CMS is now Offering “Cheat Sheets” for the Upcoming ICD-10 Implementation

To help physicians and other providers get quickly up to speed, CMS has released a series of clinical coding “cheat sheets,” or quick reference guides that match common clinical concepts with their proper ICD-10 codes. These “cheat sheets”, deemed Clinical Concept Series by CMS, are available for six specialties including family practice, internal medicine, cardiology, OB/GYN, orthopedics and pediatrics.     Each guide in the Clinical Concepts Series compiles key information from the Road to 10 online resource package in to a PDF format that can be readily shared, emailed, posted to websites, and printed. The PDF guides include common ICD-10 codes, clinical documentation tips, clinical scenarios, and links to Road to 10. You can links to the Clinical Concept Guides for each of the six specialties toward the end of this post.   What Does it Include? We will use the Family Practice Clinical Concepts Guide for this example. The free 31-page resource includes a list of ICD-10 codes and corresponding ICD-9 codes that family physicians use most often including: abdominal pain, acute respiratory infections, back and neck pain, chest pain, headache, hypertension and urinary tract infections. The guide also provides family physicians clinical documentation tips on common health topics such as asthma, underdosing (new to ICD-10), abdominal pain and tenderness, and injuries.   CMS Clinical Concept Series: Family Practice Internal Medicine Cardiology OB/GYN Orthopedics Pediatrics   Because quality clinical documentation is essential for communicating the intent of an encounter, confirming medical necessity, and providing detail to support ICD-10 code selection, CMS has also provided outpatient focused scenarios to illustrate specific ICD-10 documentation and coding nuances related to your specialty. We’ve included some...

5 Medical Billing and Collection Tips for All Practices

Although medical practices are rarely thought of as businesses in the same sense retail shops or restaurants are, revenue is necessary to keeping a practice running. If your practice is struggling with billing or collections, here are the top five strategies you should try: Get Better Data on Your Current Billing Practices If you’re not quite sure exactly where your practice is losing money, it’s time to gather better data. Most medical billing systems will allow you to run reports (and if yours doesn’t, it’s time for an upgrade). Are you treating patients only to find out their insurance isn’t valid? Getting denials? Struggling to get patients themselves to pay bills promptly? Those are all common culprits, but there could be other problems you need to resolve. Collect Co-Pays at Time of Service The easiest way to ensure you’re not losing little sums of money repeatedly is to collect co-pays on the spot. Make your policy clear, and reschedule anyone who shows up unprepared to pay (except for acutely ill individuals, of course; you and your office staff will have to exercise judgment as to your ethical responsibilities). If you offer payment plans, make sure patients know in advance exactly what amounts will need to be paid when so they can’t use confusion as an excuse for delaying or refusing payment. Give Your Patients as Many Payment Options as Possible The easier it is for people to pay you, the better. There’s nothing wrong with steering people toward certain forms of payment (especially if you have to pay a fee to deposit checks, for example), but be sure to...

Medical Software Systems in the Real World: A Case Study

It’s easy to talk about the benefits of medical software systems such as electronic health records and integrated medical billing systems/medical appointment software in theory. It’s thought that using internal or online EHR software can improve efficiency by around 6% a year, and features such as billing integration and appointment reminders can be key in improving profitability. It’s no wonder, then, that the adoption of EHRs has been so rapid. In 2011, just 55% of physicians had an EHR system; it’s tough to get more recent data, but the federal government estimates that as of 2013, nearly 80% of physicians had started using electronic systems. Plus, nearly half of physicians who don’t have systems plan to either purchase one or implement the use of one that’s already been purchased within the next year. But do these medical software systems actually live up to their potential in the real world? One recently published case study indicates they can — and, indeed, go far beyond expectations. What EHR Implementation Looks Like A 13-provider eye clinic in North Carolina was able to earn back its initial investment on an EHR system (around $500,000) in less than three years due to lower administrative labor costs, higher revenue and increased productivity, according to the study published July 22 in the journal Ophthalmology. “Our clinic was a busy, high-volume practice to start with,” Dr. Robert E. Wiggins Jr, the case study’s lead author, told Medscape Medical News. “Those providers were able to see a few more patients a day. Those small changes in productivity really amounted to a substantial increase in profitability.” Moreover, benefits increased...

Electronic Medical Records Deliver — When Doctors Actually Check Them

A new study has found that electronic medical records can indeed deliver on promises of increased efficiency and better patient care — that is, if doctors actually check them. The study, conducted by the Brookings Institution, analyzed care given to more than 2,000 patients in the emergency departments of three hospitals in Western New York. It concluded that doctors can drastically lower the number of unnecessary lab tests and radiology exams ordered by routinely checking a network of electronic medical records. How drastically? The number of lab tests dropped by 52% when the emergency rooms employed assistants to check medical software systems; radiology exams such as CT scans were reduced by 36%. That’s nothing to sneeze at. Key Insights There are a few things to take away from the study: Interconnectedness Is Key to Realizing Potential One important thing to recognize about the study is that the medical personnel involved were checking not only an internal electronic record, but an online EMR software plugged into HEALTHeLINK, a voluntary database that allows patients to have their information shared among providers at different offices and hospitals. This kind of sharing (often referred to as “interoperability”) has been a major challenge to realizing the full potential of electronic records. Hiring and Workflow Need to Accommodate EMRs The study found that the money saved by not performing extra tests was enough to hire medical assistants to actually check the records. This suggests that changing staffing and workflow can be a viable alternative to expecting doctors to perform this type of research for every patient. That’s important in light of findings such as one 2014...

7 Questions to Ask Before Buying an EMR Software System

If you’re looking at statistics regarding electronic medical records (also called electronic health records), you might be getting confused. It’s true that EMR software is quickly becoming standard. In 2011, only slightly more than half — 55% — of physicians had adopted EMR or EHR systems. But adoption of basic systems spiked 21% between 2012 and 2013 alone, and, by 2013, 69% of physicians reported participating or intending to participate in Medicare and Medicaid Incentive Programs (participating, obviously, requires having an electronic record system).     But it’s a little more complex than that. According to a report from 2014, only barely more than half — 50.7% — of providers were using fully functional EMR software, and a full 40% weren’t satisfied with their current medical software systems. How can you choose a functional system and avoid sinking money into software that doesn’t actually boost efficiency and improve patient care, as EMRs are supposed to do?   Here are the seven most important questions to ask before buying EMR software or signing a contract with a software provider:   Is the Software Suitable for My Specialty? Some software systems are much more adaptable than others for certain specialties. While a cardiology EMR, for example, may not be marked explicitly as such, you should ask what percentage of a medical software company’s business focuses on your specialty. Are Practice Management Features Integrated? If you’re going to invest in new software, you might as well choose a system that’s multi-functional. EMR practice management software can help you handle everything from scheduling to billing, rather than simply replacing paper patient records. How...