Jul 26, 2015

ICD-10 is still on track to take effect October 1, 2015. As time passes without any serious opposition on the horizon, it appears very likely that the go-live will occur.

Providers will need preparation for the transition to ICD-10. The Precyse modules are in place in HealthStream. Remember, if the due date is Aug. 31, 2015, the learning module is required and must be completed by this date. If the due date is Dec. 31, 2015, this is an optional learning module that you may choose to do for your own benefit. The optional learning will disappear from your HealthStream account after Dec. 31. CME credit is available for all modules. There is the potential to opt out if you have completed similar ICD-10 training prior to this assignment. Contact Claire O'Brien if this could apply to you.                

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CDS nurses and coders often ask providers to document whether a condition was ruled out or resolved. These are two very different outcomes in the coding world. Let's discuss the distinction coders have to make between the words 'ruled out' and 'resolved'.   

'Resolved' refers to a condition that did exist, was probably treated, and got better. This is good information for coders since we know that many conditions resolve because of treatment.

'Ruled out' means the condition was once suspected, but was never really present, then ruled out after further study. That is fine if it is correct, but sometimes a provider will mistakenly document that a condition was 'ruled out' when it had been present and treated.

The problem is that any condition that was ruled out cannot be billed for, will not contribute to length of stay, severity of illness, or risk of mortality for that hospital stay. We only want to use that terminology if the condition was never present. When a provider incorrectly documents that a condition was ruled out, it does not matter how much great documentation or evidence preceded that statement. All of that is lost.  

Be very careful when answering a query with the 'ruled out' answer choice. There can be negative consequences when answered incorrectly.

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The Physician Payment Provision of the Patient Protection and Affordable Care Act became law on March 23, 2010, to promote transparency for financial relationships between certain health care providers and drug and device manufacturers. Open Payment requires:

• Applicable manufacturers of covered drugs, devices, biologicals, and medical supplies to report payments or other transfers of value they make to physicians and teaching hospitals to CMS;
• Applicable manufacturers and applicable group purchasing organizations (GPOs) to report to CMS certain ownership or investment interests held by physicians or their immediate family members; and
• Applicable GPOs to report to CMS payments or other transfers of value made to physician owners or investors if they held ownership or an investment interest at any point during the reporting year.

CMS collects this data annually, aggregates it, and publishes it on a public website.  

The second year of Open Payments data is now available! CMS published the 2014 Open Payment data about transfers of value by drug and medical device makers to health care providers on June 30. The data includes information about 11.4 million financial transactions, attributed to more than 600,000 physicians and 1,100 teaching hospitals, totaling $6.49 billion. We encourage you to check out the Open Payment data dashboard. 

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Pre-surgical screening and surgery access supervisor

The position and role of the surgery access coordinator has changed to that of a supervisor position responsible for pre-surgical screening and surgery access. Ericka Brown, who has been in the role of surgery access coordinator for the past year has accepted the position and will transition into the new role effective June 29, 2015.

This role will continue to provide support as a liaison between surgical services and surgeon offices. The surgery access supervisor will support process improvement along with the compilation and reporting of data, as well as provide oversight of the daily operations of pre-surgical screening. With this expansion to Ericka's position, Tess Rice will no longer be the assistant nurse manager over PSS and will focus solely on prep and recovery.  

Ericka is located in her same office space in Building C, 2nd floor at the west end of the back hallway.

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Jesse T. Buedefeldt-Pollard, MD - Obstetrics & Gynecology

Willamette Health Partners OBGYN 

Oregon Anesthesiology Group, PC