[Posted on www.Avvo.com]

Last year, a driver fell asleep at the wheel and struck my daughter’s car head-on. She had a bad cut and abrasion on her head, and an extremely bad break in her ankle. Her wrist was fractured, as well.
My husband and I were alarmed by our daughter’s description of the other driver’s behavior, making us believe he might not be a stand up kind of guy. We realized our daughter’s injuries were such that she would have a potentially bad facial scar and a lifetime of dealing with the extensive damage to her ankle. Thankfully, the other driver carried insurance, but we were concerned because he had the same insurance carrier we have. It stands to reason that the insurance company might be more concerned with protecting itself, as opposed to looking out for our daughter’s best interest. Hence, the search for a lawyer.
We consulted with three lawyers and Richard Adler seemed the obvious choice, though ultimately, it was to be my daughter’s call. I think it fair to say that she was impressed with Mr. Adler’s calm, friendly, approach. He outlined an anticipated progression of events, and a realistic potential financial outcome.
We never would have been able to navigate our way, on our own, through what can be a complicated process. We did not have the knowledge or familiarity of the insurance process to have known how to gain the maximum outcome for our daughter. Richard Adler and his staff handled it all with professionalism, and in a timely and pleasant manner. I believe they did all that was possible on her behalf. Also, it was hugely helpful and stress relieving to have Mr. Adler’s staff handling communications with the insurance companies (both car and medical), and dealing with payments to medical providers.
He and his staff had the foresight, and took the time, to give our daughter some great advice about not engaging in careless spending and considering investments instead. They also recommended she keep her financial situation private in order to avoid being asked to lend money, something that might not have occurred to us.
Hopefully, we will never require Mr. Adler’s services again, but I would not hesitate to utilize them, if needed, and I would heartily recommend him to anyone with a similar need.

Annual Walk Like MADD Fundraiser for Mothers Against Drunk Driving

The law firm of Adler Giersch ps is sponsoring and participating in this year’s Mothers Against Drunk Driving’s annual “Walk Like MADD” 5K on October 11, 2014 at UW Husky Stadium in Seattle.  MADD provides vital support services to survivors of drunk driving and their families.  This event is a great way to provide support.

Here is how you can help out:

  1. Join our team.  Please register online at http://support.madd.org/goto/adlergierschps click on register as an individual at the bottom of the page.  Bring your family and friends.  Opening ceremony begins at 8:00am.  Walk begins at 8:30am.  The cost to join is only $20.00 per person as a walker, $30.00 as a runner, $15.00 for children 5-21, and $10.00 for dog.  Registration includes a great T-shirt for the event. After September 10th registration fee will increase to $25.00 for adults, $20.00 for children, $15.00 for dogs.
  2. Start a New Team!: Round up your family, friends, and colleagues to walk together.  Registration fees are the same as above.  This is a great opportunity for team building within a company.
  3. Donate to our team.  Go to our team page, http://support.madd.org/goto/adlergierschps to make a direct online pledge to Team Adler ♦ Giersch, ps.  All donations will go directly to this event.

For more information about MADD, visit www.madd.org/local-offices/wa/.  We hope to see you on October 11th!

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Deadline for conversion to ICD-10 Codes Set for October 1, 2015: Are You Ready?

By Arthur D. Leritz, Attorney at Law

There are few certainties in life – death and taxes sure, but also add converting ICD-10 to that list.  The U.S. Department of Health and Human Services issued a statement July 31, 2014 finalizing October 1, 2015 as the new compliance date for healthcare providers.    So what does this mean for your practice?  If you are like me, you shudder at the thought of “upgrades” to systems that are supposed to make processes simpler.

This transition to ICD-10 is required for everyone covered by HIPAA, not just those who submit Medicare or Medicaid claims.  This also means that claims submitted to Medicare and Medicaid after the deadline will not be processed.  The ICD-10 transition does not affect the CPT coding for outpatient procedures and physician services.  The ICD-10 system has two parts:

  1. ICD-10-CM for diagnosis coding; and
  2. ICD-10-PCS for inpatient hospital procedure coding.

Diagnosis for ICD-10-CM uses 3 to 7 alphanumeric digits instead of the 3 to 5 numerical digit system with ICD-9-CM.

Below are links to websites that contain excellent information about the transition:

http://www.cms.gov/Medicare/Coding/ICD10/

Background/General ICD-10 Information:

http://www.roadto10.org/quick-references/

ICD-10 Checklists, Guides and Timelines for large and small practices:

http://cms.gov/Medicare/Coding/ICD10/ProviderResources.html

The following is a link that will show you the new codes by specialty:

http://www.roadto10.org/

Also, in my research on this issue I found a very useful website that will convert ICD-9 codes to ICD-10 codes for you:

http://www.icd10data.com/Convert

I cannot vouch for the accuracy or reliability of this website, but it is a great way to get started.  (I did cross-reference the search results with the information on www.roadto10.org and the codes searched were the same.)  For example, I plugged in some common codes I see on cases and came up with the following tables:

Neck and Back Pain:

ICD – 9-CM: ICD – 10-CM:
1. 723.1  (Cervicalgia) M54.2 (Cervicalgia)
2. 724.1  (Pain in Thoracic Spine) M54.6 (Pain in Thoracic Spine)
3. 724.2  (Lumbago) M54.5 (Low Back Pain)
4. 724.3  (Sciatica) M54.30 (Sciatica, unspecified side);or M54.31 (Sciatica, Right Side); or M54.32 (Sciatica, Left Side)
5. 724.5  (Backache, unspecified) M54.89 (Other dorsalgia); or M54.9 (Dorsalgia, unspecified)

Thoracic, Thoracolumbar and Lumbosacral Intervetebral Disc Disorders:

ICD – 9-CM: ICD – 10-CM:
1. 722.10 (Displacement of lumbar disc without myelopathy): M51.26 (Other intervertebral disc displacement, lumbar region); or M51.27 (Other intervertebral disc displacement, lumbosacral region)
2. 722.11 (Displacement of lumbar disc with myelopathy): M51.24 (Other intervertebral disc displacement, thoracic region); or M51.25 (Other intervertebral disc displacement, thoracolumbar region)
3. 722.31 (Schmorl’s nodes, thoracic region): M51.44 (Schmorl’s nodes, thoracic region); or M51.45 (Schmorl’s nodes, thoracolumbar region)
4. 722.32 (Schmorl’s nodes, lumbar region): M51.46 (Shmorl’s nodes, lumbar region); or M51.47 (Schmorl’s nodes, lumbosacral region)
5. 722.51(Degeneration of thoracic or thoracolumbar intervertebral disc): M51.34 (Other intervertebral disc degeneration, thoracic region); or M51.35 (Other intervertebral disc degeneration, thoracolumbar region)
6. 722.52(Degeneration of lumbar or lumbosacral intervertebral disc): M51.36 (Other intervertebral disc degeneration, lumbar region); or M51.37 (Other intervertebral disc degeneration, lumbosacral region)
7. 722.72 (Intervertebral disc disorder with myelopathy, thoracic region): M51.04 (Intervertebral disc disorders with myelopathy, thoracic region): or M51.05 (Intervertebral disc disorders      with myelopathy, thoracolumbar region)
8. 722.73 Intervertebral disc disorder with myelopathy, lumbar  region): M51.06 (Intervertebral disc disorders with myelopathy, lumbar region)
9. 722.90 (Other and unspecified disc disorder, unspecified region): M46.40 (Discitis, unspecified, site unspecified); or M51.9 (Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder)
10. 722.92(Other and unspecified disc disorder, thoracic region): M46.45 (Discitis, unspecified, thoracolumbar region); or M51.84 (Other intervertebral disc disorders, thoracic region); or M51.85 (Other intervertebral disc disorders, thoracolumbar region)
11. 722.93 (Other and unspecified disc disorder, lumbar region): M46.47 (Discitis, unspecified, lumbosacral region); or M51.86 (Other intervertebral disc disorders, lumbar region); or M51.85 (Other intervertebral disc disorders, lumbosacral region)
12. 724.40 (Degeneration of cervical disc): M50.30 (Other cervical disc degeneration, unspecified cervical region)
13. 847.2 (Sprain of the lumbar region): S33.5XXA[1]

 

For providers who have not yet started the transition to ICD-10, The Center for Medicare Services (CMS) recommends the following:

  • Establish a transition team or ICD-10 project coordinator, depending on the size of your organization, to lead the transition to ICD-10 for your organization.
  • Develop a plan for making the transition to ICD-10; include a timeline that identifies tasks to be completed and crucial milestones/relationships, task owners, resources needed, and estimated start and end dates.
  • Determine how ICD-10 will affect your organization. Start by reviewing how and where you currently use ICD-9 codes. Make sure you have accounted for the use of ICD-9 in authorizations/pre-certifications, physician orders, medical records, superbills/encounter forms, practice management and billing systems, and coding manuals.
  • Review how ICD-10 will affect clinical documentation requirements and electronic health record (EHR) templates.
  • Communicate the plan, timeline, and new system changes and processes to your organization, and ensure that leadership and staff understand the extent of the effort the ICD-10 transition requires.
  • Secure a budget that accounts for software upgrades/software license costs, hardware procurement, staff training costs, revision of forms, work flow changes during and after implementation, and risk mitigation.
  • Talk with your payers, billing and IT staff, and practice management system and/or EHR vendors about their preparations and readiness.
  • Coordinate your ICD-10 transition plans among your trading partners and evaluate contracts with payers and vendors for policy revisions, testing timelines, and costs related to the ICD-10 transition.
  • Talk to your trading partners about testing, and create a testing plan. [2]

 


[1] “A” is for initial encounter, “D” is used for subsequent encounter and “S” is used for Sequella.  For “XX”, use 11 for Right, 12 for Left.
[2] http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10FAQs2013.pdf