During the last year, the buzz from the health information management (HIM) and coding community has consistently reflected that, as a whole, the industry continues to feel the strain of tight budgets and squeeze of limited resources, especially with the approach of ICD-10 implementation. Coders reacted to the effects this has had on their compensation levels in the 2011 JustCoding Coder Salary Survey, the results of which are also discussed.
As you run down your mental to-do list for the rest of the afternoon, you realize you're double-booked for multiple meetings, and you're having trouble prioritizing because your phone keeps buzzing with new e-mail notifications. If you're a health information management (HIM) director, this scenario likely repeats day in and day out. Luckily Monica Pappas, RHIA, Patti Reisinger, RHIT, CCS, and Tesa Topley, RHIA, provide tips and strategies for HIM directors to help manage all that they juggle, and prevent stress from getting out of control.
The American Hospital Association does not plan to “convert” past issues of Coding Clinic for ICD-10-CM/PCS. Lynne Spryszak, RN, CCDS, CPC, discusses why this decision has caused concern among coders and clinical documentation improvement specialists, who for years have relied on the guidance published in Coding Clinic to assist with coding complicated diagnoses or procedures.
A coder can be misled when coding directly from an encoder, and heavy dependence on one can ultimately affect a coder’s skill set. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDIS, CCDS, explains that a critical limitation of encoders is that they cannot physically reason. This inability to deduce often contributes to inaccurate ICD-9-CM code assignment at the expense of clinical accuracy in the reporting of disease processes, not to mention potential reimbursement and measures of continuity of care post-hospitalization.
Just when you thought you had your RAC processes in place, more changes appear on the horizon. CMS wasn't shy about making changes to the Medicare RAC program in 2011. For example, the second half of the year saw demand letters shift to become the responsibility of Medicare Administrative Contractors (MAC)—a change that went into effect January 3, 2012. Joseph Zebrowitz, MD, and Debbie Mackaman, RHIA, CHCO, comment on this change as well as other updates, including the RAC Statement of Work, the Medicaid RAC final rule, and the new pre-bill demonstration program.
Times are changing, and, most likely, so are the jobs of your health information management (HIM) staff members. In some cases, there's a sudden addition of responsibilities, such as the implementation of the recovery audit contractor program. In other cases, the increased use of technology triggers a shift. If these changes aren't managed appropriately, you may end up with declines in performance, careless errors, low productivity, or diminished quality. Elizabeth Layman, PhD, RHIA, CCS, FAHIMA, shares her approach to HIM department and job restructuring.
Computer-assisted coding (CAC) is a hot topic these days. Many industry experts claim that CAC is the wave of the future—that its accuracy has been proven, and that humans cannot match its productivity. With CAC, elements such as fatigue, stress, and inexperience are no longer factors that can negatively affect code assignment. Many articles and vendors sing its praises. However, is it really all that? Robert S. Gold, MD, and Lori Cushing, RHIT, CCS, discuss some relevant concepts.
When Jim Brown, FHFMA, RHIA, CCS, started working at Jefferson Regional Medical Center in early November 2010, he quickly realized that there were a number of opportunities to improve their health information management operations and efficiencies. In this article, Brown shares strategies and tips for how he and his management team were able to identify areas that needed improvement and reduce department expenses and come in 9.5% ($149K) under budget for the end of fiscal year 2011.
