Only a Small Percent of ICD-10 Claims Denied Due To Coding Errors

On October 1, 2015 health systems across the country transitioned to the International Classification of Diseases, 10th Revision – ICD-10. According to CMS, more than 4.6 million claims have been processed daily since the October 1st transition from ICD-9 to ICD-10, but only a small percentage of those denied claims have come from invalid ICD-10 codes.   A recent announcement from CMS explains that, while 10 percent of the claims filed between October 1st and October 27th were denied, less than 1 percent of those were denied because of invalid codes. In comparison to their historical baseline, the current ICD-10 denials due to inaccurate codes are even less than the amount of claims denied from invalid ICD-9 codes. “CMS has been carefully monitoring the transition and is pleased to report that claims are processing normally,” the announcement notes. HealthIT Outcomes and iHealth Beat quotes George Arges, senior director of the American Hospital Association’s health data management group, as saying, “The data CMS released indicate claims are being received and passing the first round of edits at rates similar to pre-ICD-10 levels.” However, he said the organization “will not have a complete assessment of the transition until mid-November,”noting, “The normal rate for processing claims from submission to payment is an average of 43 days.” CMS also plans to issue another update in November because many ICD-10 claims have not yet been fully processed. Much of this wait period is due to Medicare claims, which take several days to be processed and, once processed, also take two weeks before issuing a payment. In addition, Medicaid claims can take up to 30 days to be submitted...

ICD-10 Holiday Code of the Week | Intentional Self Poisoning, Tryptophan

In the third installment of our ICD-10 Countdown to the Holidays Code of the Week Series,  AntWorks has chosen T50.3X2D, Poisoning by electrolytic, caloric and water-balance agents, intentional self-harm, subsequent encounter. Essentially this translates to the intentional self poisoning with tryptophan.   Anyone that has ever celebrated Thanksgiving is well aware of that drowsy feeling induced by overeating at Thanksgiving Dinner. But, did you know that your sleepiness is actually caused by tryptophan in your beloved turkey? We have all actually been self poisoning ourselves with tryptophan every Thanksgiving, and may have never known! While we do love our turkey leftovers, make sure you plan for an extra nap in your day the next time you consume a large amount of turkey. Stay tuned next week for our fourth ICD-10 Holiday Code of the Week, and remember, if you’re struggling with your medical coding or billing vendor, AntWorks can be the next solution for your medical practice! Is your medical practice looking for new medical software solutions? AntWorks can assist with your EHR, Practice Management, Revenue Cycle Management and Medical Scheduling needs. Contact us or rquest a demo today to learn more. Request a...

A Blog Stuffed With ICD-10 Thanksgiving Themed Codes

In order to properly celebrate Thanksgiving, the only holiday that promises great food, loads of leftovers, wonderful company and a lengthy nap in the middle of the day, we’ve put together a list of Thanksgiving Themed ICD-10 codes. What do we think of when we hear ‘Thanksgiving’? How about family and friends, pumpkin pie, food induced napping, football, crazed shoppers, and, of course, turkey? Continue reading for our list of ICD-10 Thanksgiving Codes.     If You’re Hunting Your Own Turkey this Thanksgiving Pecked By Turkey (W61.43XA): There is no need to explain. All of you hunters out there, stay safe. We heard that turkeys have some foul tempers. (See what we did there?) So Maybe You’re Stuck in the Kitchen Cooking Contact with Powered Kitchen Appliance (W29.0): We’ve all been there. You’re running around the kitchen like a mad (wo)man trying to get the Thanksgiving Dinner finished on time, and you burn your arm on the oven rack or make contact with the electric mixer. For Those Who Expect to Eat Their Weight in Turkey Burn of mouth Pharynx (T28.0XXA): Make sure to take your time while eating to avoid any potential consumption-related injuries. Slowness and Poor Responsiveness (R45.4): Have you ever heard of tryptophan? The turkey’s almost bathed in it. Watch your turkey consumption or you may end up napping through leftovers! If You’ve Had a Recent Falling Out With Your Family Problems in Relationship with the In-Laws (Z63.1): Whether you’re in a small tiff or you’ve just gone World War III on your In-Laws, remember that it’s the Holidays. Kumbaya, my friends. Sibling Rivalry (Z62.891): Whether you’re the youngest,...

How to Handle Negative Online Physician Reviews

As the average patient becomes more and more digitally connected, online physician reviews and rating websites are taking a larger role in a practice’s ability to attract new patients. Similar to personal recommendations and referrals, positive online reviews are also becoming an essential component to draw new patients. Assuming that you’re a good physician, most of your online reviews will likely be positive, but how do you handle a negative review?   A negative online review can often ruin your day, particularly if you feel that review isn’t 100% deserved. In this situation, it can be tempting to lash out against the reviewer online, among other things, in response, but remember this one rule of the internet: anything that you post online will live on forever. If you repeat that statement three more times to yourself after receiving a negative physician review, you could save yourself from a grave mistake. Remember: if you currently have a good amount of positive reviews, any outlier negative review will be diluted by the others.  Still, it’s important to know how to respond to a negative review, and what you can take away from them.   Responding to a Negative Online Physician Review First, decide whether the review was warranted. Negative reviews offer valuable feedback (no matter how poorly expressed), including feedback that patients are too afraid to tell their physicians directly.  Take a moment to read through the negative review, research the patient and their history with your practice, and decide for yourself whether the review was warranted. It’s no surprise that people sometimes overreact, so you may encounter fake or slightly fabricated negative reviews, but remember to...

ICD-10 Holiday Code of the Week | Fall From Stairs and Steps Due to Ice and Snow

In the second installment of our ICD-10 Countdown to the Holidays Code of the Week Series,  AntWorks has chosen W00.1: Fall from stairs and steps due to ice and snow.   Now, this week’s code may not be holiday themed per se, but it is relevant for those of you living in states that get moderate to heavy snow fall in the winter. Have you ever taken a fall down some icy stairs or slipped on black ice?  If not, you’re a lucky one.  There have been many a times when we’ve seen our life flash before our eyes during a slip down the icy stairs. For reference, see the clip below that shows Marv from Home Alone.     Our point? Any fall due to ice or snow could land you hurting in your Doctor’s office. Thankfully, we now have W00.1 to cover all of the scrapes, cuts, and bruises that could appear due to a fall from ice or snow. Stay tuned next week for our third ICD-10 Holiday Code of the Week, and remember, if you’re struggling with your medical coding or billing vendor, AntWorks can be the next solution for your medical practice! Is your medical practice looking for new medical software solutions? AntWorks can assist with your EHR, Practice Management, Revenue Cycle Management and Medical Scheduling needs. Contact us or rquest a demo today to learn more. Request a Demo...