Proposed 1 Year Delay in ICD-10 Implementation

On Tuesday, April 17, 2012, the Department of Health and Human Services published a proposed rule, entitled " Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for ICD–10–CM and ICD–10–PCS Medical Data Code Sets"

The proposed rule can be downloaded at: http://www.gpo.gov/fdsys/pkg/FR-2012-04-17/pdf/2012-8718.pdf

In addition to a proposed delay in the compliance date for ICD-10 (to October 1, 2014), there are proposals for a Unique Health Plan Identifier, and an identifier for entities that currently cannot obtain an NPI.

Comments on the proposed rule are being accepted until May 17, 2012 at 5:00pm EST.

Code Numbers Instead of a Narrative Diagnosis

All too often, we see a diagnosis code written in the medical record, in lieu of a narrative diagnosis.  In those instances, we cannot code what has been written for two important reasons:

• Coding is done based on the narrative documentation in the medical record--with no narrative, no coding can take place
• There's no way of telling if the diagnosis code in the chart is correct (i.e., what the provider meant to code)

We get this question at least once a year--and sometimes it leads to lively exchanges.  Thankfully, Coding Clinic, Q1 2012, has decided to address it.  Their answer, in part reads:

"There are regulatory and accreditation directives that require providers to supply documentation in order to support code assignment. Providers need to have the ability to specifically document the patient's diagnosis, condition, and/or problem. Therefore, it is not appropriate for providers to list the code number or select a code number from a list of codes in place of a written diagnosis."

So--the next time you're asked if a provider can just write the code in the chart--you'll know where to point them for clear guidance.

Keeping Up with What's New in Medicare

The Medicare program is massive, and ever changing.  Changes come out several times a year--Part A changes around September, Part B changes in January.  Add that to changes in ICD-9 and CPT, changes in your commercial business--it's all a bit much.

How can you keep up with all these changes? The CMS website is difficult to navigate--and finding things is complicated. 

But, one great place to bookmark and visit frequently is the Medlearn Matters webpage.  This page has educational materials about new Medicare programs and coverage. It's a great way to keep up with what's new in Medicare.  https://www.cms.gov/MLNProducts/

In addition, there's a Medlearns Product Catalog, that allows you to order certain printed matter.  You can view the catalog at https://www.cms.gov/MLNProducts/downloads/MLNCatalog.pdf

You can learn about EHR incentives, the annual wellness exam, and even take online training courses, some of which have CEUs for coders.

Although you won't find everything there--you will find a lot of information about new and changed programs on the Medlearn Home page.