Vote AGAINST H.R. 4302

Vote NO to HR 4302

Copy this pic and email, tweet, send and share with your senators before Monday’s vote!

Not sure how to reach them?  AHIMA provides their phone numbers here and clicking here is a site which offers direct links to their individual websites, facebook, twitter etc.

~Heidi

 

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Delaying ICD-10 is basically enabling those who won’t step up…

What would you say to a friend or family member who continues to support someone who doesn’t try, refuses to do “the right thing” and procrastinates time and time again at the expense and sacrifice of others?  You would say “Stop enabling them!  Make them accountable and stop accepting their excuses!”

When that friend or family member justifies it by saying they are too busy, or they do try – they just don’t have time, you probably just shake your head and accept it.  Later when you talk to others you admit that all they are doing is “enabling” that person by letting them continue to take advantage of others.  The cycle never stops and the same tired excuses just continue to be made.

That is basically what will happen if the Senate does not remove language from H.R. 4302 delaying implementation of ICD-10. It should also be noted how this is the same bill which also includes support of a one year extension of the Special Diabetes Program.  How can you support that program and not allow implementation of  ICD-10 which would allow for much greater specificity and accuracy with the new diabetes codes? Diagnosis codes are not only used for claims submission.  Those same codes are also used for research and the outdated ICD-9 prevents valid identification of the actual signs, symptoms, injury, disease and cause for the very people who need it the most.

When will we make the U.S. accountable and start using the code set every other country has been using for years, especially since the last delay resulted in so much more awareness and effort from those who support ICD-10. What is the bottom line answer explaining why this continues to be delayed year after year?

MEDICINE NEEDS A MORE ACCURATE AND DESCRIPTIVE CODE SET TO IDENTIFY AND DOCUMENT HOW AND WHY PATIENTS ARE BEING TREATED.

WHY IS THE UNITED STATES THE ONLY COUNTRY DELAYING ICD-10 IMPLEMENTATION?

1. Cost can’t be a factor – billions have already been spent and countless hours have been sacrificed by hospitals, facilities, vendors and INDIVIDUALS –many of which have done so with their own money!
2. Education can’t be a factor – The Affordable Care Act allowed Health Information Management curriculum to be developed and implemented in numerous colleges and other educational institutions to prepare the industry. Countless websites, insurance companies and many others, including CMS offer FREE training and resources to learn ICD-10.
3. Time can’t be a factor – The United States began the process to modify the World Health Organization’s ICD-10 code set in 1994. Draft version of ICD-10-CM were made available in 2002, 2007, 2009, 2010, 2011, 2012, 2013 and 2014 and the opportunity for public comment has been offered time and time again. Why has it taken the U.S. over TWENTY YEARS to adopt this code set?

If time, money and education are the some of the reasons the AMA and other opponents support delaying ICD-10, why haven’t they postponed vacations, time off, improvements to their homes and/or offices, bonuses, conferences etc. Why haven’t they used some of that time and money instead to take advantage of FREE EDUCATION offered by cms.gov and countless other sources so we can finally adopt ICD-10 and begin implementation?

If a healthcare provider can “block off” a week or two here and there for the examples listed above, why would it be so difficult to “block off” time and work with staff and others to improve documentation and understanding of the billing cycle along with ICD-10?  I guess the answer is the same one given when there is always a support system willing to enable you to keep making the wrong choices.

UNITED STATES DOCTORS AND GOVERNMENT OFFICIALS CANNOT ARGUE THE VALUE OF ACCURATE DIAGNOSIS CODING SUPPORTED BY COMPLETE AND VALID DOCUMENTATION IN THE MEDICAL RECORD.

REMOVING THE LANGUAGE DELAYING ICD-10 IN H.R. 4302 WILL ALLOW THE THOUSANDS OF INDIVIDUALS, HOSPITALS, VENDORS, EDUCATIONAL INSTITUTIONS AND MANY OTHERS TO UTILIZE WHAT EACH OF THEM HAS TIRELESSLY PREPARED FOR.

PLEASE DON’T PENALIZE THE PEOPLE WHO HAVE WORKED SO HARD ONLY TO ENABLE THOSE WHO ARE STILL NOT READY AFTER 15+ YEARS OF NOTICE.   UNACCEPTABLE EXCUSES CANNOT BE ACCEPTED ANY LONGER!

~Heidi

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CMS Open Door Forum for Healthcare Professionals

Centers for Medicare & Medicaid Services offers a platform for providers, nurses and other allied health professionals to discuss issues in an open forum.

Join today’s meeting and discuss or listen in on Physicians Payment beginning April 1, Upcoming PQRS & eRx milestone, ICD-10 Testing Update and more.

MeetingDial 1-800-837-1935 and use Conference ID 71049613 or click here for more details and to download the agenda.

~Heidi

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ICD-10 Delay? NO WAY!

My day actually started late last night when I closed my books after studying ICD-10-CM Guidelines, Conventions and coding scenarios for yet another day.  I closed my eyes while promising myself that when I woke up, I’d review a couple more things and then finally take the assessment I’ve been preparing for.

I traveled to Chicago and attended the AHIMA ICD-10-CM Trainers Academy exactly two weeks ago today.  I paid for the flight and hotel along with AHIMA’s fee for the Academy out of my own pocket.  I knew I needed to do this because if I want to be taken seriously as a medical coder, I needed to have that well-known and respected title in order to prove my skill.

This morning when I woke up I was excited – TODAY WAS THE DAY!  I worked on a few things and started my final review – I was actually looking forward to the assessment.  At 2:20 I got the “urgent” email from AHIMA about needing to take immediate action.  I couldn’t believe it – an ICD-10 delay?  I tweeted, called Ohio’s three congressmen, and emailed my friends.  I hit Facebook, LinkedIn – even Pinterest!

congress

I actually took the time to post a comment to whitehouse.gov. and talk my kids into tweeting congress members as well.  I’ve been following posts and commentary all over the place and when I finally looked at the time, it was after six o’clock.

Then it hit me – today was the day I was supposed to take my test…  Sigh…..  Why bother? I felt so defeated and just sat, staring at my books and notes when that familiar “ding” went off on my phone. Then another and another.   Brad Justus, the ICD-10 Whisperer from ICD10Watch was favoriting my tweets!

To really understand, you would have to go back to when you first started tweeting.  Remember how exciting it was to randomly get a message that “someone” was following you?  That’s where I’m at right now and when I got this on my phone

Brad_

my entire mood shifted.  It’s after nine o’clock and as soon as I publish this post I’m taking the damn assessment!  I’ve worked hard preparing for it and I’m confident that if other people are still tweeting and talking about this, there is an amazing chance the language delaying ICD-10 will be removed and I need to be ready!

Thanks @Brad_Justus – wish me luck!

~Heidi

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Why Cheat Sheets Should be Illegal for ICD-10-CM Coders

How many times have medical billers or coders in private practice offices relied on the infamous “cheat sheet” to get their job done? Oh, if only I had a dollar for every “cheat sheet” I reviewed that was outdated, incomplete or just plain wrong in every way imaginable…

I know everybody has one but I refuse to call them “cheat sheets”. The very name implies that it is accurate and holds exactly what you need to know to code for claim submission. Pulling out the “cheat sheet” is what typically happens when new-hires arrive at an office or facility and it’s used as a way to train. Of course, that new-hire has little to no experience because doctors won’t pay for a trained biller/coder. If they stay on they’ll use that tattered piece of paper and just re-type it or copy it year after year instead of reviewing it for accuracy and updating it.

Take hypertension or HTN – how many coder/billers automatically think 401.9? I’ll be watching a medical show of some kind or Bizarre ER (LOVE that show!) and whenever I hear hypertension I immediately think 401.9. With ICD-10 the familiarity and confidence which comes from knowing 401.9 is forever gone… How we’ll miss that beloved code!

I propose that the phrase “cheat sheet” be replaced with REFERENCE SHEET beginning October 1 as well. Say it again – slowly – R E F E R E N C E   S H E E T…. Doesn’t that phrase invite a feeling of not being the end all-be all? Or better yet, doesn’t that phrase imply how it’s a starting point to actually accomplishing something?

So many companies are offering “cheat sheets” for doctors to buy which promise to convert their existing diagnosis codes to the ICD-10 equivalent. If you are familiar with ICD-10 at all, you know how impossible that is. I recently came across one comparison for a Primary Care practice and their one page superbill listing ICD-9 codes was converted to 9 pages with the ICD-10-CM! Paperless office, indeed!

What needs to happen is that doctors need to actually read all 180+ pages of the ICD-10-CM Guidelines in order to understand the complexities of this new system. A critical thinker with a solid background in medical terminology and anatomy is necessary to realize when one code may be affected by another guideline. The days of hiring your neighbor’s daughter because she needs a job are over.

Doctors and practice managers must also take heed and realize how saving a few dollars per hour for “a billing girl” will end up costing much, much more overall if they are not properly trained in ICD-10-CM and it would behoove your practice to send staff to a training course as soon as possible and – heaven forbid – attend one yourself!

Positions held by medical billers and coders are complex and intricate. It’s not just picking a code and entering it in the right box. You must know and understand everything about coding along with carrier-specific guidelines, rules and regulations. As an in or out of network provider, you are contracted to abide by those rules and will face audits, penalties or exclusions if you don’t.

books

Many times when I consult for a practice and review an old and aged AR, those claims were typically billed with outdated or invalid codes. Staff couldn’t figure out why they weren’t paid, even though they resubmitted them over and over. I’ll point out the inaccurate and invalid codes to the doctor and his/her response will be “Can you just make us a new cheat sheet real quick?”

On the inside I shudder and roll my eyes but on the outside I’ll just smile and say “Of course, and while I do that, why don’t you make me a cheat sheet for treating all the patients you may or may not see this week?”

~Heidi

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If you can’t figure out the hype about ICD-10…

For most people working in healthcare, October 1 seems to bring about three different expressions – utter dread, excitement or a look that says “eh? What about it?”

October 1, 2014 is the day ICD-10-CM-PCS will go into effect. If you work in healthcare and haven’t heard about this, you are definitely in for a surprise and really should google it or go to cms.gov for more info. This change will affect EVERYONE in the industry, and it affects every person who receives healthcare services as well.

I’m surprised on a daily basis by how many people aren’t ready, or at least making an attempt to GET ready. Don’t most people like to be sure of what diagnosis they are giving – or getting for that matter? And another issue which medical professionals typically don’t like to talk about is (whispering voice) money. Doesn’t everyone like to get paid? (shhhhhh…..)

Think about hanging a picture on a wall – all you need is a hammer and a nail, right?
Well, what happens if you don’t have a hammer? What if you have both – but the wall is concrete – will that nail work? What if you have both the hammer and the nail, but the picture is HUGE and weighs 142.5 lbs. Will you still accomplish what you originally set out to do?

hammerIn that scenario, without a hammer you would find one or use something else. (I’ve used a meat tenderizer before and it actually works quite well!) If you don’t think the type of nail matters, go to a hardware store or even your local drugstore and check out the variety of nails available today. Guys should get this – and they are probably laughing right now… Whatev!

Anyway – you get the idea. What you ultimately decide as your “tools” to convert ICD-9 to ICD-10 determines how the job will be done. It might actually work (bricks make great hammers too) but was it done right?  In a sense, that’s kind of what the new ICD-10 coding is like.

In ICD-9, there were too many codes which were not specific enough or didn’t even exist. There are so many more codes to choose from in ICD-10 and that requires doctors to really specify to their coders/billers what the diagnosis is so the right code is used on the claim. But don’t think that’s enough – the documentation MUST support what you did as well. Kind of always did have to be included in the notes, but I digress…

Ask questions and learn about it NOW! Doctors should start conversations with their staff about anatomy and any medical terms they think staff might not be familiar with. Talking about your specialty and what you are actually thinking and doing to come up with the care you give patients is interesting – some of us really look up to you!

What have you done to prepare? If nothing, are you looking into consultants and certified coders to help you in November and December when the insurance checks have stopped coming in?

~Heidi

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Ready for the new 1500 Claim Form?

Great summarized article on the changes taking effect April 1 – just a few short days away! Providers should be aware how this directly affects claims submissions.

Even though your vendor or clearinghouse is ready doesn’t always mean YOU are. The information must go to them correctly FIRST so they can do their part and actually file it. Talk to your staff and your practice management system support team to find out the details.

CMS 1500 Form

For example, do you perform EKGs or other services in the office? Your billers must enter DK in box 17.

Are you submitting ICD-9-CM codes? Make sure to complete box 21 with a 9 – if you don’t your claim will not pass edits.

Manage My Practice – How to Complete the CMS-1500

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Do you work in healthcare?

This blog is for anyone who works with medical records and wants to be part of an open-discussion environment.  Everyone who works in healthcare is either responsible for the entries made or the use of that record in some way.  What you do and how you do it results in the need for HIM (Health Information Management).

professions

Whether you are the person entering the new patient information or the coder/biller preparing and submitting claims, you will be sure to learn something.

Doctors, Nurse Practitioners, nurses and technicians are also welcome to follow – and hopefully comment and share your views as well.  One of the most important things to remember is how we are a team working through the challenges healthcare is facing today.

Healthcare administrators – your input is just as important! Even though you may not be involved in direct patient care, your need to understand the how’s and why’s things happen are critical to the reports and findings you are responsible for.

medical people

I’m looking forward to sharing information and my opinions as well as hearing from YOU!  Our views may be misguided or don’t consider some unknown variable at times – my hope is that we are all open to talking about it and coming away with a better understanding.

~Heidi

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Incredible Optical Illusion

illusion

Either you see it or you don’t!

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Who is Heidi Kollmorgen?

Coder – HIM Professional – Mom of 6

I’m all of the above and more!

I’ve thought about doing this for such a long time and now that I’m doing it I’m nervous! What will people think? Did I pick a good theme? Will anyone ever “follow” me? Just a few of the questions running through my mind right now…

My background is in health information management and I’ve worked hard to educate myself and learn all aspects of practice management. Coding, billing, follow-up on claims, working with patients on payment arrangements are a few of the things I really enjoy. Lately I’ve come to realize the benefits of knowing all I can about leadership, team management and appreciating continuing education. In this challenging time of transition in healthcare, you can never expect to know everything and you must always be open to change.

I’m excited to engage with you – I hope we can learn from each other and truly succeed in our goals – whatever they may be! Of course, I should add that I have a wicked sense of humor at times and comments I make could easily be taken out of context by new friends joining my circle. Fair warning – I will be honest and straight with my opinions but when you need advice or a verified source for information I share here, you will never be disappointed.

I’ve decided to include a personal page here as well, I genuinely want to really get to know my followers and we all have amazing stories to share. Coders and billers as well as anyone else come to a point in their life not only by what they do – but what they have experienced in their life overall. This is the core of what makes each of us unique and awesome in our own individual way!

AHIMA and medical practice management are true passions in my life although, not mentioning how blessed I am to have six fabulously inspiring kids would be unfair. Managing a busy household and learning the art of delegation has helped me tremendously on the professional side. They support me and help me so much – I am truly blessed!

The gang!

Haley ~ Dylan ~ Hanna ~ Hunter ~ Hope ~ Hadyn

Well, that’s a short summary about me – what about you?

Talk to you soon!

~Heidi~

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