 By Susan Gatehouse, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer As we near the end of what some consider the most unprecedented year in coding, there are more updates to review and decipher in preparation for 2021.
The Centers for Disease Control and Prevention (CDC), under the National Emergencies Act Section 201 and 301, announced further additions to ICD-10-CM classification related to COVID-19. And, CMS has posted new guidelines for ICD-10 CM/PCS coding and an updated MS-DRGs, Version 38.1 ─ all effective Jan. 1, 2021. Updates include new ICD-10-CM and PCS codes for COVID-19.
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 By Susan Gatehouse, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer Recently, the Centers for Medicare & Medicaid Services (CMS) provided a temporary respite on audit activities due to the COVID-19 crisis. This was undoubtedly a welcomed break, as providers were dealing with unplanned layoffs and the furlough of employees, while at the same time, they were required to suspend nonessential procedures. Understandably, however, this respite could not go on forever, and the resumption of audit activity has been expected. ─ Now is the time to prepare, assess provider requirements, and ensure proper compliance is in place.
 By Susan Gatehouse, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer Eligible healthcare facilities have begun to recover lost revenue from COVID care for uninsured patients through the U.S. Department of Health and Human Services (HHS) Provider Relief Fund. However, with benefits subject to funding limitations, and the recently proposed removal of an additional $25 billion from the Provider Relief Fund, organizations without efficient processes in place may find themselves at a disadvantage. Implementing swift, proactive remedies may help ensure claims reimbursement while available.
 By Susan Gatehouse, RHIT, CCS,CPC, AHIMA-Approved ICD-10-CM/PCS Trainer Released Aug. 4, the Outpatient Prospective Payment System (OPPS) proposed rule for 2021 would eliminate the Medicare inpatient-only list of services while increasing the number of Ambulatory Service Center (ASC)-eligible procedures. The rule would also increase 340B payment cuts, and looks to overhaul the hospital star-rating system.
 Axea's CEO, Susan Gatehouse was featured in a recent article published by Analytics Insight – "The 10 Most Influential Women in Technology 2020".
Analytics Insight celebrates inspiring women leaders, spotlighting forward-thinking women technologists. The piece provides a collection of interviews highlighting some of the most influential women leaders in business today, and their different perspectives on disruptive technologies affecting their industry.  By Susan Gatehouse, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer With concerns of COVID-19 having a disproportionate impact on certain individuals, such as minorities and the elderly, public health experts are requiring more detailed data, provided on a real-time basis – further supporting the reliability and integrity of data being central to healthcare.
Reexamining Internal Compliance Plans as Relaxed Regulations Recede amid COVID-19 Mitigation6/9/2020  By Susan Gatehouse, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer While we continue to remain amid a pandemic, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has not skipped a beat in pressing forward with their plan for addressing potentially fraudulent activity associated with COVID 19 billing.
The current administration has funneled a tremendous amount of money into healthcare systems. It will not be long before they take steps to ensure that the funds were appropriated as intended.  By Susan Gatehouse, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer Waivers, modifiers, lab tests, multiple diagnosis codes…the layers and specifics of COVID-19 coding cannot be overlooked when ensuring appropriate reimbursement and safeguarding claims against third-party payer audits.
As hospitals and healthcare organizations begin to assess the required steps necessary to prepare for the transition back to a pre-COVID-19 operating environment, apart from timelines and state and local guidelines, much still needs to be examined to establish stability.  By Susan Gatehouse, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer Managing the after-effects of coding and billing as COVID-19 cases start to move through an organization’s billing cycle, while maintaining up-to-date information, could prove challenging.
 By Susan Gatehouse, RHIT, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer In a featured article published by ICD10 Monitor News, Axea's CEO Susan Gatehouse discusses the importance of understanding the different components of the methodology used to support the projections for “Flattening the Curve” on COVID-19 cases.
Statistical models provided by The Institute of Health Metrics and Evaluation (IHME) illustrate the timing of the approaching peak of coronavirus cases and deaths. As healthcare professionals, what can we decipher from this data to effectively use to identify issues and manage and treat patients? |
