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ICD-11, Release of Information Covered at National Conference

By Heather Hogstrom

AHIMA recently held its 90th Annual Convention and Exhibit in Miami. Hot topics ranged from patient identification to managing HIM implementation projects.

One key topic for coders was the eventual transition to ICD-11. The session “Looking to the Future: What ICD-11 Has in Store for HIM” by Kathy Giannangelo, MA, RHIA, CCS, CPHIMS, FAHIMA, an HIM consultant at Kathy Giannangelo Consulting LLC, covered how ICD-11 will be different from ICD-10.

ICD-11, which will feature five new chapters, will allow searching via coding tool or tabular list. New features include precoordination and stem codes, postcoordination, sanctioning rules, multiple parenting, and linearizations. Additionally, cluster coding will allow a backslash between two stem codes or an ampersand between a code and an extension.

In 2019, ICD-11 will be presented at the World Health Assembly for endorsement, after which it is expected to go into effect in 2022. Giannangelo anticipates that the United States will move forward with this in a different fashion than previous coding transitions. She also expects this implementation to be much shorter in duration than the decades it took to transition to ICD-10.

Another popular topic at the conference was right to access vs patient authorization. The difference was explained in a session by Kathryn Ayers Wickenhauser, MBA, CHTS, CHPC, a compliance and industry education manager at DataFile Technologies. Right to access, which can be in the form of a letter or a verbal request from a patient, is the right of an individual or personal representative to obtain their records, without unreasonable delay, in the format they choose, and for a reasonable, cost-based fee.

Meanwhile, patient authorization, which is the disclosure of protected health information (PHI) outside of Treatment, Payment, and Healthcare operations and the privacy rule, authorizes the release of PHI from and to specified entities. Many attendees indicated that they’ve had lawyers contact them requesting records, citing right to access.

According to Wickenhauser, disability attorneys are taking advantage of this in an effort to limit their costs (health care organizations charge a flat fee of $6.50 for this service). However, right to access allows patients or their personal representative (ie, someone who makes medical decisions for the patient—not attorneys) to direct that their PHI be sent to a third party (eg, another provider, researcher, or a consumer tool—but not lawyers).

Additionally, $6.50 is only a suggested fee—not the cap—and is one of three methods allowed to determine the cost of providing copies of patient records. In addition to using a flat fee, the other methods are the average cost, according to a fee schedule, and the actual cost, which would be determined each time.

— Heather Hogstrom is an editorial assistant at For The Record.