 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.
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 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?  As we look to the future, there is hope for positive change to come from the COVID-19 pandemic. The vulnerabilities that are certain to be exposed in our health system from this unprecedented event may help to assist in heightening focus on Social Determinants of Health, (SDoH), to prevent mass spread of disease, unnecessary loss of lives, and ultimately address global health inequities.
 BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINER Think that coding for emergency department encounters is a straightforward proposition? Well, think again.
Much is demanded of ED coders, including the ability to quickly interpret key elements in physician documentation and make accurate code assignments — all while meeting lofty productivity expectations. Missteps in the fast-paced, high-volume ED environment can lead to significant impacts on billing, reimbursements, and even patient care. BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINER  The testing phase for the Appropriate Use Criteria (AUC) Program officially began January 1, 2020. Upon implementation of the program, physicians and other healthcare professionals who order an advanced diagnostic imaging test (MRI, CT, PET, and nuclear medicine; does not include X-rays, ultrasounds, or fluoroscopy services) must consult with AUC using a qualified decision support mechanism (CDSM). Professionals who provide these tests will be required to register the ordering professional’s consultation of AUC to be paid for the service.
Providers will be required to use a qualified CDSM (certified as meeting Centers for Medicare & Medicaid Services/CMS requirements). If a provider does not follow AUC requirements and is discovered to have ordering patterns deemed as outliers, the law mandates that CMS require prior authorization. G-codes are needed for every advanced imaging service, and claims with multiple G-codes “shall be’’ accepted. Close the Loopholes on Outpatient Claim Denials: Proactive Measures to Recoup Lost Revenue12/11/2019  BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINERUnfortunately, the majority of healthcare organizations encounter claim denials on a reasonably regular basis, often, habitually. Though claim denials may be an unavoidable reality in the world of healthcare, ineffective claim denials management can result in even more lost revenue.
 Axea Solutions is honored to be placed on HealthcareTech Outlooks' robust list of the Top 10 Revenue Cycle Management Solution providers of 2019. With decades of expertise developed around coding accuracy and clinical documentation improvement, as well as claims denial management, Axea Solutions is considered to be one of the pioneers in the Revenue Cycle Management arena.
 BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINER Building Clinical Documentation Improvement (CDI) programs to capture quality data on Severity of Illness, can help to strengthen hospital quality measures by providing granular level reporting of a patient’s encounter – ultimately increasing revenue and mitigating related compliance risk.
The ICD-10 Monitor News, recently featured an article written by Axea’s CEO, Susan Gatehouse on the various distinctions of mortality, morbidity, and the Severity of Illness (SOI). Often, when used in the healthcare environment, these terms are interwoven, however, by definition, they are quite different. Axea’s CEO, Susan Gatehouse -- Featured on Public Television Show hosted by Laurence Fishburne10/8/2019  Axea Solution's CEO, Susan Gatehouse was recently interviewed in a segment for public television on the future of technology and AI in healthcare. Discussing the importance of accurate, actionable data and how it relates to the digital transformation happening in the world of healthcare, Susan shared her insight on the possibilities of the possibilities of these advancements.
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