By Lisa A. Eramo, MA
Presenters touched on a variety of hot topics at the most recent RIHIMA meeting: Data mining, patient matching, and evaluation and management (E/M) coding. Approximately 40 people attended the event held in Warwick, Rhode Island on January 17, 2020.
Data management skills a ‘must’ for HIM
Lolita M. Jones, MSHS, RHIA, CCS, healthcare data mining consultant at iquerydata.com encouraged attendees to gain data management skills so they can continue to add value in an increasingly artificial intelligence-driven healthcare environment. In the not-so-distant future, Jones said HIM professionals will be charged with auditing large data sets, identifying patterns, and recommending physician education. They’ll no longer manually assign codes and perform audits with limited sample sizes. Those with data management skills will be able to weather the storms of change and prevail, she added.
HIM professionals with data management skills, for example, can convert official coding guidelines into database queries to identify potential coding problems proactively—before payers and Recovery Audit Contractors do, said Jones. Why is it critical for HIM to write these queries? They possess the subject matter expertise to identify all of the diagnosis and procedure codes that apply to each query, said Jones. They can also help decision makers draw accurate conclusions and glean actionable insights from the data, she added.
How does one obtain data management knowledge without obtaining a master’s degree? Grassroots education at local and regional AHIMA meetings, said Jones. HIM professionals can also attend data management-related tracks at the annual AHIMA conference or take a variety of courses online.
Patient matching is more critical today than ever before
Letha E. Steward, MA, RHIA, director of customer relations at Quadramed gave an informative presentation on patient matching in the context of mergers, acquisitions, and health information exchange. A duplicate record doesn’t just affect one hospital—it affects many providers in real-time, said Steward. “As soon as you create a duplicate, the patient’s medical record is fragmented,” she added.
When hospitals and physician practice merge onto a single EHR platform, they must have a process in place to identify and resolve duplicates, said Steward. She encouraged organizations to use referential data because it’s updated as life events occur, and it can enhance automated matching. She also encouraged attendees to think about using cell phone numbers as unique identifiers because they don’t change often.
E/M documentation problems persist
Oby Egbunike, CPC, COC, CPC-I, CCS-P, director of professional coding at Lahey Health Care System, Burlington, MA spoke about the importance of the chief complaint—a detail that’s often omitted from E/M documentation. “This is the driver for whatever else the physician is going to do,” she said.
When documenting the exam, Egbunike said physicians should consider this question: Is the exam for the purpose of diagnosing and treating the patient or for coding? For example, a full organ system exam isn’t necessary for an ear infection, she added.