ICD-10-CM: Myths Gone Wild

As the ICD-10-CM implementation date nears, it seems that the buzz has heightened and along with the buzz comes half-truths and misconceptions.   A recent online article in Forbes’s magazine focused on coding.  The article, “Doctors Lag Far Behind On New Medicare Diagnosis Codes,” implies that ICD-10-CM codes are Medicare codes.  Because the United States uses ICD-9-CM (and eventually ICD-10-CM) in the billing process, we have ventured away from real reason we code:  to have an efficient, consistent system of capturing data that supports healthcare decision making in our country.   Do we ca

Maria Bounos from Wolters Kluwer joins "Talk Ten Tuesday" to discuss ICD-10: Now and Then

 Maria Bounos, RN, MPM, CPC-H, Practice Lead Coding and Reimbursement Products from Wolters Kluwer, will appear on’s “Talk Ten Tuesday” on October 14, 2013 at 10am EDT as part of an expert panel to discuss ICD-10: Now and Then. Register Now!

Government Shutdown

The content team at Wolters Kluwer Law & Business wanted to provide you with an update on the products, given the government shutdown.

Here is what the majorify of the government sites are stating: "Due to the lapse in government funding, only web sites supporting excepted functions will be updated unless otherwise funded. As a result, the information on this website may not be up to date, the transactions submitted via the website may not be processed, and the agency may not be able to respond to inquiries until appropriations are enacted. Updates regarding government operating status and resumption of normal operations can be found at" 

New York State Goes Paperless for Health Commerce System Accounts

The New York State Senate passed the Internet System for Tracking Over-Prescribing (“I-STOP”) Act in order to curb abuse and diversion of prescription drugs.  The program requires prescribers to review the patient’s recent history of controlled substance prescriptions, which offers providers more information to exercise professional judgment in treating patients.  Starting on August 27, 2013, any New York State (NYS) licensed prescriber who holds a valid DEA registration must consult New York’s online Prescription Monitoring Program (PMP) Registry prior to prescribing Schedule II, III or IV

OIG Work Plan To Be Released in January 2014!!

The Office of the Inspector General has just announced that its annual Work Plan will not be released in the Fall!  The Work Plan is usually released in early October.  But now, the OIG says the "Work Plan will next appear in January 2014. This change from the usual October release will better align with priorities OIG has set for the coming year, a time of continuing fiscal challenges."

Is ICD-10 really needed in the US?

Key industry players, such as the AMA and MGMA, have questioned whether we really need ICD-10-CM in this country.  They seem to think there will be no benefit to clinicians with the upcoming change in the diagnosis coding system.  I think they’re wrong.  The current system hasn’t been overhauled since 1979.  It’s been updated every year but it can’t move forward to work in the electronic environment and it can’t capture information about current day medical practice.  It’s pretty hard to describe cutting edge medicine with a 34 year old system. 

Medicare and Inpatient Consultations

CMS made a major blooper in their announcement about a new set of claims edits designed to keep providers from reporting new patient evaluation and management (E/M) services more frequently than allowed. But the good news is that they have fixed the edits and you should not run into any problems with them as long as you are following correct E/M coding guidelines. On May 3 CMS issued Transmittal 1231, which explained the new edits. The Transmittal listed the codes that CMS considered to be new patient services.


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