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Here’s to the Coders! Healthcare’s Quiet Heroes
It’s finally November. I say “finally†because like many of you, I was unsure what the month of October would bring to the HIM world in the aftermath of the ICD-10 implementation. One thing we know for sure: we’re all still here, and the sky did not fall. For me the most interesting aspect of the transition from September 30 to October 1 this year was all the noise coming out of some corners of healthcare, and the quiet resolution to simply do whatever it takes from those in the Coding corner. While other constituencies expressed their concerns in loud and persistent voices, in healthcare organizations everywhere, coders pulled the heaviest loads; had the least clout and the most work to do in preparation for the transition from ICD-9 to ICD-10.
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2,600 pages of Medicare rules in 200 words or less
CMS clarified Medicare rules last week. Below is a summary of those rules and how they may affect you.
- Rural health clinics and federally qualified health centers are eligible to bill for Medicare’s chronic care management code, provided they use the most up-to-date certified EHR.
- CMS is holding off on implementing “appropriate use criteria†that will eventually require physicians to consult clinical decision support software about the necessity of certain services before providing them. The agency needs to establish a process for specifying "appropriate use" criteria before the technology can be developed. CMS hopes to do that in next year’s physician fee schedule.
- EHR measures won’t be included in the 2014 data set on the Physician Compare web site because of “inaccuracies, specifically given the number of errors in the [electronic Clinical Quality Measure] submission data,†CMS said.
- CMS created four new telemedicine billing codes, revolving around end-stage renal disease and prolonged in-patient observation. However, telemedicine services must still be provided at a health care facility, as a patient’s home is not an originating site under federal law, CMS said.
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Digital Health Consumer Adoption: 2015
Historically, the consumer space in digital health has been one of the most challenging categories for investors, including Rock Health. The failure to discover and build massive companies has led to fear, anchored to widely-held perceptions of the consumer relationship to healthcare. In search of real data around the space, we surveyed thousands of individuals (representing the entire U.S. adult population). Our goal was to answer a few key questions: 1) What are the current rates of penetration for the major B2C digital health categories? 2) What are the primary demographic and attitudinal drivers of adoption? 3) What are individual’s attitudes towards data privacy and who do consumers trust in terms of sharing health data? This report presents the data from our most recent survey, run over the summer and including over 4,000 individuals. The results may surprise you.
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A few blips mar ICD-10 rollout
It's been mostly smooth sailing with a few rough spots one month into the national conversion to the International Classification of Diseases, 10th Revision, of diagnostic and procedural codes, better known as ICD-10. The CMS issued a statement Thursday saying Medicare fee-for-service claims “are processing normally,†with 4.6 million a day being run through the agency's Medicare Administrative Contractors (MACs), the same daily throughput as the agency's “historical baseline.†The rate of Medicare claims rejected due to incomplete or invalid information is 2%, the same as normal, according to the CMS. The total Medicare claims denial rate for all reasons is 10.1%, up from a 10% baseline, the CMS said.
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