Conflicting Diagnoses – When to Query and When Not To ...

With ICD-10 just around the corner, many facilities are in the process of reviewing their physician documentation and their coding and querying processes in the Health Information Management (HIM) department and Clinical Documentation Improvement Programs (CDIP). These reviews are being performed to determine – will my documentation be sufficient for ICD-10 coding requirements. Do my coding processes result in compliant and optimal claims?

ICD-10-PCS 2012 Update Available on CMS Website

 The 2012 ICD-10-PCS Update is available for download on the CMS website at: In addition to the Index and Table file, the 2012 Guidelines are also posted.  This is the last full update that will be published prior to the implementation date of October 1, 2013.

2012 Brings an Exciting New Set of Procedures Codes

You would almost think that after all these years there really couldn’t be many additional CPT procedure code set updates. The 2012 codes, however, have been released and we do find another year with new codes, definition changes and deleted codes. Some changes are of course more dramatic than others. For example, there are a lot of new laboratory codes for genetic testing, which is not surprising given that this an emerging area in medicine. Next to lab I think the areas with the greatest number of changes for 2012 are cardiology and pain management.

Drugs of Abuse: Qualitative Testing (Webinar Replay)

Click Here to view a replay of the "Drugs of Abuse: Qualitative Testing - What has the industry learned?" Webinar! This presentation will cover understanding the laboratory issues noted by the OIG. Attendees will learn which qualitative drug testing is at risk and what steps to take to mitigate the risk by:

Meaningful Use - A Roadmap from Risk Assessment to Remediation (Webinar Replay)

Click Here to view a replay of the Webinar! Meaningful Use, HIPAA, State regulations and many other standards require a risk assessment as part of compliance. But what comes after the risk assessment? How do organizations take what they have learned about their environment and risks and turn that into an actionable and appropriate plan for remediation?

Understanding CMS Medicare Manuals, Transmittals & MLN Matters

Because the CMS Manuals are so critical to compliance, coding, reimbursement, and audit, it is important to understand what is going on with the manual format, transmittals links and changes. I hope this mini-tutorial helps.

CMS Publications

Medicare makes available on its website 2 publications:
1 - Transmittals, which are CHANGES to the Pub 100 "Internet Only" Manuals, or IOMs.
2 - Copies of the CURRENT versions of the manual, broken down by Chapter, in PDF format.

Meaningful Use and Your Compliance Program (Webinar Replay)

Click Here to view a replay of the Webinar!  Compliance Officers are active participants in their organization's efforts to achieve Meaningful Use and meet the CMS goals to improve quality, engage patients and families, improve care coordination, improve public health, and ensure adequate privacy and security protections for personal health information.


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