Updated "Ask a Coder" questions on HCC University!

We've added 9 new questions, most about ICD-10, to the Ask a Coder section on HCCUniversity.com.  In addition, most of the older questions have been updated to include ICD-10 information.

On the Full Encounter Data/ICD-10 page, we've added an updated CMS Encounter Data Processing System (EDPS) Newsletter, which reminds physicians and DME suppliers that ICD-9 and ICD-10 cannot be billed on the same claim/encounter.  If there are services both prior to and on or after 10-1-15, you must split them and put them on separate claims.

For hospitals, the discharge date determines which coding system applies to the whole claim.  So, if a patient is admitted on 9-20-15, and discharged on 10-1-15, all services will be billed under the ICD-10 coding system.

Finally, remember you can ask risk adjustment related coding questions by submitting an email to coding@scanhealthplan.com.

Stay tuned for more exciting news from HCCUniversity.com!

Updated Job Openings in HealthCare Informatics

We've recently had a position filled, so I wanted to be sure and post an updated list of jobs open in our HealthCare Informatics family.  If you're interested in one of the positions, click the link, and read the full job description.  You can apply online!  All of the positions are in our Long Beach office.

Job Title	Requisition Number	Position Type	Standard Hours
Healthcare Informatics Analyst II	14-1588	Full Time - Regular	40
Encounter Data Specialist - Report Analyst	15-1769	Full Time - Regular	40
Project Manager - HCI	15-1863	Full Time - Regular	40
Sr. Encounter Data Specialist - Technical Reporting Analyst	15-1904	Full Time - Regular	40
Health Care Analyst Sr.	15-1919	Full Time - Regular	40

Important Information on ICD-10 Excludes 1 Notes

Although the general ICD-10 instruction is that an Excludes 1 note means you cannot code two conditions together, the National Center for Health Statistics has posted an exception on their website. The NCHS is one of the 4 cooperating parties for ICD-10, and is responsible for posting the ICD-10 code book and guidelines.  The exception reads as follows:

"We have received several questions regarding the interpretation of Excludes1 notes in ICD-10-CM when the conditions are unrelated to one another. Answer: If the two conditions are not related to one another, it is permissible to report both codes despite the presence of an Excludes1 note. For example, the Excludes1 note at code range R40-R46, states that symptoms and signs constituting part of a pattern of mental disorder (F01-F99) cannot be assigned with the R40-R46 codes. However, if dizziness (R42) is not a component of the mental health condition (e.g., dizziness is unrelated to bipolar disorder), then separate codes may be assigned for both dizziness and bipolar disorder. In another example, code range I60-I69 (Cerebrovascular Diseases) has an Excludes1 note for traumatic intracranial hemorrhage (S06.-). Codes in I60-I69 should not be used for a diagnosis of traumatic intracranial hemorrhage. However, if the patient has both a current traumatic intracranial hemorrhage and sequela from a previous stroke, then it would be appropriate to assign both a code from S06- and I69-."



You can read the exception on their website, as well as download important ICD-10 documents at: http://www.cdc.gov/nchs/icd/icd10cm.htm

Healthcare Informatics Job Postings

We just wanted to post all of our current Healthcare Informatic Job Postings for you.  You can click on the link to be taken to the job description, and information on how to apply for the job.  We hope you'll consider joining the Healthcare Informatics family!

Job Title	Requisition Number	City	Standard Hours	Post Date
Healthcare Informatics Analyst II	14-1588	Long Beach	40	10/06/2014
Data Analyst - HEDIS & Medicare Star	15-1694	Long Beach	40	02/06/2015
Encounter Data Specialist - Report Analyst	15-1769	Long Beach	40	04/10/2015
Project Manager - HCI	15-1863	Long Beach	40	07/02/2015
Sr. Encounter Data Specialist - Technical Reporting Analyst	15-1904	Long Beach	40	08/20/2015
Health Care Analyst Sr.	15-1919	Long Beach	40	08/27/2015

New Healthcare Informatics Job Posting

The position below was posted on October 5.  Please be sure to check out last Thursday's post for other positions still available as part of our Healthcare Informatics Family!  Just click on the job title to be taken to the full posting for the position.

Healthcare Informatics Analyst II

14-1588

Healthcare Informatics

Long Beach

CMS ICD-10 Ombudsman and Coordination Center Available

I received the email below from CMS today, and thought I would share it with you.

CMS has established a coordination center and an ombudsman to help providers

 through this difficult transition to ICD-10. These are fantastic resources for providers,

so that they can resolve issues once they've exhausted their attempts to find the right

code for a situation.  It's reprinted below, and we hope you find it helpful.

Because of CMS formatting that I can't change, it does appear a little funny on our site, but the information is so useful, I hope you'll look past that.

News Updates | October 7, 2015

ICD-10 Ombudsman and ICD-10 Coordination Center Here to Support Your Transition Needs It’s important that you know help’s available if you have problems with ICD-10: ICThe ICD-10 Ombudsman, Dr. Bill Rogers, can be your impartial advocate You can contact the ICD-10 Coordination Center ICD-10 Ombudsman Dr. Rogers, a practicing emergency room physician, is known to many of you   already. Since 2002, he has been the Director of the Agency’s Physicians  Regulatory Issues Team, assisting physicians, other practitioners, and medical societies in identifying and simplifying Medicare policies and regulations. His role  as ombudsman will be to be a one-stop shop for you with questions and concerns  and to be your internal advocate inside CMS. ICD-10 Coordination Center The Coordination Center is a dedicated group of Medicare, Medicaid, and    information technology systems experts drawn from across CMS. They have  the full support of the entire CMS staff to address any issues quickly and   completely. First-Line ICD-10 Information and Support For general ICD-10 information, we have many resources on our                CMS ICD-10 website and Road to 10 webpage. Contact the MAC for Medicare claims questions. Your MAC                             is your first line for Medicare claims help. MACs cannot                                     respond to questions about Medicaid or Commercial health plans. If you have a Medicaid claim question contact your State Medicaid Agency. If you have a commercial or private health plan claim question               , please contact your health plan directly. Keep Up to Date on ICD-10 Visit the CMS ICD-10 website and Roadto10.org for the latest news and  resources, including the ICD-10 Quick Start Guide. Sign up for  CMS ICD-10 Email Updates and follow us on Twitter.

Using Diagnoses From Prior Encounters

One of the most common questions we get is whether or not a diagnosis from an earlier encounter can be used for a current encounter.

Standard coding advice has always been that a diagnosis cannot be "pulled forward" to a new encounter. Coding Clinic, Q3, 2013 has addressed this issue.  In part, the Coding Clinic advice says:

"Conditions documented on previous encounters may not be clinically relevant on the current encounter.... However, if the condition is not documented in the current health record, it would be inappropriate to go back to previous encounters to retrieve a diagnosis without physician confirmation."

Coding Clinic indicated this advice applies to both ICD-9 and ICD-10 coding.  We hope this advice will clear up this frequent question.

ICD-10 Reminders!

The long awaited day is here--and ICD-10 is a reality.  Just a few reminders for claim/encounter submissions around the implementation date.

1)  Claims/encounters cannot contain both ICD-9 and ICD-10 codes.  If you have dates of service before 10-1 and on or after 10-1, the services should be split onto separate claims.
2)   If it is a hospital insurance claim/encounter, the "date of service" is the discharge date, and all services should be submitted with the coding system in effect on the discharge date.
3)  Still need help?  Check CMS' roadto10.org for more information.
4) Don't forget HCCUniversity.com.  We have several presentations on ICD-10 that should help!

Good luck, and happy coding!!

Job Openings in Healthcare Informatics

Below are the current job openings in our Healthcare Informatics Department.  As a reminder, all are full time postitions, in our Long Beach Office.  You can apply by clicking on the job title link.

Job Title	Requisition Number	Area of Interest	Position Type	Standard Hours
Healthcare Informatics Analyst II	14-1588	Healthcare Informatics	Full Time - Regular	40
Data Analyst - HEDIS & Medicare Star	15-1694	Healthcare Informatics	Full Time - Regular	40
Encounter Data Specialist - Report Analyst	15-1769	Healthcare Informatics	Full Time - Regular	40
Project Manager - HCI	15-1863	Healthcare Informatics	Full Time - Regular	40
Sr. Encounter Data Specialist - Technical Reporting Analyst	15-1904	Healthcare Informatics	Full Time - Regular	40
Health Care Analyst Sr.	15-1919	Healthcare Informatics	Full Time - Regular	40