Check Out 3 Ways to Stay Ahead of Coding and Billing Trends

Wed, Jun 22, 2016 --

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The medical coding profession has come a long way in a year. Last year at this time, just about every coding article on the Internet warned of the dangers involved as the U.S. healthcare industry transitioned from ICD-9 to ICD-10. Last summer, headlines trumpeted the AMA’s agreement to stop fighting CMS on the ICD-10 implementation. CMS promised to name an ICD-10 ombudsman, and it named William Rogers, MD, a practicing ER physician at Georgetown University Hospital, to lead CMS’s ICD-10 Coordination Center. Today, the ICD-10 Coordination Center has been shut down, “given the success of the implementation,” CMS’s website explains.

Looking back at the millions of words written in the last few years about the ICD-10 transition, you have to wonder what’s coming next. How do you stay ahead of the trends in medical coding and billing so you’re never blindsided by a big change? Here are a few things to watch for in the coming months.

1. Keep Striving for ICD-10 Claims Success

Keep your eye on your practice’s claims denial rates. Though RelayHealth reported in February that denials held steady from the days of ICD-9, as many as 1 in 5 claims is still denied or delayed as it works its way through the revenue cycle. CMS’s ICD-10 Next Steps Toolkit can help providers identify opportunities for improvement by assessing key performance indicators like days to final bill, days to payment, etc. Using revenue cycle analysis as CMS suggests could help your practice close some gaps in reimbursement.

2. Protect Your Practice’s EMR Against Ransomware Attacks

Last year, 2015, may have been “the year of the healthcare hack,” but 2016 has brought a new twist on the old hacker game. The latest cybercrime trend is ransomware, a “virtual stickup” where a hacker finds the weakest link in your computer system, holds it hostage, and makes you pay a ransom to regain access to your data.

What’s the solution? Just like your HIPAA Risk Assessment requires, back up your data frequently and maintain a detailed, well thought-out data recovery plan. By the way, it’s best to keep your backup separate from your network, so that it’s accessible if you’re hit with a ransomware attack. When you review your security risk assessment and recovery plan, don’t forget to look at “endpoint devices” like smartphones and tablets, as these devices are increasingly vulnerable to hackers.

At least three hospitals this spring were hit with ransomware attacks: Hollywood Presbyterian Medical Center, Methodist Hospital in Kentucky, and MedStar Health in the Washington, DC, area. Hollywood Presbyterian, in a bid to quickly restore its systems and administrative functions, was to pay the demanded 40 Bitcoin ransom (equivalent to $17,000) to the hackers.

3. Maintain Your Credentials

Professional certifications and credentials like the CPC from AAPC or the CCA and CCS from AHIMA require continuing education. What better way to keep up with your industry than by completing mandated learning activities to maintain your credential? Your credential tells others in your profession that you have passed a test measuring your knowledge about your profession, its ins and outs, and its guidelines and rules. In medical coding, credentials do matter, so if you are not already certified, make plans to take an exam as soon as possible. Make your continuing education work for you!

How About You?

What future trends do you see that will reshape the medical coding profession? Let us know what you think in the comment box below.

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Susan taught health information and healthcare documentation at the community college level for more than 20 years. She has a special love for medical language and terminology. She is passionate about ensuring accurate patient healthcare documentation through education. She has a master's degree in healthcare administration, is a certified healthcare documentation specialist, and serves as immediate past president for the Association for Healthcare Documentation Integrity (AHDI).

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