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In This Issue
Industry Insight
HIT Use by Physicians, Hospitals More Than Doubles Since 2012

Health and Human Services (HHS) Secretary Kathleen Sebelius recently announced that more than one-half of all physicians and other eligible providers have received Medicare or Medicaid incentive payments for adopting or meaningfully using EHRs. HHS has met and exceeded its goal for 50% of physician offices and 80% of eligible hospitals to have EHRs by the end of 2013.

Since the Obama administration started encouraging providers to adopt EHRs, usage has increased dramatically. According to a 2012 Centers for Disease Control and Prevention survey, the percentage of physicians using an advanced EHR system was just 17% in 2008. Today, more than 50% of eligible professionals (mostly physicians) have demonstrated meaningful use and received an incentive payment. For hospitals, just 9% had adopted EHRs in 2008, but today, more than 80% have demonstrated meaningful use of EHRs.

Read more »
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Editor's E-Note
When it comes to clinical documentation improvement programs, it’s often difficult for providers to know whether they’re getting bang for their buck. Various systems lead down different paths, making calculations problematic and time consuming.

This month’s E-News Exclusive examines why it’s important to factor in nontangible benefits when it comes time to decide whether a system is earning its keep.

Lee DeOrio, editor
E-News Exclusives
Getting the Most From Your Documentation Dollars
By Randy Olver

Implementing an EHR system significantly impacts physician documentation workflows. Demands to measure, track, and monitor patient outcomes are intensifying, making efficient and thorough documentation challenging.

Documentation is not a one-size-fits-all model, and return on investment (ROI) is not a straightforward calculation. Organizations must keep individual physician work habits in mind—along with tangible and intangible costs—to select the best method of information capture for the practice. Each method of patient encounter documentation in an EHR has its benefits and drawbacks.

Full Story »
Recently in For The Record
How to Fix Poor Dictation
Poor dictation habits can cause havoc for befuddled medical transcriptionists, resulting in safety risks and delayed turnaround times. Read more »

EHRs and Infection Control
A study details how EHR technology is failing to help infection preventionists collect data more efficiently. Read more »

In Sync With ICD-10
In the race to prepare for the new codes, will providers and payers be able to successfully cross the finish line together? Read more »

2013 OIG Work Plan: HHS Targets Three Areas
Mechanical ventilation, Medicare’s transfer policy, and cancelled surgeries take top billing. Read more »
Industry Insight
New Initiative to Help Drive
Precision Medicine Forward

The University of California, San Francisco has announced the formation of a Center for Digital Health Innovation.

Google Glass Applications
in Health Care

On his blog, a surgeon imagines how Google Glass can reshape health care.
Tech & Tools
Medisoft Mobile
and Lytec Mobile

McKesson Corporation recently released two apps that offer a seamless integration of mobile computing technology and practice management systems: Medisoft Mobile is designed for use on Medisoft V18, and Lytec Mobile is designed for use on Lytec 2013. The apps allow providers to use their smartphones or tablets to view their schedules and transmit charges, diagnosis codes, and notes to the front desk or biller. The electronic capture of charges and diagnoses also eliminates the need for paper superbills, helping streamline documentation and reducing the chance for data-entry errors.

Concussion QuickCheck
The American Academy of Neurology’s Concussion QuickCheck app helps coaches, athletic trainers, parents, and athletes quickly evaluate whether someone may have a concussion and needs treatment. The app was developed in partnership with the academy’s updated guideline for diagnosing and evaluating sports concussion. Key information and tools include common signs and symptoms of concussion, what to do if an athlete suffers a head injury during a game or whether the athlete appears to have a concussion, and when an athlete should return to the game. It also provides help finding a nearby neurologist and state laws on concussion. Learn more »
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HFMA Conference News
Consumers Front and Center at HFMA Annual Conference
By Cassi L. Birnbaum, MS, RHIA, FAHIMA, CPHQ

I had the pleasure and privilege of attending last month’s Healthcare Financial Management Association (HFMA) annual conference in Orlando, Florida, which appeared to have lighter attendance than last year’s leadership conference, probably because of the proximity of Father’s Day. Nonetheless, the conference’s themes were louder, substantive, and more consumer focused (transparent) than last year, beginning with HFMA President Joseph F. Fifer’s proclamation that the organization had created a hospital price transparency task force. This stems from the fact that patients are paying more health care expenses out of pocket, and organizations need to be accountable for what they charge.

Full Story »
Career Opportunities for HIM Professionals
A Secure, Anonymous Résumé Bank
Job Alerts Sent to Your E-mail
The nation's top employers and recruiters of HIM talent advertise in For The Record magazine and post their job openings on AlliedHealthCareers.com. Check out the most recent opportunities that have been submitted by employers across from the country!

Medical Coder — UC Health, Cincinnati, OH
Remote Coding Validator — Staten Island University Hospital, Staten Island, NY
HIM Coder - Inpatient — Staten Island University Hospital, Staten Island, NY
Director of Medical Records — Gracie Square Hospital, New York, NY
Ask the Expert
Have a coding or transcription question? Get an expert answer by sending an
e-mail to edit@gvpub.com.

This month’s selection:
A patient had extracorporeal membrane oxygenation (ECMO) cannulas placed without initiation of ECMO. Cannulation sutures were placed at the distal ascending aorta and the right atrial appendage. Carmeda-coated arterial and venous cannulas were placed there (10 and 18 French, respectively) and secured with orange tourniquets. These were tied and clipped. The cannulas were flushed with heparinized saline and later connected to constant low-dose heparin infusions.

How would this be coded as an ICD-9 procedure?

Deb Heil, RHIT, CCS
Children's Hospitals and Clinics of Minnesota

The cannulation for extracorporeal oxygenation is included in 39.65 (Coding Clinic for ICD-9-CM, 1989, second quarter, p. 17), but without ECMO the description says "arterious and venous cannulas were placed at the distal ascending aorta and right atrial appendage” resulting in code 39.93. The terms searched in the ICD-9-CM procedure index are insertion; cannula; arteriovenous—the appropriate ICD-9-CM procedure code is 39.93.

— Michelle L. White, RHIA, is director of coding services for Pyramid Healthcare Solutions.
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