We don’t live in a bubble. We are a globalized economy. Until artificial intelligence has total capability in healthcare, the human touch is what sets us apart from just carrying out a set of functions efficiently. Since the COVID-19 pandemic landed, it has had an unprecedented impact on most countries, and an already taxed U.S. health system regarding mental health and...

Finding purpose through meaningful work has been on the minds of many lately. Purpose, essential to organizational development and the lifeblood of the human heart as it relates to the whole organizational body system, is what makes life meaningful. Often, health care workers enter the health care field because they love to help people and contribute to enhancing a...

When the final rule for the FY2022 Inpatient Prospective Payment System (IPPS) came out, it included the statement that we will now have clinical coding updates twice a year for ICD-10-CM and ICD-10-PCS, once in April and the usual large update in October. Keeping with their statement, the Centers for Medicare and Medicaid Services (CMS) announced that three (3) new...

According to a Pew Research Center analysis, retirement looms for 3.5 million retirees over the next year, including the most recent labor force data.1 Many organizations face this worrisome predicament, yet many health information management departments struggle with being proactive in their planning efforts. This week's blog post asked three healthcare industry leaders...

Several important updates and additions were made to the ICD-10-CM Official Guidelines for Coding and Reporting for fiscal year 2022. Although key changes will be highlighted in this article, be sure to review the new and revised guidance in its entirety to ensure proper diagnosis coding and reporting. Additionally, visit our blogs about 9 Tips to Calm Coder Anxiety, ...

Metrics represent values to measure an organization’s strategy. Leaders should understand that metrics cannot replace strategy. It can lead to behaviors that undermine the very strategy the metrics expect to measure, resulting in negative consequences for all. Remember the severe negative repercussions the banking giant, Wells Fargo experienced when it aggressively pushed...

Summary   As the world of healthcare becomes more complex, healthcare executives are searching for ways to curb costs quickly and substantially while remaining competitive and profitable. Outsourcing is one way to reduce inefficiencies and eliminate redundancy. Let's explore some of the pain points health systems and hospitals face along with the pros and cons of using...

MTHFR. Sounds almost rude, doesn’t it? However, it is NOT something for which your mother would threaten to wash your mouth out with soap, I promise. MTHFR stands for methylenetetrahydrofolate reductase – so obviously, using the abbreviation is easier than saying that mouthful every time. What, exactly, IS MTHFR? It’s a genetic mutation affecting approximately 30% of the...

Social Determinants of Health: Everyone's Challenge and Benefit Concurrent with a refined focus on Social Determinants of Health, the benefit of using electronic health records for managing the health of populations as well as individuals has garnered attention. With the implementation of provisions of the ONC’s Cures Act Final Rule, patients, providers, health systems,...

Do you have trouble with IR coding? It can be difficult to determine code selection but understanding the rules can go a long way to understanding how CPT code assignment works. It’s all about the position of the catheter and the hierarchy of the codes. In a non-selective catheter placement, the catheter stays in the original vessel that was punctured or advances only to...

As value-based healthcare models continue to grow, the collection and documentation of social determinants of health data has become a key factor in improving patient care and outcomes. As HIM and Coding Professionals, our role in understanding, collecting and appropriately reporting social determinants of health is more important than ever. What are social determinants...

Certain elements of documentation must be present to code infusions, injections, and hydrations properly. An order by the physician, which must be dated, timed, and signed with the name of the drug, the dose and the route of administration should be on file for services performed. Infusion services require direct supervision by medical staff. The coder should next ask a...

Quality studies and improvements have much more value than merely meeting a cancer program standards requirement. If planned well and properly conducted, quality studies can energize the members of the team, reduce inefficiencies, increase cost effectiveness, and deliver value to the organization and patients it serves.   Read Part 1 of this article series HERE.  The...

Remote Patient Monitoring or RPM is expanding and expanding quickly. This type of technology can assist with the remote assessment and monitoring of chronic conditions such as, Chronic Obstructive Pulmonary Disease (COPD), Heart Failure, Diabetes, Obesity, Hypertension, etc. This monitoring process allows for clinicians to address changes and/or concerns in the patient’s...

This article will provide some key points on how you can incorporate the current Office of Inspector General (OIG) items and future items into your organization’s auditing and monitoring functions. Paying attention to what the OIG for Health and Human Services (HHS) plans to audit and monitor during the upcoming year should be a one of the key drivers in developing your...

The Growth In HIM Roles In just 10 short years, the times have changed and with those changes the challenges facing today’s healthcare organizations are impacted by the speed of technology and continued decreasing revenue margins. When we think back to Health Information Management (HIM) Departments a decade ago, we were focused on managing a medical record that was...

This past September, I had the privilege of attending the AHIMA annual convention in New Orleans. I was particularly looking forward to presentations on information governance and ICD-10. Not only was I able to learn more about both of these important topics, but I also learned about several other initiatives that will surely affect the HIM profession going forward. ...

HIM Outsourcing Our industry’s transition to EHRs has opened new doors for health information management (HIM). HIM’s operational areas have become more specialized than ever. The result? Many healthcare executives are now able to reduce expenses, reallocate staff and free up space through centralization and remote workers. According to a recent HealthLeaders CFO Forum,...

Jack and Suzy Welch suggest that most of us are confused about innovation. They state, “You’re getting innovation all wrong. Innovation is a series of little steps that cumulatively lead up to a big deal that changes the game.” When it comes to HIM and EHRs, I believe they are absolutely correct. The EHR was “a big deal that changed the game” for healthcare providers....

How to Successfully Navigate Appeals Even with the temporary suspension of RAC reviews, hospitals continue to deal with insurance denials from a multitude of third party payers. Cathie Wilde, CCS Vice President of Coding Responding to these coding denials is time consuming. HIM, revenue cycle and coding professionals are further frustrated when they believe their...