Making your ICD-10 testing count.

Appropriate planning and testing are crucial to organizations' chances of making a smooth changeover to ICD-10, which is scheduled to go into effect Oct. 1, 2015. Setbacks during the transition in 2012 from the old version of the HIPAA standard transactions (version 4010) to the new version (5010) offer lessons for the ICD-10 preparation period. Organizations should make a point of devoting adequate resources to ICD-10 testing, working with large payers and using genuine medical data, and efficiently applying what they learn during the testing period.

Re-engineering the coding workflow: assessing today with an eye toward tomorrow.

EHRs, CAC, ICD-10--coding is in the midst of profound change. Which makes this the best time to re-engineer coding workflow. Five steps help HIM professionals assess and evolve coding workflows with an eye toward tomorrow.

Factors predicting inhaled corticosteroid responsiveness in African American patients with asthma.

BACKGROUND: African American patients disproportionately experience uncontrolled asthma. Treatment with an inhaled corticosteroid (ICS) is considered first-line therapy for persistent asthma. OBJECTIVE: We sought to determine the degree to which African American patients respond to ICS medication and whether the level of response is influenced by other factors, including genetic ancestry. METHODS: Patients aged 12 to 56 years who received care from a large health system in southeast Michigan and who resided in Detroit were recruited to participate if they had a diagnosis of asthma. Patients were treated with 6 weeks of inhaled beclomethasone dipropionate, and pulmonary function was remeasured after treatment. Ancestry was determined by genotyping ancestry-informative markers. The main outcome measure was ICS responsiveness defined as the change in prebronchodilator FEV(1) over the 6-week course of treatment. RESULTS: Among 147 participating African American patients with asthma, average improvement in FEV(1) after 6 weeks of ICS treatment was 11.6%. The mean proportion of African ancestry in this group was 78.4%. The degree of baseline bronchodilator reversibility was the only factor consistently associated with ICS responsiveness, as measured by both an improvement in FEV(1) and patient-reported asthma control (P = .001 and P = .021, respectively). The proportion of African ancestry was not significantly associated with ICS responsiveness. CONCLUSIONS: Although baseline pulmonary function parameters appear to be associated with the likelihood to respond to ICS treatment, the proportion of genetic African ancestry does not. This study suggests that genetic ancestry might not contribute to differences in ICS controller response among African American patients with asthma.