The clarifications continue over CMS’s approach to signature stamps. This past July CMS issued a clarification that stamps were not permissable on any medical record. Now a new clarification advises that some payers do not accept stamps but the Conditions of Participation do not prohibit them.

In the latest memorandum, dated October 24, CMS writes that the Conditions of Participation:

“do not prohibit the use of rubber stamps in a hospital setting, when properly controlled, for authentication of medical record entries. However, as a point of information for surveyors and providers, we are taking this opportunity to add an information-only statement to the interpretive guidance for §482.24(c)(1) to note that some payers, including Medicare, may not accept such stamps as sufficient documentation to support a claim for payment.”

AHIMA has submitted official comments on the adoption and implementation of the ICD-10-CM and ICD-10-PCS classification systems. In part, AHIMA:

• Recommends that the implementation of the two classifications and the related HIPAA transaction updates should occur over a three-year period, with the date of final compliance no later than October 1, 2012
• Supports a single compliance date across the entire US healthcare industry and recommends that the compliance date, once designated, not be extended, which would cause confusion and add costs (more…)

UPDATE: CMS has since released new clarification stating that stamps are not prohibited under the Conditions of Participation, but that some payers may not accept them.

The Centers for Medicare and Medicaid Services no longer accepts signature stamps on any record. CMS attempted to clarify the scope of the ban this summer, but the message may not have percolated to all corners of the industry yet.

In July CMS stated that “stamped signatures are not acceptable on any medical record.” The prohibition applies to all providers and suppliers. Medicare will only accept “handwritten, electronic signatures or facsimiles of original written or electronic signatures.”

In spring CMS published a ban on signature stamps focused narrowly on the certification of terminal illness for hospice. The subsequent July notice explicitly included all medical records. (more…)

AHIMA has posted an analysis of the ICD-10 Notice of Proposed Rule Making. The analysis is a summary, offered to the healthcare industry as an aid when considering the proposal. It is not AHIMA’s position on the adoption of ICD-10-CM and ICD-10-PCS. AHIMA will publish its comments and recommendations prior to the close of the public commenting period on October 21. (more…)

On Friday, August 15, the Department of Health and Human Services (HHS) issued a notice of proposed rule making (NPRM) to replace the ICD-9-CM code set.

The announcement, issued by the Centers for Medicare and Medicaid, indicates that display copies of the anticipated NPRMs have been filed. The official NPRMs–one related to adoption of the ICD-10-CM and ICD-10-PCS classifications and the second related to upgrades of the HIPAA claims-related transactions–will be published in the Federal Register on Friday, August 22, 2008. Additional information will soon be available on the CMS Web pages.

The CMS announcement specifies an October 1, 2011, compliance date for the two sets of changes.  Comments on the proposed rules are due no later that October 21, 2008.

AHIMA will offer a free 90-minute Webinar on the NPRM on Tuesday, August 26, 2008. AHIMA staff will also publish an analysis of the proposed rule.

Clinical documentation improvement programs can enhance the clinical record and capture lost reimbursement. But they can be a challenge. Getting physician buy-in, avoiding turf wars between documentation specialists, coders, and nurses, and measuring program success are just a few of the challenges many facilities face with their programs. Below are a few tricks of the trade on running a successful CDIP, lent by experienced clinical documentation specialists. (more…)

The Centers for Medicare and Medicaid Services has published proposed rules for OPPS and ASC PPS in 2009.

2009 OPPS
CMS projects that proposed CY 2009 payment rates under the outpatient prospective payment system (OPPS) will result in a 3.2 percent increase in Medicare payment for providers paid under the OPPS.

(more…)

Preparing for ICD-10 barely made the top 10 in the Journal’s July coding challenges poll. That’s largely a reflection of the more immediate challenges coding professionals have on their desks right now. Without an implementation date, preparing for ICD-10 is likely to take a back seat in many organizations.

However, transitioning successfully to the new code set will take a lot of preparation. AHIMA has been preparing ICD-10 materials for several years now. They are available from a special ICD-10 page on the AHIMA Web site and in the FORE Library: HIM Body of Knowledge (accessible through the MyAHIMA member log-in on the home page).

In particular, the practice brief “ICD-10 Preparation Checklist” outlines a multiyear plan divided into four major phases. The article “Why ICD-10 Is Worth the Trouble” frames the high-level case for healthcare’s need for a contemporary coding system.

The Centers for Medicare and Medicaid (CMS) has reported on the status of the recovery audit contractor (RAC) program in Medicare for fiscal year 2007. In the report, CMS highlights improvements that will be made as it implements the permanent RAC program by 2010. (more…)