Wednesday, September 27, 2017

Key Notes For The Week of 09/29/2017



Keynotes for the Week of  09/29/2017

ICD-10

The 2018 ICD-10-CM (FY2018) scheduled to take effect 10/01/2017. The changes will be effective from October 1, 2017 through September 30, 2018 and for patient encounters occurring from October 1, 2017 through September 30, 2018.
There are approximately 363 new codes, 142 deletions, and more than 250 code revisions. Some of the revisions were not in the proposed changes for 2018 and were added to the release for 2018.  

A noteworthy change was made to the codes for substance abuse remission, which will be classified by severity as mild, moderate, or severe. The following are a few of the new codes from Chapter 2, Neoplasms (C00-D49):

C96.20 Malignant mast cell neoplasm, unspecified
C96.21 Aggressive systemic mastocytosis
C96.22 Mast cell sarcoma
C96.29 Other malignant mast cell neoplasm

And at the beginning of Chapter 4 Endocrine, Nutritional, and Metabolic Diseases (E00-E89), you will see these new codes have been added for 2018:

E11.1 Type 2 diabetes mellitus with ketoacidosis
E11.10 Type 2 diabetes mellitus with ketoacidosis without coma
E11.11 Type 2 diabetes mellitus with ketoacidosis with coma

Also, there are some new codes for myocardial infarction and heart failure that we will all need to review carefully. 

Fraud and Abuse Update:

The Federal Government’s law enforcement efforts respecting health care fraud were quite robust. 

Financial recoveries obtained from the Federal Government’s fraud and abuse program are used to protect the financial solvency of Medicare.  The Health Insurance Portability and Accountability Act of 1996 (HIPAA) amended the Social Security Act, Section 1128(c) to create the Health Care Fraud and Abuse Control Program, which was designed to (and does) combat fraud and abuse in the health care industry.  The Report was issued per statutory requirements, as part of the Health Care Fraud and Abuse Control Program.

All health care providers engaged in questionable practices should be concerned about serious risks they face, as the Federal Government is committed to aggressively combatting healthcare fraud and abuse.  HHS and DOJ employ sophisticated data mining, predictive analytics, trend evaluation and modeling approaches in their oversight of Federal programs and related law enforcement activities.

Electronic Health Record
Whether patient health information is on a computer, in an Electronic Health Record (EHR), on paper, or in other media, providers have responsibilities for safeguarding the information by meeting the requirements of the Rules.
The Health Insurance Portability and Accountability Act (HIPAA) Rules provide federal protections for patient health information held by Covered Entities (CEs) and Business Associates (BAs) and give patients an array of rights with respect to that information. This suite of regulations includes the Privacy Rule, which protects the privacy of individually identifiable health information; the Security Rule, which sets national standards for the security of electronic Protected Health Information (ePHI); and the Breach Notification Rule.
As 2017 comes to end, it is the perfect time to review , evaluate and make changes to be compliant in FSY 2018.


If you have questions about this blog post, feel free to contact us for additional information:
SILBEN Healthcare Services, INC.
Paul G. Silverio-Benet
Phone: 305-975-1171

No comments:

Post a Comment