YES HIM Consulting, Inc. Your Consulting Firm for Auditing, Coding and Education

ICD Codes

MEAT Criteria

HCC Chronic Conditions and M.E.A.T. Criteria

By Karen Youmans / January 13, 2020 / 0 Comments

As a follow-up to our previous articles “The HCC Coding Specialist: Benefiting payers, providers, and patients” and “HCC Medicare Advantage background and overview,” we now review HCC chronic conditions and the M.E.A.T. documentation criteria.

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CPT Updates

CPT Changes for 2020 – Part Two

By Teri Jorwic / January 10, 2020 / 0 Comments

CPT 2020 changes took effect on January 1, 2020. In Part 2, we continue with a discussion of revisions in the Evaluation and Management, and Medicine sections, along with an overview of updates in the Radiology, Pathology and Laboratory, and the new Category III codes.

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ICD-11

ICD-11 Overview

By Karen Youmans / January 6, 2020 / 0 Comments

The World Health Organization (WHO) recently released the 11th edition of the International Classification of Diseases (ICD-11). This release was presented at the World Health Assembly on May 25, 2019 for adoption by member states, and will come into effect on January 1, 2022. However, note that it is still unknown when ICD-11 will be ready for implementation in the United States.

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2020 CPT Code Changes

New Year, New Codes: CPT Changes for 2020

By Teri Jorwic / December 30, 2019 / 0 Comments

As we turn the calendar to a new decade, the 2020 CPT code changes take effect. This year there are a total of 394 changes to CPT, bringing the total number of codes to 10,471. This includes 248 new codes, 71 deletions, and 75 code revisions, according to the American Medical Association (AMA). This is Part 1 of a 2-Part Series. In this article, we will discuss the changes in the Surgery Section.

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Optimal Quality Coding

Optimal Quality Coding Prevents Medical Claims Denials

By YES HIM Consulting / December 16, 2019 / 0 Comments

Medical billing denials generate significant cost for providers and hospitals that could be avoided by improving claims data management and optimizing medical coding processes. Optimal quality coding effectively prevents medical claims denials by reducing the potential for manual error and addressing concerns over fast approaching time limits.

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Revenue Cycle Management

Clinical Documentation Integrity Significance in Revenue Cycle Management Success in Healthcare

By Mari Cely / November 6, 2019 / 0 Comments

Perhaps the most vulnerable of issues in the Revenue Cycle Management process is the potential for incorrect information creation in a patient’s chart. Data disparities duplicate or inaccurate medical record number recording, and unverified insurance verifications processes in place can potentiate claim denials. Revenue Cycle Management can be thought of as the method of transportation to take an organization from one place to where it needs to go. For the transport to occur successfully and be operationally sound, the processes in place to support it must be accurate and deliberate.

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Patient Safety Indicators PSI

How to Assess Quality of Care at Hospitals: Patient Safety Indicators

By John Franz / October 15, 2019 / 0 Comments

The Agency for Healthcare Research and Quality (AHRQ) developed Patient Safety Indicators (PSI) to judge the quality of care at Hospitals.  The data can be used:

  • By patients to choose where they go for care
  • Third party payers to select facilities to contract for services
  • Assist QA departments identify potential problem areas
  • Help leadership assess. monitor, track, and improve patient safety
  • Determine financial gain or loss (CMS PSI 90, contract bonuses for quality)
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2020 ICD-10-PCS Guideline Changes: Make Room for Exceptions

By Teri Jorwic / October 15, 2019 / 0 Comments

Make Room for Exceptions: This years’ updates to the ICD-10-PCS Official Guidelines for Coding and Reporting include a new section, updates to an existing section, new guidance on a body part, some editorial changes and the introduction to the possibility of exceptions for special cases.

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Understanding ICD-10 Codes and Why They’re Important

By YES HIM Consulting / September 10, 2019 / 0 Comments

Every disease, injury, and symptom has its own ICD-10 code. But what exactly is their purpose and what makes them so important?

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ICD 10 training

Is the ICD-10 PCS Coding and Implementation System Worth the Trouble?

By YES HIM Consulting / August 14, 2019 / 0 Comments

The 10th release of the International Classification of Diseases (ICD-10) is the most recent cutting-edge edition to the system of codes that categorizes every disease or health problem around the globe. The earlier edition was published about four decades ago, and henceforth the release of ICD-10 coding was predicted as a sweeping change in the world of medical coding.

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