic origin, combined efforts are required to reduce morbidity or perinatal and early mortality, and address the considerable decline in an individual's quality of life and socioeconomic potential. Their specificities, i.e., a limited number of patients and scarcity of relevant knowledge and expertise, make RDs a unique condition which requires wide cooperation at a supranational level. Many steps were therefore taken to develop a network of European Reference Centers and to improve RDs coding and classification. In Italy, the RDs issue was addressed in 2001 with the development of a national network and a national registry coordinated by the National Center for RDs of the Italian National Institute of Health. Registries are an important resource for the development of appropriate public health policies and research on specific RDs. Research on RDs is essential for the development of novel therapeutic approaches and requires the involvement of scientific societies and patient organizations. Nevertheless, the management of patients with a chronic-RD requires a qualified care network. The network for RDs of Piedmont and the Aosta Valley (northwest Italy) represents an example of health care organization based on the availability of advanced therapies close to the patient's home.
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McCleskey S. [With introduction of the nursing complex measures score the first successes appeared in nursing]. Kinderkrankenschwester 2016; 35:218-219. [PMID: 27483642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Archer A, Campbell A, D'Amato C, McLeod M, Rugg D. Putting the ICD-10-CM/PCS GEMs into Practice (Updated). J AHIMA 2016; 87:48-53. [PMID: 27055341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Fant C, Theiss MA. Transitioning to ICD-10: Implications for nurse practitioners. Nurse Pract 2015; 40:22-31. [PMID: 26383022 DOI: 10.1097/01.npr.0000471363.10111.b2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Coding patients' diagnoses and institutional procedures under the International Classification of Diseases transitioned from the ICD-9 to ICD-10, effective October 1, 2015, which has many implications for nurse practitioners.
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Affiliation(s)
- Catherine Fant
- Catherine Fant is a professor at Kaplan University, Chicago, Ill. Mary Anne Theiss is a professor at Kaplan University, Chicago, Ill
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12
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Tennant RM. 5 last-minute ICD-10 steps for physician practices. MGMA Connex 2015; 15:13-14. [PMID: 26529912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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13
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Weems S, Heller P, Fenton SH. Results from the Veterans Health Administration ICD-10-CM/PCS Coding Pilot Study. Perspect Health Inf Manag 2015; 12:1b. [PMID: 26396553 PMCID: PMC4558479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Veterans Health Administration (VHA) of the US Department of Veterans Affairs has been preparing for the October 1, 2015, conversion to the International Classification of Diseases, Tenth Revision, Clinical Modification and Procedural Coding System (ICD-10-CM/PCS) for more than four years. The VHA's Office of Informatics and Analytics ICD-10 Program Management Office established an ICD-10 Learning Lab to explore expected operational challenges. This study was conducted to determine the effects of the classification system conversion on coding productivity. ICD codes are integral to VHA business processes and are used for purposes such as clinical studies, performance measurement, workload capture, cost determination, Veterans Equitable Resource Allocation (VERA) determination, morbidity and mortality classification, indexing of hospital records by disease and operations, data storage and retrieval, research purposes, and reimbursement. The data collection for this study occurred in multiple VHA sites across several months using standardized methods. It is commonly accepted that coding productivity will decrease with the implementation of ICD-10-CM/PCS. The findings of this study suggest that the decrease will be more significant for inpatient coding productivity (64.5 percent productivity decrease) than for ambulatory care coding productivity (6.7 percent productivity decrease). This study reveals the following important points regarding ICD-10-CM/PCS coding productivity: 1. Ambulatory care ICD-10-CM coding productivity is not expected to decrease as significantly as inpatient ICD-10-CM/PCS coding productivity. 2. Coder training and type of record (inpatient versus outpatient) affect coding productivity. 3. Inpatient coding productivity is decreased when a procedure requiring ICD-10-PCS coding is present. It is highly recommended that organizations perform their own analyses to determine the effects of ICD-10-CM/PCS implementation on coding productivity.
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Affiliation(s)
- Shelley Weems
- Shelley Weems, RHIA, CCS, is a health information management specialist in the Veterans Health Administration Office of Informatics and Analytics in Washington, DC
| | - Pamela Heller
- Pamela Heller, RHIA, CCS-P, is the director of health information management in the Veterans Health Administration Office of Informatics and Analytics in Washington, DC
| | - Susan H Fenton
- Susan H. Fenton, PhD, RHIA, FAHIMA, is a program specialist in the Veterans Health Administration Office of Informatics and Analytics in Washington, DC
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Butler M. Life After ICD-10. J AHIMA 2015; 86:22-27. [PMID: 26489223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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15
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Hinkle-Azzara B, Carr K. Answering the TOUGH ICD10 Questions. J AHIMA 2015; 86:28-32. [PMID: 26489224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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ICD-10 is finally on the horizon. Hosp Peer Rev 2015; 40:52-3. [PMID: 26000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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17
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Freeman J, Petterson S, Bazemore A. Accounting for complexity: aligning current payment models with the breadth of care by different specialties. Am Fam Physician 2014; 90:790. [PMID: 25611714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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18
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Bendix J. CODE with CONFIDENCE. Optimize your coding strategy for 2015. Med Econ 2014; 91:17-22. [PMID: 26242060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Tennant R. Tracking ICD-10: A guide to internal assessments. MGMA Connex 2014; 14:20-21. [PMID: 27366810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Franklin J. The ABCs of HHS-HCCs. Taking a closer look at the commercial risk adjustment. J AHIMA 2014; 85:76-79. [PMID: 25682650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Office of the Secretary, HHS. Administrative simplification: change to the compliance date for the International Classification of Diseases, 10th Revision (ICD-10-CM and ICD-10-PCS) medical data code sets. Final rule. Fed Regist 2014; 79:45128-34. [PMID: 25122944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This final rule implements section 212 of the Protecting Access to Medicare Act of 2014 by changing the compliance date for the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) for diagnosis coding, including the Official ICD-10-CM Guidelines for Coding and Reporting, and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding, including the Official ICD-10-PCS Guidelines for Coding and Reporting, from October 1, 2014 to October 1, 2015. It also requires the continued use of the International Classification of Diseases, 9th Revision, Clinical Modification, Volumes 1 and 2 (diagnoses), and 3 (procedures) (ICD-9-CM), including the Official ICD-9-CM Guidelines for Coding and Reporting, through September 30, 2015.
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Studeny J, Coustasse A. Personal health records: is rapid adoption hindering interoperability? Perspect Health Inf Manag 2014; 11:1e. [PMID: 25214822 PMCID: PMC4142513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The establishment of the Meaningful Use criteria has created a critical need for robust interoperability of health records. A universal definition of a personal health record (PHR) has not been agreed upon. Standardized code sets have been built for specific entities, but integration between them has not been supported. The purpose of this research study was to explore the hindrance and promotion of interoperability standards in relationship to PHRs to describe interoperability progress in this area. The study was conducted following the basic principles of a systematic review, with 61 articles used in the study. Lagging interoperability has stemmed from slow adoption by patients, creation of disparate systems due to rapid development to meet requirements for the Meaningful Use stages, and rapid early development of PHRs prior to the mandate for integration among multiple systems. Findings of this study suggest that deadlines for implementation to capture Meaningful Use incentive payments are supporting the creation of PHR data silos, thereby hindering the goal of high-level interoperability.
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Affiliation(s)
- Jana Studeny
- Jana Studeny, RN-BC, MSHI, is a graduate of the Healthcare Informatics Program at Marshall University in Huntington, WV
| | - Alberto Coustasse
- Alberto Coustasse, DrPH, MD, MBA, MPH, is an associate professor of the healthcare administration program in the College of Business at Marshall University in South Charleston, WV
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Dowling R. EHR documentation: avoid note cloning and up-coding. Med Econ 2014; 91:33. [PMID: 25219156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Systematic approach to scheduling smoothes out the daily wrinkles. OR Manager 2014; 30:21-3. [PMID: 25004608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Gray L. ICD-10: time to take action. Med Econ 2014; 91:36-39. [PMID: 25233765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Endicott M. DIY: grow your own coders. Organizations develop programs to internally cultivate coders. J AHIMA 2014; 85:60-61. [PMID: 24834559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Mulaik MW. Physician supervision of radiology services. Radiol Manage 2014; 36:40-42. [PMID: 24757906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Leon-Chisen N. With a few months to go, are you ready for ICD-10? Hosp Health Netw 2014; 88:12. [PMID: 24923018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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McLaughlin DB. Coming in October: ICD-10. Healthc Exec 2014; 29:62-64. [PMID: 24724319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Morrissey J. The drama builds. Hosp Health Netw 2014; 88:36-40. [PMID: 24693736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Eramo LA. Peeking over the fence. J AHIMA 2014; 85:30-33. [PMID: 24645397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Johnston G. Managing and mapping coded ICD-9-CM data to ICD-10-CM/PCS. J AHIMA 2013; 84:72-74. [PMID: 24059160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Clark JS. Adapting enterprise workflow for ICD-10-CM/PCS. J AHIMA 2013; 84:48-51. [PMID: 23844543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Zelingher J, Ash N. [Data coding in the Israeli healthcare system - do choices provide the answers to our system's needs?]. Harefuah 2013; 152:267-309. [PMID: 23885449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The IsraeLi healthcare system has undergone major processes for the adoption of health information technologies (HIT), and enjoys high Levels of utilization in hospital and ambulatory care. Coding is an essential infrastructure component of HIT, and ts purpose is to represent data in a simplified and common format, enhancing its manipulation by digital systems. Proper coding of data enables efficient identification, storage, retrieval and communication of data. UtiLization of uniform coding systems by different organizations enables data interoperability between them, facilitating communication and integrating data elements originating in different information systems from various organizations. Current needs in Israel for heaLth data coding include recording and reporting of diagnoses for hospitalized patients, outpatients and visitors of the Emergency Department, coding of procedures and operations, coding of pathology findings, reporting of discharge diagnoses and causes of death, billing codes, organizational data warehouses and national registries. New national projects for cLinicaL data integration, obligatory reporting of quality indicators and new Ministry of Health (MOH) requirements for HIT necessitate a high Level of interoperability that can be achieved only through the adoption of uniform coding. Additional pressures were introduced by the USA decision to stop the maintenance of the ICD-9-CM codes that are also used by Israeli healthcare, and the adoption of ICD-10-C and ICD-10-PCS as the main coding system for billing purpose. The USA has also mandated utilization of SNOMED-CT as the coding terminology for the ELectronic Health Record problem list, and for reporting quality indicators to the CMS. Hence, the Israeli MOH has recently decided that discharge diagnoses will be reported using ICD-10-CM codes, and SNOMED-CT will be used to code the cLinical information in the EHR. We reviewed the characteristics, strengths and weaknesses of these two coding systems. In summary, the adoption of ICD-10-CM is in line with the USA decision to abandon ICD-9-CM, and the Israeli heaLthcare system could benefit from USA heaLthcare efforts in this direction. The Large content of SNOMED-CT and its sophisticated hierarchical data structure will enable advanced cLinicaL decision support and quality improvement applications.
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Affiliation(s)
- Julian Zelingher
- Clalit Health Services Corporate Headquarters, Ministry of Health.
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Tennant R. Implementing ICD-10: enhancing clinical documentation. MGMA Connex 2013; 13:16-17. [PMID: 23814902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Houser SH, Morgan D, Clements K, Hart-Hester S. Assessing the planning and implementation strategies for the ICD-10-CM/PCS coding transition in Alabama hospitals. Perspect Health Inf Manag 2013; 10:1a. [PMID: 23805061 PMCID: PMC3692320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Health information management (HIM) professionals play a significant role in transitioning from ICD-9-CM to ICD-10-CM/PCS. ICD-10-CM/PCS coding will impact many operational aspects of healthcare facilities, such as physicians' documentation in health records, coders' process for review of clinical information, the billing process, and the payers' reimbursement to the healthcare facilities. This article examines the level of readiness and planning for ICD-10-CM/PCS implementation among hospitals in Alabama, identifies training methods/approaches to be used by the hospitals, and discusses the challenges to the ICD-10-CM/PCS coding transition. A 16-question survey was distributed to 116 Alabama hospital HIM directors in December 2011 with follow-up through February 2012. Fifty-three percent of respondent hospitals began the planning process in 2011, and most facilities were halfway or less than halfway to completion of specific implementation tasks. Hospital coders will be or are being trained using in-house training, through seminars/webinars, or by consultants. The impact of ICD-10-CM/PCS implementation can be minimized by training coders in advance, hiring new coders, and adjusting coders' productivity measures. Three major challenges to the transition were identified: the need to interact with physicians and other providers more often to obtain information needed to code in ICD-10-CM/PCS systems, education and training of coders and other ICD-10-CM/PCS users, and dependence on vendors for major technology upgrades for ICD-10-CM/PCS systems. Survey results provide beneficial information for HIM professionals and other users of coded data to assist in establishing sound practice standards for ICD-10-CM/PCS coding implementation. Adequate planning and preparation will be essential to the successful implementation of ICD-10-CM/PCS.
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Affiliation(s)
- Shannon H Houser
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA
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Leon-Chisen N. If we procrastinate long enough, will ICD-11 be ready? Hosp Health Netw 2013; 87:12. [PMID: 23617104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Savarise M. Coding for hospital admission, consultations, and emergency department visits. Bull Am Coll Surg 2013; 98:54-56. [PMID: 23441509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Alonso P, Love TR. Holistic coding requires amped up clinical documentation. J AHIMA 2013; 84:50-51. [PMID: 23379033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Paula Alonso
- University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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Guardia A, Meyer R, Rohner P. The CASSANDRE Project: automated alerts for optimal coding of diagnosis and interventions. World Hosp Health Serv 2013; 49:21-24. [PMID: 24683811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
As of 1 January 2012,all Swiss hospitals have had to charge acute somatic care hospitalization according to the Swiss disease related group (DRG) System. In this system, hospital bills are based on the discharge summaries. Coders analyze these in order to identify diagnostic and interventional codes. These codes are used by the system grouper to determine a specific DRG code and cost-weight. The amount to be charged per episode is based on this cost-weight. Since acute care billing relies on discharge summaries and knowing that these are incomplete, our aim was to inprove the completeness of these documents by automatically detecting pathologies that should have been coded and charged. We also aimed to help improve the selection of the main diagnosis. We have implemented algorithms for the automatic detection of pathologies that directly inform the coders whilst by-passing the physician. Final validation of the new pathologies remains with the physician. Our results are very encouraging from a financial point of view.
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Lewis M. Superbills simplify coding for outpatient procedures. Med Econ 2012; 89:66. [PMID: 23516913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Maxine Lewis
- Medical Coding & Reimbursement, Cincinnati, Ohio, USA
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Nirantharakumar K, Marshall T, Hemming K, Narendran P, Coleman JJ. Inpatient electronic prescribing data can be used to identify 'lost' discharge codes for diabetes. Diabet Med 2012; 29:e430-5. [PMID: 22998394 DOI: 10.1111/dme.12020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM Accurate assessment of missed discharge codes for diabetes is critical for effective planning of hospital diabetes services. We wished to estimate the frequency of missed discharge diagnostic codes for diabetes and the impact missed codes would have on diabetes-related payments to the hospital. METHODS We linked Patient Administration System data to the Prescribing Information and Communication System. We defined diabetes as those having a discharge code for diabetes in the Patient Administration System and those on anti-diabetic medication in the Prescribing Information and Communication System. Based on the two sources, we calculated the estimated missed discharge codes for diabetes using the capture-recapture technique. We generated the Healthcare Resource Group for a given admission before and after correction for the missed code to estimate the impact that correction would make on payments to the hospital. RESULTS Among the 171 067 admissions linked, 22 412 (13.1%) had a code for diabetes at discharge. An additional 2706 admissions were classified as having diabetes based on prescription data. The capture-recapture technique estimated there were 4588 (2.7% of all admissions) admissions with diabetes missed by current coding, of which 2706 (60%) would be obtained from prescription data. After adding a diabetes diagnostic code, 12.8% of the missed admissions with diabetes resulted in a change to the Healthcare Resource Group tariff code and payment. CONCLUSION The use of electronic prescription data is a simple solution to correct for missed discharge diagnostic codes.
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Batres J. EHRs offer coders opportunities, challenges. J AHIMA 2012; 83:76-78. [PMID: 23061358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Leenheer C. The clinical documentation advantage protecting the revenue cycle under ICD-10. Healthc Financ Manage 2012; 66:104-6, 108, 110 passim. [PMID: 22978036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Healthcare providers need to prepare their revenue cycles for the profound increase in coding complexity and detail that will result from the transition to ICD-10. The best strategy for providers to build a solid foundation for effective ICD-10 coding, and thereby protect the revenue cycle, is to establish a clinical documentation improvement (CDI) program. CDI specialists will need to work with physicians to ensure the level of specificity required for ICD-10 coding is included in the clinical documentation.
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Zeisset A, Bowman S. Strategies for ICD-10 implementation. Healthc Financ Manage 2012; 66:96-102. [PMID: 22978035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Hospitals and health systems should consider seven strategies for preparing for the conversion from ICD-9-CM to ICD-10-CM/PCS: Form a project planning team. Assess the range of impact on each department and on productivity, revenue, and resources. Perform a gap analysis. Analyze data. Develop a training strategy specific to coding professionals and heavy data users. Work to improve documentation. Communicate with vendors regarding their plans for the transition to ICD-10.
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Hartman K, Phillips SC, Sornberger L. Computer-assisted coding at the Cleveland Clinic: a strategic solution. Addressing clinical documentation improvement, ICD-10-CM/PCS implementation, and more. J AHIMA 2012; 83:24-28. [PMID: 22896948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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DeVault K. Best practices for coding productivity: assessing productivity in ICD-9 to prepare for ICD-10. J AHIMA 2012; 83:72-74. [PMID: 22896957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Gregory KE, Radovinsky L. Research strategies that result in optimal data collection from the patient medical record. Appl Nurs Res 2012; 25:108-16. [PMID: 20974093 PMCID: PMC3030926 DOI: 10.1016/j.apnr.2010.02.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 02/01/2010] [Accepted: 02/03/2010] [Indexed: 11/17/2022]
Abstract
Data obtained from the patient medical record are often a component of clinical research led by nurse investigators. The rigor of the data collection methods correlates to the reliability of the data and, ultimately, the analytical outcome of the study. Research strategies for reliable data collection from the patient medical record include the development of a precise data collection tool, the use of a coding manual, and ongoing communication with research staff.
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Affiliation(s)
- Katherine E Gregory
- W.F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USA.
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Comfort A. Ensuring remote coding compliance. J AHIMA 2012; 83:56-57. [PMID: 22567806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Hughes C. ICD-10: what you need to know now. Fam Pract Manag 2012; 19:29-31. [PMID: 22534441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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