“We have one final surprise tonight – and it’s something we’ve all been able to keep a secret,” laughed Angie Christen. She was holding a large, white album with a ribbon tied around it.
“Betsy, can you please come up here?”
It was the final night of Health Information Associates 25th Anniversary celebration and, to mark the momentous occasion, founder and CEO Betsy Bailey invited all HIA employees and their guest to the Salamander Resort in Middleburg, Virginia. The three-day event was exactly what she had hoped for, a nonstop celebration with everyone that helped the company reach this milestone.
“We wanted to give you something to show how much we appreciate you, this company, and all it has brought to our lives,” continued Christen as Bailey made her way to the stage.
The past three days had been a truly humbling experience for Bailey – she never imagined her one-woman coding consulting company , which she started in a home office in North Carolina, would turn into one of the most respected in the industry, creating more than 250 jobs in its 25 years.
But the celebration was also bittersweet as there was one very important member of the HIA family missing – her dad, Deane Beamer, with whom she founded the company with in 1992. Beamer passed away in 2012 at the age of 78.
Once Christen gave the album to Bailey and she realized its contents, she was speechless. In the album were handwritten letters from every HIA employee. Many of them had been with the company for more than a decade. Each letter told a different story of how they came on board with the company and what the HIA family meant to them.
It was a pinch-me-moment for Bailey.
“I still don’t know how this all happened,” she laughed.
Growing up, Bailey and her dad had a special bond – especially when it came to business.
“I loved it. Especially those dinner table conversations, talking about the healthcare industry and bouncing ideas off of each other,” she said. “It’s just how I grew up.”
Beamer, a veteran of the United States Air Force, studied at the Medical College of Virginia where he received his Master’s Degree in Hospital Administration. He completed his residency at Memorial Mission Hospital in Asheville, North Carolina and then moved to Marion, Virginia to serve as CEO where he was instrumental in establishing Smyth County Community Hospital. After retiring from SCCH, Beamer consulted and served in various interim hospital CEO positions throughout the Southeast.
Bailey attended Emory & Henry College for three years, before transferring with her now husband Bruce to the Medical College of Virginia where she received her BS in Health Information Management. Following graduation she took a job as the Director of Medical Records at Tidewater Memorial Hospital from 1987-1988 (now Riverside Tappahannock) and then moved on in 1988 to the Director of HIM at Humana St. Lukes Hospital in Richmond, Va. (now Parham Doctors Hospital )
Bailey’s husband, having completed his Masters in Health Administration, was offered a job as Assistant CEO at Humana Clinch Valley in Richlands, Virginia in 1990 (now Clinch Valley Medical Center) It was following their relocation to Richlands that Bailey entered the healthcare auditing world as a self-employed consultant. Her first client in 1990 was her Dad’s hospital. Once Beamer saw his daughter’s findings and the educational opportunities for his coding staff, he spread the word to other area hospitals that this is something they really should be doing. Bailey added several more hospitals to her small business.
“I honestly wanted to help these not-for-profit hospitals get the reimbursement they deserved because the smaller facilities were struggling in those days. In addition, I loved teaching what I knew about coding to their staff.”
It was also during this period that Bailey had her first child, Beth Ann, in 1991.
As Bruce’s career progressed, the couple moved to North Carolina to pursue an opportunity at Lake Norman Regional Medical Center in Mooresville.
“Supporting Bruce’s career and being a mom were important to me,” she said. “But I also wanted to continue to grow my own business and keep my coding skills sharp. I guess you could say I wanted to have it all.”
It was in 1992 that Bailey landed her largest client to date – a group of HCA hospitals based out of Richmond, VA. At the same time she found out she was pregnant with her second child, Tyler.
“I remember thinking ‘there’s no way I can handle this all on my own and do these contracts justice,’” said Bailey. “That’s when my dad advised me that it may be time to hire someone to help me.”
That same year, Bailey with the support of her dad founded Health Information Associates, Inc. They hired their first employee, Pam Riddle, that same year. In the year to follow she hired her next two employees Amanda Williams (now Roeschke) and Patti Kulp, both who were former classmates at Medical College of Virginia with her…and are still with the company to this day.
“And I guess that’s when it all started,” laughed Bailey.
In the first five years, Bailey also hired Christen, now VP of Operations at HIA and Joel Shealy, now VP of Business Development.
“I swear, even in the early years, I just thought ‘this is so much fun, I get to work with my best friends every day and do something I love.’”
“It still hadn’t hit me.”
As the coding review relationships continued to grow, more and more clients began looking for other ways to take advantage of HIA’s expertise. Soon the requests for as needed coding support to cover vacations, maternity leaves and vacancies began rolling in and another mainstay service line was born. Interim Coding Management was not far behind and eventually services were expanded to encompass the physician coding and compliance side.
Bailey says the gradual growth of HIA over the next several years – during which she also welcomed her third child, Rachel – was by design.
“We grew slowly but steadily. We didn’t want to take big risks and I never wanted to hire someone if I couldn’t guarantee consistent work for them,” she said. “Clients were patient with us because they knew the quality of work we produced – so they would wait until we could fulfill the contract.”
Bailey says Christen and Shealy were instrumental to HIA’s growth.
“Every corner we turned another opportunity presented itself and we would say ‘okay what do we need to do to get to this level?’ – but we never made huge leaps or ventured outside of our area of expertise, coding,” said Bailey. “We made every decision as a team.”
By 1999, HIA had clients in 26 states. It was that same year that Bailey took over the company as sole owner, with Beamer continuing to serve as an advisor.
By 2011, the company had more than doubled in size.
Today, HIA has clients spanning 45 states and continues to employ only the best in the industry.
“For me, these aren’t just employees – they are family,” said Bailey.
The sentiment rings true to all that HIA does – from its slogan The People Behind the Numbers to its annual meeting, instead called the Family Reunion.
“Even as we continue to hire on more people, we still maintain the core values we established so many years ago,” said Bailey. “HIA is only as good as its people – and I truly believe we have the best of the best in this industry.”
Bailey often refers to HIA as another child of hers, and she believes the culture she has established for the company is not something to take for granted.
Case and point: she wants her kids to work elsewhere for at least two years until they even consider joining the company.
“I don’t believe in just giving your children a handout because you have a successful business,” she said. “Of course, you always want them to be interested in what you are doing, but it’s up to them to figure that part out. I would love to have them all working for HIA someday but this may not be the path for all of them – they have their own interests and I support that.
That sentiment made this year’s celebration that much more special for Bailey, whose daughter Beth Ann Moran, 26, joined the company as part of the recruitment team nearly two years ago.
“To see her have the same love and respect for this company and its people that I do – it makes me unbelievably proud,” said Bailey.
Moran says joining the HIA family “officially” is a dream come true.
“I grew up with most of you and I feel so lucky to be a part of this amazing company,” said Moran during the event Salamander. “I saw how hard my mom worked and how much she and my ‘Big Daddy’ cared for all of you, so it really is special for me.”
For Bailey, it’s a full circle moment.
“Now it’s Beth Ann and me, in addition to my husband, sitting at the dinner table, talking business and bouncing ideas off of each other,” she said.
Bailey paused for a moment as she looked at the album of letters before continuing.
“I can’t thank you all enough for taking a leap of faith and joining me on this journey,” said Bailey. “Working with you all day in and day out has been the greatest joy of my life.”
She could only think of one other person who would be more overjoyed than her in that moment.
“I have no doubt that my dad is up there, celebrating harder, screaming louder, than any of us right now,” she said. “He is so proud of all we have done.”
In the weeks following the celebration, Bailey says she reads the letters often daily.
“They are constant reminders of how lucky I am to be in this position and they serve as motivation on those days when you are feeling down or stressed,” she said.
As for what is next for HIA, Bailey says she will do what she’s always done, work with her team to ensure they are on the right track.
“The industry is changing so much and, we have to change with it. Or change before it,” she said. “We need to be prepared for what’s coming – and we will be.”
Bailey says the company will navigate the changes the same way they always have – as a team.
“I think we are successful because the people working here have a say – their voices matter,” she said. “And that’s something – no matter how much we grow – that’s something we’ll never change.”
Last week, we looked at tidbits for reporting the ICD-10-CM codes for pregnancy/obstetric records. Now we will look at some for the ICD-10-PCS reporting of these records. In reporting the appropriate ICD-10-PCS codes a coder must know what is included in the terminology of products of conception (POC).
Chances are, we all know someone affected by heart disease and stroke, because about 2,300 Americans die of cardiovascular disease each day, an average of 1 death every 38 seconds. But together we can change that.
There was a time when coding delivery records was considered simple. Many times, these types of records were given to the newer coders. However, as coding becomes more complex, this is no longer the case. With the implementation of ICD-10-CM came more codes for very detailed and specific issues that occur during pregnancy, childbirth and the puerperium.
When it comes to coding and documentation, finding your own rhythm can lead to positive results. For our series, Find Your Routine, we interviewed our most productive coders and asked them what steps they take to find a rhythm that works for them. This week, we talked with Allison Curry, RHIT, CCS, Coding Specialist at Health Information Associates, about the steps she takes to find her routine.
One way to shorten a lengthy query is by avoiding repetition in the supporting documentation. Does the same diagnosis really need to be mentioned multiple times in the clinical indicators? Is it necessary to list the results of a chest x-ray twice? Does listing the same documentation multiple times give further specification or explanation to the query?
Tobacco use can lead to tobacco/nicotine dependence and serious health problems. Quitting smoking greatly reduces the risk of developing smoking-related diseases. Tobacco/nicotine dependence is a condition that often requires repeated treatments, but there are helpful treatments and resources for quitting.
This is Part 5 of a five part series on the new 2019 CPT codes. For the remaining areas we will just briefly summarize the section. Due to the intricate nature of these sections in CPT, it is recommended that the coder read the entire section notes associated with the new codes.
This is Part 4 of a five part series on the new 2019 CPT codes. In this series we will explore the CPT changes for FY 2019 and include examples to help the coder understand the new codes. There is 1 new lymphatic code, 2 new digestive system codes with 3 deletions, 3 new urinary system codes with one deletion and 7 deleted nervous system codes with 2 revisions.
This is Part 3 of a five part series on the new 2019 CPT codes. In this series we will explore the CPT changes for FY2019 and include examples to help the coder understand the new codes. There are 9 new cardiovascular CPT codes added with 2 deletions and 3 revisions.
When it comes to coding and documentation, finding your own rhythm can lead to positive results. For our series, Find Your Routine, we interviewed our most productive coders and asked them what steps they take to find a rhythm that works for them. This week, we talked with Tilina Sablan, RHIT, CCS, Coding Specialist with Health Information Associates, about the steps she takes to find her routine.
This is Part 2 of a five part series on the new 2019 CPT codes. In this series we will explore the CPT changes for FY2019 and include examples to help the coder understand the new codes. There are 4 new musculoskeletal CPT codes added with 2 deletions and 0 revisions.
This is Part 1 of a five part series on the new 2019 CPT codes. In this series we will explore the CPT changes for FY2019 and include examples to help the coder understand the new codes. There were 15 new integumentary CPT codes added with 3 deletions and 1 revision.
In part 5 of our series, we look at DRG 64—Intracranial hemorrhage or cerebral infarction with MCC. For this DRG recommendation the majority (almost all) were recommended to DRG 65 (Intracranial hemorrhage or cerebral infarction with CC) with deletion of the reported MCC.
The majority of the recommendations from DRG 190 (Chronic obstructive pulmonary disease w/MCC) was to DRG 189 (Pulmonary edema and respiratory failure) with re-sequencing of respiratory failure as the PDX or adding as a new code and sequenced as PDX.
The majority of the recommendations from DRG 853 (Infectious & parasitic disease with O.R. procedure with MCC) were to DRG 871 (Septicemia w/o MV 96+ hours with MCC) with deletion or revision of the PCS code. Some of these required physician query.
The majority of the recommendations from DRG 872 (Septicemia w/o mechanical ventilation 96+ hours w/o MCC) were to DRG 871 (Septicemia w/o mechanical ventilation 96+ hours with MCC) with the addition of an MCC to the account. Not all of these required a physician query and were present in the medical record documentation without any clarification needed prior to coding.
The majority of the recommendations from DRG 871 (Septicemia w/o MV 96+ hours with MCC) were to DRG 872 (Septicemia w/o MV 96+ hours w/o MCC) with the recommendation to delete the reported MCC or query for clarification to support the MCC that had been reported.
Every year, we make plans to live a healthier, more organized, and balanced life. For some of us, we end up falling short of those expectations. This year, to keep us on track with our New Year’s goals, we have put together a few of the most common New Year’s resolutions along with their ICD-10 diagnoses codes. Check out our tips and tricks for a healthy 2019!
Top 5 ProFee diagnosis changes found in recent HIA reviews: 1. I10 – Essential (Primary) Hypertension; 2. E11.9 – Type 2 Diabetes Mellitus Without Complications; 3. K29.60 – Other Gastritis Without Bleeding; 4. R13.19 – Other Dysphagia; 5. I25.10 – Atherosclerotic Heart Disease of Native Coronary Artery Without Angina Pectoris.
What is the principal procedure? The procedure that is performed for definitive treatment or is taking care of a complication is the principal procedure. Procedures for diagnostic or exploratory purposes that are performed in addition to a procedure being performed for definitive treatment, would be reported in addition to the principal procedure.
A query question that is directive in nature, indicating what the provider should document, rather than asking for his/her professional determination of clinical facts, constitutes a leading query. The provider should not be made to feel obligated to document anything.
When I start coding a chart, I enter all account information in log and do any abstracting—disposition, admitting, and attending—take care of all of that first. ED, H&P, consult, progress reports, and discharge summary.
Some Speed Reading Tips: Once you start reading, don’t stop! Read the text straight through. If you have any question after you have completed reading the material, go back and reread the relevant sections. Reread the marked sections of the text (the items you indicated that you didn’t quite understand). Write a small summary at the beginning of the chapter – consisting about 3-4 sentences.
In HIA quality reviews we are finding that some coders are reporting Z41.2—Encounter for routine and ritual circumcision, during the male newborn birth admission, when circumcision is performed prior to discharge.
The cause/etiology of GI bleeding is not always easily determined. During procedures, to work the bleeding up, there are often multiple potential sources of bleeding found but not identified as the culprit. Many of these findings have “with” or “in” in the main or subterms.
On December 1, 2018, the HIA team based at our headquarters in Pawleys Island, South Carolina received a visit from a surprise guest – meet Otis, HIA’s very own Elf on a Shelf. Otis will be sticking around until Christmas to keep an eye on all of us. We have a feeling he may get into some trouble! Check back daily to see what Otis is up to. #OtisOnOtisDrive
When it comes to coding and documentation, finding your own rhythm can lead to positive results. For our new series, Find Your Routine, we interviewed our most productive coders and asked them what steps they take to find a rhythm that works for them. This week, we talked with Crystal Junkins, CCS, CPC, Coding Specialist with Health Information Associates, about the steps she takes to find her routine.
COPD is a respiratory condition where there is chronic obstruction to airflow in the lungs. Air is breathed into the lungs but a patient with COPD has trouble emptying air out of the lungs. This can also cause patients with COPD to have CO2 retention. COPD is an irreversible and progressive disease in which the lung function worsens as time goes on.
Tissue findings interpreted by a pathologist are not equivalent to the attending physician’s medical diagnosis based on the patient’s clinical condition. If the attending physician has not indicated the significance of an abnormal finding within a pathology report…