Record numbers anticipated for the annual event

Each year, the American Academy of Professional Coders’ National Conference draws attendees from across the globe. Record numbers are anticipated for the 17th Annual National Conference at The Rio Hotel in Las Vegas April 5-8, 2009. The 2009 National Conference promises to provide coders, physicians and health care professionals with up-to-date and necessary educational courses. Registration for the conference is now open. Read more »

The Advance Medical Technology Association, American Hospital Association and American Health Information Management Association urged Congress in a letter Tuesday not to delay adoption of the new ICD-10 diagnosis and coding system.

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HHS Publishes Proposed Changes to HIPAA Transaction and Code Set Standards

On August 22, 2008, the Department of Health and Human Services (HHS) published proposed changes to the HIPAA Transaction and Code Set Rules signaling the intent to eliminate use of ICD-9-CM as the codes for reporting diagnoses and implementation of ICD-10-CM with a proposed compliance date of October 1, 2011. See 73 Fed. Reg. 49796 (Aug. 22, 2008). There are no staggered implementation dates (for example, small vs. large entities) except for Medicaid Pharmacy Subrogation in the proposed ruling.

As best we can interpret, below is a summary of the ruling:

1. ICD-10-CM increases the number of codes from approximately 13,000 ICD-9-CM diagnosis codes to 68,000 ICD-10-CM codes.
2. An approximate 87,000 ICD-10-PCS codes will be required for inpatient procedure coding, up from the 4,000 codes currently used in ICD-9-CM.
3. The ICD-10-CM codes are up to seven characters in an alpha-numeric system and provide significantly increased granularity over ICD-9-CM codes.
4. HHS believes the long-term benefits of ICD-10-CM include:
   - Able to handle new procedures (estimated 1% of all procedures each year are new)
   - Potentially fewer improper and rejected claims
   - Improved disease management
   - Harmonization of disease monitoring worldwide since most of the rest of the world is already using ICD-10-CM codes

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The Department of Health and Human Services (HHS) announced Friday a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10-CM (diagnosis) and ICD-10-PCS (hospital procedure) code sets, effective Oct. 1, 2011. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as health care claims. Version 5010 is essential to use of the ICD-10 codes. Read more »

In the 2009 Inpatient Prospective Payment System (IPPS) final rule, released July 31 by CMS you can expect payment updates and quality care incentives.

Provisions in the 2009 IPPS final rule include:

• The final transition to 100 percent cost-based payment rates
• A requirement for hospital cost reports to distinguish between high and low cost supplies and devices
• A final transition to Medicare severity diagnosis-related groups (MS-DRGs), and “modest changes” to the program
• IPPS 2009 rates update of 3.6 percent for inflation (1.6 percent for hospitals that don’t submit quality data). CMS estimates Medicare spending to increase 1.8 percent in 2009, which will reduce the IPPS rate by 0.9 percent. This is in addition to the 0.6 percent reduction carried over from the 2008 IPPS final rule, according to HealthLeaders Media.
• An objective analysis of how payments would change if the Medicare Payment Advisory Commission (MedPAC) wage index reform proposal is adapted
• Twenty percent of the budget neutrality adjustment calculated on a state-by-state basis and 80 percent calculated on a national basis
• The criteria for new geographic reclassification phased in
• A higher-paying MS-DRG in cases using a total artificial heart, as well as new technology Add-On payments in approved clinical trial settings
• New Emergency Medical Treatment and Labor Act (EMTALA) guidelines
• The current Medicare Advantage regulation amended to allow collection of encounter-level data from MA organizations for services furnished to their enrollees
• The capital IPPS teaching adjustment phased out
• Capital Indirect Graduate Medical Education (IME) payments reduced to half of the amount provided under the current formula
• Rebased payment rates for sole community hospitals (SCHs) based on 2006 hospital-specific rates, if doing so results in a higher payment rate than in 1982, 1987 or 1996

The final rule also includes 367 additions (most of which appear in the August issue of Coding Edge), 61 revisions and 25 deletions to ICD-9-CM codes.

Due to length, CMS did not publish Tables 6G and 6H (additions to and deletions from the Complications and Comorbidity Exclusion List, respectively) in the final rule. They are available on the Acute Inpatient PPS section of the CMS Web site.

The final rule, effective for discharges on or after Oct. 1 through Sept. 30, 2009, is on the CMS Web site, and is scheduled to appear in the August 19 Federal Register.

Working in a fast-paced emergency department (ED) is stressful on everyone involved, even the coder. An expert ED coder is fluent with current coding practices plus the unique rules that apply to this fast-paced environment. Depending on the situation and the payer, there are special rules that apply. As a certified coder in an ED, you stay up-to-date with this specialized coding. One way to demonstrate you are an expert ED coder is by earning certified professional coder-ED (CPC-ED®) credential.

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The federal government has brought a bumper crop of new diagnosis codes to market this year, and many of them will make coding in radiology easier.

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So we’ve got this patient here who was injured in this spaceship accident. You know, just a routine, uh, orbital mishap. But how do we account for that? Oh, right, it’s ICD-9 code E845 — “Accident involving spacecraft.”

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—More than 1,800 coders packed up their sunscreen and sunglasses and headed here on June 8-11, to enjoy the 90 degree weather and the chance to “See the World of Coding” at the American Academy of Professional Coders (AAPC) 16th National Conference at the Gaylord Palms Resort and Convention Center.

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The American Academy of Professional Coders (AAPC, www.aapc.com), the nation’s largest education and credentialing association for medical coders, announces that it has hired Julia Bond-Smith as its director of client development. Bond-Smith will assist both the Education and Marketing departments in extending education outreach. Read more »