ICD-10 is a New Era

By Dr. Robert (Bob) Day, Jr., Broadway Eye Center, Garland, TXdr_bob_day_web

When I started learning ICD coding, my dad, Dr. Robert Day, Sr., was President of the American Optometric Association (AOA), and they had just published the first Current Optometric Information and Terminology (COIT) book in June 1974.  It was optometry’s first attempt to participate in the new medical trend of systematically classifying diseases.  Optometry was just beginning to become more than simply prescribing a pair of glasses to help patients realize improved vision.

Learning ICD-9 versus ICD-10 is very much like comparing learning multiplication tables to learning calculus.  I can’t remember a time when I didn’t know my multiplication tables, but I remember struggling to learn calculus all too well.  I probably learned multiplication in the second or third grade. It was a straightforward process where one problem produces only one answer.  For example, 2×2 can only equal 4—easy enough, right? Then you advance to calculus (particularly differential) where one problem can produce multiple possible answers.  The learning process is far more complex, and the answers, at least initially, are far less obvious. But it can be done; you just need to spend the time to identify your best resource and to understand your goal.

Even now, I calculate simple multiplication in my head, but for calculus I need the help of technology (a calculator) to do calculus.  Likewise, ICD-9 is committed to memory, but for ICD-10, I will depend on technology in the form of my electronic health record system to handle most of the ICD-10 coding.

Speculation abounds, but it’s reasonable to assume that ICD-10 will mark the end of the paper super-bill and coding from memory. Under ICD-10, the AOA’s Express Mapping Card alone is four pages with almost 300 codes.  ICD-10 is clearly more complex, and trying to manage it without the help of technology will drastically add time and expense to your coding.

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Sink or Swim with ICD-10; My story

dr_bob_day_webBy Dr. Robert (Bob) Day, Jr., Broadway Eye Center, Garland, TX

In our office, preparing for ICD-10 coding is similar to a life-boat drill….go over the basics and depend on the technology used by the boat captain to keep you from getting in the water over your head.

The Basics

To get started, I identified the resource that’s familiar and comfortable to me. In my case, it’s the American Optometric Association (AOA).

My staff and I viewed webinar recordings from AOA’s EyeLearn Webinar recordings.They were very interesting to watch, but like most continuing education lectures, I’m not likely to remember much of it.

We also chose the AOA’s 2015 ICD-10 Coding Bundle, for those times when we would need to look up specific codes. With our reference library in place, I consciously rejected all online websites that show conversion tables from ICD-9 to ICD-10. These websites only give unspecified eye codes, even though ICD-10 is based on which eye is being coded.

Finally, and in my opinion most importantly, I will depend on the technology of my Electronic Health Record software to take care of 95% of the coding for me.  I know that a few patients will present with strange problems (corneal injury to the right eye from a left elbow of a taller person during basketball practice on a Tuesday!) for which I will rely on my reference book. But for the most part, I will trust my EHR to steer me out of the undertow.

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Enhancing the Patient Experience – Is EHR Really Necessary?

Steve Baker, President, Eyefinity

Steve Baker, President, Eyefinity

There’s a lot of noise and disagreement about electronic health records (EHR) right now. For some it may seem like there is no end in sight. For others, this is not as big a deal as some are making it out to be.

 
Read the four key things that a certified EHR can help you do to improve your business and enhance patient care.

Read full article republished with permission from Western Pennsylvania Healthcare News.

Use EHR as an Effective Patient Education Tool

Dr. Duane Wires

Duane Wires, OD

A key goal of health care reform is to improve patient outcomes, and getting patients engaged in their treatment plans is a critical component in that process. Your EHR system can help you achieve that–if you learn to optimize it.

Read the entire article:Use EHR as an Effective Patient Education Tool

Reprinted with permission from Review of Optometric Business.

 

April Is Important Month for Meaningful Use

It's AprilApril 1 marks the second quarter for Medicare providers to begin meaningful use. No matter if you are a Medicaid or Medicare provider, attesting involves three months of reporting for meaningful use in 2014.

If you’re participating in the Medicare EHR Incentive Program, the three months must begin at the start of the quarter (i.e., January 1, April 1, July 1,or October 1). Whether you are beginning Stage 1, continuing Stage 1,or beginning Stage 2, you must update your software prior to your three-month reporting period.

The EHR Incentive Program requires eligible providers to integrate meaningful use of certified EHR technologies into their practices in stages. Each stage requires providers to meet specific measures and attest to their completion. Many providers began Stage 1 in 2011 and 2012. Those providers are required to begin Stage 2 in 2014. Providers who began Stage 1 in 2013 will continue with Stage 1 in 2014. Providers who have not participated in the program by 2014 will be subject to Medicare penalties in 2015.

Check out Eyefinity’s Meaningful Use Resource Page for helpful information about Meaningful Use 2014 Edition and certified product solutions.

VSP and AOA sit down for an open forum on healthcare reform

Last night, VSP and the AOA sat down for an informative 90-minute discussion about the inclusion of stand-alone vision plans in the Insurance Exchanges. VSP remains concerned that the AOA has no plans for assuring optometry’s access and parity in healthcare reform.

Watch the video below where Dan Mannen, OD, FAAO,  shares his concerns about “putting the fox in charge of the hen house and place our future in the hands of health plans that routinely discriminate against our profession, blocking our access and paying us less for like services.”

If you missed last night’s discussion, you’ll still be able to watch a recording the video here later today: http://vspprovesit.com/healthcare

Curious about the issues?  Find out more below (sourced from http://www.vspprovesit.com/healthcare-issues)

Issues Defined

If the Exchanges move forward as structured, private practice eye doctors will have to provide care to their patients through health plans.This new structure could lead to a variety of unintended consequences for both patients and their eye doctors.

  1. Optometrists may be locked out – Health plans have a long history of preventing optometric participation on health plan panels across the country. The Harkin Amendment, which has been touted as providing parity for all healthcare providers, does not guarantee access or parity. So, optometrists will have to rely on health plans to change the way they currently do business and allow them on their panels.
  2. Optometrists could be forced to accept reimbursement from plans like Davis, Spectera, and CompBenefits – Current law allows these plans to directly participate in the Insurance Exchanges, while disadvantaging stand-alone plans because they are not associated with a health plan. Health plans are likely to turn to these programs when and if they need an optometric network.
  3. Optometrists could see fewer patients – There are currently 100 million people in the U.S. relying on vision benefits from stand-alone vision plans. Research shows that these individuals with a stand alone benefit get vision care much more frequently than those who have a benefit through a medical plan. As patients transition out of Stand-Alone Plans and into vision/medical bundled programs, doctors are likely to see far less utilization from these patients in the future.
  4. Optometrists could lose Kaiser patients – Two thirds of Kaiser enrollees also have VSP coverage. In states with high Kaiser penetration, this could gradually disappear as employer groups enter the Exchanges and cannot continue to contract with VSP through those Exchanges.

Technology for today and tomorrow…thoughts from Dr. Kirchner

James Kirchner, OD

Technology’s impact on our lives is increasingly evident. The recent passing of Steve Jobs caused the world to reflect upon these advances and how rapidly they’re happening. Four years ago we hadn’t heard of an app—now there are thousands. It’s hard to realize the first iPadwas delivered to us less than 24 months ago! The entire global technology community appears to be moving at the speed of light. Great companies not only keep up, but as Apple, Microsoft, and Google demonstrate, they lead. Aggressive innovation is the hallmark of technology leaders. At Eyefinity®, we clearly understand and embrace this role.

As the leader in technology services and products for the eyecare industry, Eyefinity is driven to provide a steady stream of new tools providers need to meet the demands of an evolving, competitive, opthalmic market. Our mission is to assist you, our customer, in achieving success in your business.

Eyefinity is committed to empowering the eyecare professional through personalized service and innovative e-business solutions. Our e-business solutions enable you to expand and promote your practice in the most cost-effective manner, so you can focus on your service for patients. Eyefinity offers the widest spectrum of e-business management resources: from product ordering, to insurance claim processing for government and commercial carriers, to developing marketing strategies.

Recently, Eyefinity rebranded Business Essentials as eyeVantage. The online collection of key learnings, proprietary tools, and best practices in eyeVantage lay the foundation for successful practices. This is just the beginning of the business resources that will become available on eyeVantage.

The recent release of OfficeMate/ExamWRITER v10.5 is the newest version of our CCHIT-certified Complete EHR. Our v10 software series enabled a large number of users to receive stimulus payments in 2011, and we anticipate an even larger majority to receive incentive payments in 2012. We’re adamant about our commitment to continually strengthen and improve our OfficeMate/ExamWRITER software. This product serves more practices in the U.S.than all competitors combined, and it’s here to stay. We are serious about our responsibility and commitment to provide and support OfficeMate/ExamWRITER, both now and in the future.

As the technology leader in our industry, we understand our critical role in developing innovative solutions. We’re in the midst of developing many new resources to meet the demands of the evolving ophthalmic market. Watch for announcements about developments in AcuityLogic, our complete, cloud-based EHR suite that allows practices to run their business through the “cloud,” or Internet. We’re committed to leading the industry in this realm.

Eyefinity is here for you today. As an innovative technology leader and your partner, we’ll continue to provide you with the resources for your success tomorrow. This is our mission and our sole reason for existence.

– James K. Kirchner, OD
Chief Professional Officer, Eyefinity

Attesting to Meaningful Use: Another Success Story

Today’s entry comes from Ryan Wineinger, OD.

Dr. Ryan Wineinger

Dr. Wineinger has leveraged OfficeMate/ExamWRITER to fulfill meaningful use.

Many optometrists don’t want to look at or think about meaningful use (MU) because they doubt that they will be included in the HITECH Act or eligible for stimulus money. Well, I can now say that, as an optometrist, I have successfully attested to using a certified electronic health record in a meaningful manner. I am now eligible for the funds allotted in Year 1, Stage 1 of the HITECH Act.

My practice started using OfficeMate/ExamWRITER v10 the day after returning from the New Year’s holiday. In fact, I registered for the EHR incentive program on the first day that we were allowed to apply.

Our practice has used OfficeMate/ExamWRITER for the last seven years. Since we’ve been using the programs for so long, I thought that I’d be able to breeze through meaningful use. I can now honestly say it takes some time to study and understand the requirements for meeting all of the necessary measures. Once I spent a few hours studying all of the incentive program information on the CMS Web site and Eyefinity’s Meaningful Use Starter Kit, I was confident that I would know how to meet each measure.

ExamWRITER is designed in such a way that I didn’t need to document my eye examinations much differently than I did before the incentive program. There are areas of the software where I had to document items in a different place, because fields were added or moved, but I didn’t necessarily need to change what I was doing.

A critical feature in OfficeMate/ExamWRITER v10 is the MU Report Card, which helps you gauge your meaningful use. Initially, I looked at the report several times a day to ensure that I was getting credit for each measure. After the second week, I looked at the report card report only weekly to ensure that I was on pace to meet MU requirements at the end of my 90-day reporting period.

Finally, on April 18th, CMS allowed us to attest to the fact that we had indeed met the meaningful use requirements. I plugged in my numbers from my report card into the Meaningful Use Attestation Calculator to ensure I was eligible to qualify. After verifying our numbers, I logged into the attestation site, entered my information, and after roughly 30 minutes, I successfully completed the attestation process!

Now I have reached the hardest part of the process—waiting for my incentive money! Based on the calculations used for the HITECH Act, we will meet the maximum billable amount sometime this summer, and once we do that, we will receive our incentive money.

I encourage every optometrist out there to start using an EMR. I feel that it gives me more information at my fingertips and allows me to provide more thorough care for my patients. The government believes this, too, and that is why they allowed optometrists to participate in the HITECH Act. I’m happy to say that OfficeMate/ExamWRITER gave me the appropriate tools to participate in the meaningful use incentive program.

Dr. Ryan Wineinger received his undergraduate degree from Kansas University. He then graduated from The Southern College of Optometry in Memphis, Tennessee. After graduation, he went into practice with his father at Wineinger Eyecare. Dr. Wineinger thoroughly enjoys the technological side of optometry and has made concentrated efforts to bring in the latest equipment to ensure that his patients are receiving the highest level of comprehensive care possible in regards to their eyesight. He is a member of the American Optometric Association and the Greater Kansas City Optometric Society.

Have you registered for the Medicare and Medicaid EHR Incentive Program? Don’t delay! Register today!

Haven’t registered for the Medicare and Medicaid EHR Incentive Program? Not to worry! Kim Castleberry, O.D., of Plano Eye Associates walks you through the process, step-by-step, in the video below.  Remember: Even if you don’t have your certified EMR in place yet, you can and should register now.

We thank Dr. Castleberry for providing this important video!

Understanding Meaningful Use Objectives, Part 2

A message from James Kirchner, OD, Chief Professional Officer for Eyefinity/OfficeMate:

Dr. James Kirchner

In a previous article, I took you through the first six Meaningful Use (MU) objectives in the “core” group as established by the CMS (Centers for Medicare and Medicaid Services). In this edition, I’m going to explain the remaining nine MU objectives. Remember, CMS divided the 25 meaningful use objectives into two groups: the first group of 15, called “core” objectives, and the second group of 10, called “menu” objectives. The directive from CMS is that eligible providers must complete all 15 core items and at least five of the 10 menu items, for a total of 20, to meet MU requirements. As I’ve mentioned before, there are exclusions available to the eligible provider, allowing noncompletion of an objective, yet fulfilling MU. I will address these exclusions in a future Trends and Tactics.

If you missed the first six from the last article, you can still read it on our blog. Remember, for all of these easy-to-accomplish MU objectives, OfficeMate/ExamWRITER v10 will provide the necessary tools that allow you to fulfill the requirements.

Here are the remaining nine core objectives:

1.     CPOE (Computer Physician Order Entry) for medication orders
More than 30% of unique patients, with at least one medication in their medication list as
seen by the EP, must have at least one medication ordered using CPOE.

2.     Implement drug-drug and drug-allergy interaction checks.
The EP has enabled this functionality for the entire EHR reporting period.

3.     Implement one clinical decision support rule and the ability to track compliance
with the rule.

OfficeMate/ExamWRITER v10 will give you this ability.

4.     Report clinical quality measures to CMS or the state.
Extension of PQRI reporting using OfficeMate/ExamWRITER v10

5.     Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
OfficeMate/ExamWRITER v10 will provide this functionality.

6.     Generate and transmit permissible prescriptions electronically (eRx).
More than 40% of all permissible prescriptions written by the EP are transmitted
electronically using certified EHR technology.

7.     Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies, discharge summary, procedures), upon request.
More than 50% of all unique patients of the EP who request an electronic copy of their
health information are provided it within three business days.

8.     Provide clinical summaries for patients for each office visit.
Clinical summaries provided to patients for more than 50% of all office visits within three
business days

9.     Capability to exchange key clinical information electronically (for example, problem list, medication list, medication allergies, diagnostic test results) among providers of care and patient authorized entities
Performed at least one test

Now you have seen all 15 core objectives that provide meaningful use. In my next article, we’ll look at the 10 menu objectives. Remember, your certified EHR must provide you with the tools to easily fulfill the objectives. OfficeMate/ExamWRITER v10 is certified and will give you those tools. We want to enable you to qualify for the funds associated with meaningful use and help you provide the best care to your patients. The time to register for the Medicare and Medicaid EHR Incentive Program is now, even if you don’t have your certified EMR in place. We encourage you to register now.