(Top 10 Coding and Compliance List for 2014 continued) there is “an increased frequency of medical records with identical documentation across services.”3 The focus is not only on the services provided to a patient for a specific encounter compared with other patients, but also across multiple dates of services. each encounter must be uniquely documented and not just pulled forward from a previous encounter without appropriate updating and validation. It is critical that you understand how your clients are utilizing their emRs to ensure accurate and compliant billing practices. NUMBER 1: ICD-10 IMPLEMENTATION. The number one area of concern for coding and compliance in 2014 is ICD-10 implementation. Hopefully, this comes as no surprise. The implementation of a completely new diagnostic code set is a monumental task and will impact not only code assignment, but potentially all aspects of the revenue-cycle process from provider documentation of the performed services to denial management. There are still a great number of unknowns related to ICD-10 implementation, since we are the only country in the world that utilizes the code set for reimbursement purposes with multiple payor types. We must prepare for a category-five hurricane and hope that we only see a tropical storm. This list is a starting point for areas to evaluate in 2014. Depending upon the specialties that you bill for, you could create even more detailed lists to address all the nuances of each area. It is important to remember that you cannot adopt a “hear no evil, see no evil, speak no evil” approach to assisting your clients with compliance. Their success is your success, but the opposite is true as well. You choose! Melody W. Mulaik, MSHS is the president and co-founder of Coding Strategies, Inc. and Coding Metrix, Inc. located in Atlanta, GA. She is a frequent speaker and author for CSI and other nationally recognized professional organizations and publications. Melody's areas of expertise include billing and collections, coding and compliance, revenue enhancement, front-end hospital operations, management engineering, medical school relations, and operations improvement. Resources 1 www.cms.gov/Outreach-and-education/medicare-Learning- Network-mLN/mLNmattersarticles/Downloads/mm8401.pdf 2 www.cms.gov/apps/physician-fee-schedule/overview.aspx 3 https://oig.hhs.gov/reports-and-publications/archives/ workplan/2013/Work-Plan-2013.pdf page 51 36 HBma BILLINg • JaNuaRY.FeBRuaRY.2014 HBma has re-designed the certification program to encourage excellence through education and awareness of the billing industry. attaining this distinction requires attendance and participation in HBma sponsored programs. Initial CHBme certification requires 60 hours of credits, including attendance at 3 national conferences. maintaining CHBme certification requires 60 credits over a 3 year period and attendance at 2 national conferences. The 2014 spring educational Conference offers you the opportunity to acquire 14.0 hours of credit toward your CHBme designation. The two preconference programs afford 4.0 additional credit hours each. Elevate your professional stature and gain a competitive edge by pursuing certification as a CHBME! The certification program designed to encourage excellence within the HBma membership through education and awareness of our industry.
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