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ICD-10 Implementation: Still Important

Until this week, ICD-10 was on track for implementation October 1 of this year, just a few months from now. But a back room deal in Congress (that so far no one will take credit for) has packaged a 12 month ICD-10 delay with the postponement of the SGR cuts (which were certain to pass). As a result, everyone who has been getting ready for October 1 must now adjust their plans. The impact on physicians and companies (like AdvantEdge) who are prepared for ICD-10 is enormous. Training has already begun, systems have been modified, testing is underway and much more. How current ICD-10 efforts will be modified is just now being determined. The good news is that the training to date will make coders and physicians more precise, which always helps both reimbursement and compliance. And efforts by specialists to get better information from the ER and referring physicians will help them diagnose cases better and faster. The surprise delay prohibits CMS from enforcing any mandate for ICD-10...

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Welcome!

Healthcare exchanges, SGR and ICD-10 are all hot as we go to press. SGR cuts have been averted for 12 months but ICD-10 has been delayed, for reasons no one can explain, or is willing to take credit for. We also answer questions about the impact of healthcare exchanges. And there is more in the SGR bill: good news for radiology, pathology, emergency medicine and behavioral health.

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Health Insurance Exchanges (“Marketplaces”)

Nearly 7 million have signed up for insurance on the federal and state-based health insurance exchanges (“marketplaces”) by the March 31 deadline.  This means signups are complete, or does it? Two announcements in the last two weeks suggest the signups aren’t done yet.

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It’s Not Just About SGR and ICD-10

It was no surprise that Congress again delayed the SGR cut to physicians’ Medicare payments, despite serious attempts at permanent repeal. The negative surprise is the 12 month delay to ICD-10 diagnosis coding. But, buried in the details, are good surprises for radiology, pathology, emergency medicine, hospitalists and behavioral health.

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Surgery Documentation for Coding Fractures under ICD-10

One of the most challenging diagnoses for complete documentation in assigning ICD10 codes is fractures. Besides that for coders the ICD-10 codes are organized differently than ICD-9, there is much more specificity in ICD-10 codes. And for that reason, surgeons must be more specific when documenting their services.

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Breast Tomosynthesis CPT Codes Approved

In March, the CPT codes for breast tomosynthesis were accepted for use as of January 1, 2015. Whether Medicare and other payers will reimburse these codes remains to be seen but this is a critical step in the process.

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