Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

ICD-10 Claims Management

WEDI: ICD-10 Coding Guideline Negates Some Claim Audit Policies

October 31, 2016 - A new ICD-10 coding guideline conflicts with reporting and auditing policies for several quality programs as well as medical necessity rules and other healthcare regulations, stated the Workgroup for Electronic Data Interchange (WEDI) in a recent brief. While some quality programs and healthcare regulations require codes to be based on clinical documentation, the new guideline...


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ICD-10 System Codes Will See New Updates by October 1

by Vera Gruessner

The ICD-10 implementation deadline and postponements brought a variety of challenges to the healthcare field. One of those obstacles has been the constant ICD-10 system code freezes. However, on October 1, 2016, the healthcare industry...

CMS, CDC Add More than 5,000 Codes to ICD-10 Coding System

by Vera Gruessner

Last week, the Centers for Disease Control and Prevention along with the Centers for Medicare & Medicaid Services (CMS) announced some major news for the ICD-10 coding system. The two organizations have added more than 5,000 new ICD-10...

CMS Details How to Resolve ICD-10 Implementation Issues

by Jacqueline LaPointe

In the second update about ICD-10 implementation, CMS has released infographic and statement guidance on how to address issues and questions about IDC-10. The recent statement encourages providers to create a feedback system to review...

CMS Demonstrates How to Track ICD-10 Implementation Progress

by Jacqueline LaPointe

CMS has recently released an infographic urging healthcare providers to assess and analyze their ICD-10 progress by identifying key performance indicators (KPIs) and creating baselines for analysis for each KPI. The recent announcement...

3 Key Steps to Continue ICD-10 Implementation Progress

by Vera Gruessner

Now that the ICD-10 implementation has been deemed a relative success throughout the healthcare industry, the Centers for Medicare & Medicaid Services (CMS) are focused on continuing the progress related to the ICD-10 implementation....

5 Claims Reimbursement Questions and Answers

by Jacqueline DiChiara

Money talks and the healthcare industry is listening. Claims reimbursement was one of many weighty revenue cycle management topics the healthcare industry kept an ear out for this year. From the art of claims scrubbing to figuring out how...

How Physician Shortages Are Transforming Healthcare’s Future

by Jacqueline DiChiara

Just as Rome was not built in a day, neither is a doctor. Training a physician can take up to a decade; the Colosseum was perhaps ironically built in less time. With predictions of massive physician shortages gaining headway across the...

Why are Incorrect Characters a Top ICD-10 Coding Challenge?

by Jacqueline DiChiara

Lack of training for inpatient procedural coding may pose a significant challenge for the healthcare industry as 2015 comes to a close, said Teri Jorwic, ICD-10 Educator and Professor of Healthcare Informatics at the University of Illinois...

ICD-10 Mid-November Advice: Focus on Coding, EMRs, and KPIs

by Jacqueline DiChiara

The healthcare world did not necessarily end with the ICD-10 switchover. Over 4.6 million daily claims throughout the month of October were reportedly processed with a 10 percent denial rate; 13 million claims were said...

Why ICD-10 Coding Demands a Focused Compliance Perspective

by Jacqueline DiChiara

Now that mid-November is here, healthcare entities should be prepared to respond to aggressive audits and clinical documentation enforcement efforts regarding ICD-10 code selections, or will face fraudulent billing claims. Such stated...

ICD-10 October Recap: Claims Billed, But Will Denials Spike?

by Jacqueline DiChiara

Over 13 million institutional and physician ICD-10 claims valued at over $25 billion were “successfully” processed last month across 2,400 hospitals and 630,000 healthcare providers, according to...

Why the Healthcare World Didn’t End with ICD-10’s Switchover

by Jacqueline DiChiara

ICD-10 implementation – much more than a mere annual coding or technology advancement – has formally reached its one-month anniversary with ICD-10 optimism apparently going strong as the healthcare industry enters into...

CMS Reports 10% Denial Rate in 4.6M Daily Oct. ICD-10 Claims

by Jacqueline DiChiara

The ICD-10 transition has come and gone. Although primary affirmations with large numbers to boot have been reported thus far throughout the month of October, is it perhaps too soon to declare ICD-10 implementation a merely underwhelming...

1 Million First Attempt ICD-10 Claims Yield 99% Success Rate

by Jacqueline DiChiara

Nearly 1,000,000 ICD-10 claims were successfully processed the first time around within the first three weeks of October, confirms a press release from the Advanced Data Systems Corporation (ADS). "ADS was ready for...

13M ICD-10 Claims “Successfully” Processed, But What’s Next?

by Jacqueline DiChiara

As the first three weeks since ICD-10 implementation kicked off on October 1 unfold, alleged signs of positivity are being reported. Over 13 million institutional and physician ICD-10 claims valued at over $25 billion have...

86% of Physicians Say ICD-10 Diverts Focus from Patient Care

by Jacqueline DiChiara

With ICD-10 – the tenth edition of the International Classification of Diseases – implementation now a tangible reality as the healthcare industry enters mid-October, questions about ICD-10’s detrimental patient impact...

Coalition for ICD-10, CMS Release Post-ICD-10 Statements

by Jacqueline DiChiara

ICD-10 implementation is officially underway as October 1, 2015 has now come and gone. Physicians, healthcare providers, and healthcare professionals are allegedly still standing, albeit perhaps merely for now.  As...

Cerner: ICD-10 Collaboration Efforts, Support Systems Vital

by Jacqueline DiChiara

ICD-10 implementation – the tenth edition of the International Classification of Diseases – launches today, October 1, 2015, with the healthcare industry now mandated to embrace an in-with-the-new...

93% of Docs Expect ICD-10 Payment Delay Despite Grace Period

by Jacqueline DiChiara

With ICD-10 implementation kicking off tomorrow, October 1, 2015, the upcoming transition is generating severe physician trepidation about the possibility of payment delay, according to this week’s SERMO poll. Ninety-three percent of...

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