Coding Notes: The Coder Is In
By Holly Cassano, CPC
The American Hospital Association (AHA) recently announced the launch of their newest brainchild — a web-based Q&A forum called AHA Coding Clinic Advisor, a dedicated website for medical coding and question submission. As of Nov. 1, 2012, the website started accepting ICD-9 coding questions and more importantly, has also incorporated an ICD-10 forum for coding questions. Prior to the launch of this website, the only way to pose a question to the AHA was via mail or fax.
The AHA, founded in 1898, provides education for health care leaders and is a source of information on health care issues and trends. The American Hospital Association’s Central Office serves as the official U.S. clearinghouse on medical coding for the proper use of the ICD-9-CM, ICD-10-CM, ICD-10-PCS, Level I HCPCS (CPT-4 codes) for hospital providers and certain Level II HCPCS codes for hospitals, physicians, and other health professionals. The AHA is a not-for-profit association of health care provider organizations and individuals that includes more than 5,000 member hospitals, health systems, and other health care organizations, and 42,000 individual members.
Many coding and billing professionals recognize the AHA as the leading industry authority for all things ICD-9, and when questions have arisen, knew that you could write to the AHA for a resolution. Now that the AHA has included ICD-10 in the mix, this new website has paved a clear and easy path for health care professionals to obtain answers to their questions within a reasonable timeframe from an expert source.
All Things ICD-10
The AHA Coding Clinic will begin publishing ICD-10 related questions and answers as of the fourth quarter of 2012, from AHA Coding Clinic Advisor. The information will be published in the fourth quarter issue of AHA Coding Clinic, the official publication for ICD-9-CM, ICD-10-CM, and ICD-10-PCS. Coding advice and guidelines are published in collaboration with the Cooperating Parties (AHA, American Health Information Management Association, Centers for Medicare & Medicaid Services, and National Center for Health Statistics) and the Editorial Advisory Board.
For additional, please visit www.codingclinicadvisor.com
Question the Content
The AHA Coding Clinic Advisor will accept electronic questions from coding professionals who are looking for information in the following areas:
- Some HCPCS
How Does It Work?
When a health care professional submits a question to the AHA on the new website, a series of processes take place, which will track back to the submitter for a resolution. The AHA has established the following methodology in order to provide clear, concise, and fast results to users. Users must create an account and link to their employer or company before submitting a question to the AHA Central Office.
The process consists of the following:
- Hit Log In and you will be prompted through a set of steps to create a new account.
- Enter your email address or membership ID, and click the submit button.
- If there are no matching records, complete the New Account Registration form and click the Request a New Account button.
- You may submit up to three questions per one login session.
- Each question with related materials must be submitted separately and will be assigned a unique tracking number and receive a response.
- Include documents relevant to the question being submitted. Do not submit Personal Health Information (PHI), physician name, or hospital name.
- The time it takes to process a question depends upon its complexity. The AHA Central Office staff will conduct thorough research to determine a response. If necessary, the question may be forwarded to the Editorial Advisory Board for review and comment. In the latter case, processing may take up to six months for resolution. The extensive review process ensures the integrity and reliability of the answer provided.
- All questions submitted are processed free of charge.
- Do not submit the same question more than one way or more than once. This will create a duplicate in the system and significantly delay the processing of the original question.
- Question submitters will be able to track the status of their question throughout the process from start to finish. Click Check Question Status and enter the tracking number received via email after successfully submitting the question. If you do not have a tracking number or cannot find it, click the “Request My Tracking Number” link.
- All official answers will be provided in writing and mailed to your organization.
Don’t Bother Asking
As with any service of this kind, the AHA Central Office had to set some parameters around the types of questions it will respond to. The short list of what not ask includes the following:
- Inquiries from physician providers related to CPT-4 — all inquiries related to this series of codes will be referred to the American Medical Association (AMA)
- Questions related to A-codes — they will be referred to the Statistical Analysis Durable Medical Equipment Regional Carriers (SADMERCs)
- Questions on the remainder of Level II HCPCS codes related to durable medical equipment, prosthetics, orthotics, and other supplies, will be referred to Durable Medical Equipment Regional Carriers (DMERCs) or their successors, the DME Medicare Administrative Contractors (MACs), as these codes do not apply to hospital or physician providers
- Caveat for HCPCS — answers will be provided for ambulance service, radiopharmaceuticals, and Q-codes Q0136 through Q0181
- Questions related to payment or coverage issues
- Questions related to interpretation of medical record documentation, unless it relates to the application of specific coding guidelines or specific previously published coding advice
- Questions related to missing or incomplete documentation or validation of what is appropriate documentation (paper or electronic)
- Questions related to clinical issues or clinical criteria for diagnoses or procedures
- Questions related to mediating differences of opinion between providers and auditors or payers or any other third party reviewers — unless it relates to the application of specific coding guidelines or specific previously published coding advice
- Requests for the Central Office to code the entire medical record or operative report or to validate code assignment
Prior to submitting questions to the AHA’s new website, take a look at your practice’s current preparations for ICD-10 and off the short list, you should have the following in place:
- ICD-10 Blog On Corporate Intranet
- Coding Challenges
- Schedule Go To Meetings For Discussions Regarding ICD-10 Coding Questions With Your Team
- Develop An ICD-10 Library Of Training Data
With the launch of this website and the simplified method for submitting questions, it would behoove many in the industry to take advantage of this valuable resource as an adjunct to internal organizational ICD-10 preparations.