Posts tagged ‘Lisa Selman-Holman’

September 25, 2012

OASIS training in Dallas!

Looking for OASIS-C training? Look no further ….. I’m coming to Texas.

OASISC in Grapevine

March 2, 2012

Survey: ICD-10 delay could make things worse

A survey of senior healthcare professionals shows that a one-year ICD-10 would be “costly, but manageable,” but a two-year delay could be “catastrophic.”

Data exchange group Edifecs polled the professionals, the majority of whom also said that the delay will do nothing to improve readiness for the implementation, but could hinder other healthcare reform efforts.

“Costs are likely to spiral higher, and valuable resources may be lost as the industry waits for the outcome of CMS’ process to determine whether the deadline will slide,” the survey states.


February 17, 2012

Straight to ICD-11?

Don’t you think its funny that the webpage notices are titled “ICD-10-CM is coming Oct 1, 2013” with byline “It’s closer than it seems” followed by “HHS Announces Intent to Delay ICD-10-CM”?

So what’s my theory on why CMS “intends” to delay implementation? I have a couple.

First, physicians are raising a big ruckus about ICD-10. I can understand why when Medicare cuts their payment by 27% and then requires compliance with something this huge. So is CMS listening? I think it boils down to it’s an election year and, lo and behold, President Obama decides to reduce regulatory burden by delaying a regulation that has been finalized since 2009. My opinion is that continuing to use an antiquated system like ICD-9-CM increases regulatory burden. Health plans, hospital systems and other payors and providers, including HHS, have spent millions of dollars readying for ICD-10-CM. A delay now will increase the money spent and the time spent.

Second, the United States has long been behind the rest of the world in coding. A friend told me once that the folks at the World Health Organization (WHO) make fun of us because we are so far behind. Those nations now using ICD-10 are getting ready for a move to ICD-11 October 1, 2015. Does that date seem familiar? Just maybe we are going to switch gears, skip ICD-10-CM and we’ll keep up with the rest of the world with ICD-11-CM in our near future, i.e., Oct 1, 2015.

February 3, 2012

More than checking a box

I’m working on a lot of audits—responding to ADRs and requests for redeterminations these days—both probe edits and ZPICs. One of the many things I’m noticing about documentation is the non-support of homebound status.

We check boxes such as “considerable and taxing effort” and “requires assistive device” but there is little documentation to support WHY there is a considerable and taxing effort and WHY an assistive device is required. Homebound is based on the patient’s illness or injury that is creating a taxing effort to leave home.

The Medicare Benefit Policy Manual Chapter 7 30.1.1 states: “Generally speaking, a patient will be considered to be homebound if they have a condition due to an illness or injury that restricts their ability to leave their place of residence except with the aid of: supportive devices such as crutches, canes, wheelchairs, and walkers; the use of special transportation; or the assistance of another person; or if leaving home is medically contraindicated. [emphasis added] The condition that creates the homebound status needs to be clearly documented.”

Don’t just check a box and move on!! If you need any assist in responding to probe edits or ZPIC redeterminations, we are standing by to assist. The process takes time and after preparing the documentation for you we can provide targeted education to your staff to get you on the right path.

January 30, 2012

ICD-10 training in Vegas!

Come to my ICD-10 training in Las Vegas on March 5-6 ..

More details to come!