Archive for June, 2019

CODER KNOWLEDGE: UV AWARENESS & SKIN CANCER

Posted by Samantha Serfass on June 25, 2019 in Blog, News

Coder Knowledge: UV Awareness & Skin Cancer

Next month is designated as UV Safety Awareness Month which comes as no surprise.  July is the month of summer vacations, trips to the beach, summer sports and outdoor yard work. 

Did You Know? 

Skin cancer is more and more common.  In fact, according to the American Cancer Society it has become the most frequently diagnosed form of cancer in the U.S.  The Skin Cancer Foundation notes that every year there are “more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.”

Contributing factors

  1. Skin is the largest organ in the human body.
  2. The UV index is changing due to a diminished ozone layer.
  3. Patient awareness lags other, more publicized cancers.

Basal cell and squamous cell carcinomas are the most common forms of skin cancer, melanoma has the highest mortality rate. Skin cancer can be caused by too much exposure to ultraviolet (UV) rays from the sun and other sources, such as tanning beds and sun lamps. 

However, the good news is we can take highly preventative measures to decrease our risk.  During UV Safety Month, make it your practice to follow the index levels and associated protection recommendations. 

UV Index Recommended Protection
Extremely High (11+) Sunscreen, sunglasses, hat, shade, indoors from 10 a.m. until 4 p.m.
Very High (7-10) Sunscreen, sunglasses, hat, shade
High (6-7) Sunscreen, sunglasses, hat, shade
Medium (3-5) Sunscreen, sunglasses, hat
Low (0-2) Sunscreen, sunglasses

Coder Knowledge: Cell Type Matters

Clinical coding of skin cancers is based on two key factors: the type of cell involved and the anatomical site.  As mentioned above basal and squamous sell are the most common.  These types of skin cancers are often treated topically in the physician’s office and require minimal coding expertise.  However, melanoma is more invasive, and treatment typically includes a hospital encounter with radical wide excision, skin grafts, and lymph node excision.

Example Chapter 2 Index

        C44.11 Basal cell carcinoma of skin of eyelid

                  C44.111 Basal cell carcinoma of skin of unspecified eyelid

                   C44.112 Basal cell carcinoma of skin of right eyelid

                   C44.119 Basal cell carcinoma of skin of left eyelid

        C43.1   Malignant Melanoma skin of eyelid

                    C43.10 Malignant melanoma of unspecified eyelid

                    C43.11 Malignant melanoma of right eyelid

                    C43.12 Malignant melanoma of left eyelid

In ICD-10-CM, body sites are specific to site and type of skin cancer.  They require documentation of laterality for paired organs such as ears, eyes and upper and lower limbs. Physician documentation is key to specificity.

Denise Bell, CCS

Auditor/Educator

MANAGED SERVICES: REDUCING COST & INCREASING VALUE

Posted by Samantha Serfass on June 11, 2019 in Blog, News

Managed Services: Reducing Cost & Increasing Value

Today’s IT department is supporting so many initiatives:

  • Adapting to New Payment Models
  • Improved Provider & Patient Experience
  • Population Health
  • Clinical Integration
  • Performance Improvement

It’s difficult to staff projects to accommodate the demands, timeframe, and budget all while providing the expected quality of work from your organization. As the continued trend for IT department spend continues to reduce, finding solutions for highly qualified staff and accommodating the CFO becomes more challenging.  Staffing is typically around 50% of the IT budget or higher.  Today many hospital systems are leveraging Managed Services to reduce their spend by 30% or more depending on the hospital system.  

Managed Services allow the CIO and IT directors to assign local staff to the strategic projects while working with the user base to decrease tickets with the help of remote staff.   The entryway into the cost saving approach is to find the right partner.  Someone who is dedicated to proving better service then you currently have at lower cost.   Your partner should have no problems providing an SLA (Service Level Agreement) that will meet (or beat) your current IT response time.  Another cost saving approach is to also have your partner in Managed Services take responsibility for on-call / afterhours.  This can either make up for raises the hospital couldn’t afford or reduce the costs for on-call pay with employees.  

Eliminating on-call can be an employee satisfier, in any case employee satisfaction will increase by a allowing resources to get away from the routine tasks of working down tickets and moving to project which are more strategic.  Managed Services can increase resources at the beginning of the engagement to work all application models down to zero. Manage Service can readjust resources to maintain fresh tickets in the que.  Your partner manages the work effort and staffing based on your current and changing needs.  The beauty of Managed Services is employee and end-users are more satisfied. This can help decrease costs and the headaches of adjusting staff levels also is significantly reduced.

Excite Health Partners has the expertise and experience to assist with Managed Services. We can help you explore all the possibilities while tailoring a program that provides you with the best savings and value.

Todd Klein

CIO, VP of EHR Services & Digital Solutions