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The steady decrease in incomplete and delinquent records has been accomplished without suspending any of the attending physicians. On occasion, hospital administration has, at our request, sent the attending physicians a warning letter alerting them that they will be reported to the Hospital Medical Board if they fail to complete their records. Typical of a teaching facility, the housestaff is primarily responsible for dictation of discharge summaries. They are suspended without pay if they fail to complete their records after being warned. Another significant effect of this program has been the timely entry of ICD-9-CM codes into the billing system within five days of discharge. Accounts outstanding due to lack of final diagnoses and/or attestation statement signatures, ranging from 5-22 days post-discharge, have been reduced to an average of only 40-50 daily. (Vanderbilt University Medical Center averages 22,000 discharges annually). This new program has placed the Medical Record Department in total control of the incomplete/delinquent records. By having less than 300 records to handle, we can provide much better service to the physicians, locate needed records quickly, and maintain an excellent working relationship with the Patient Accounting Department. Medical and hospital administration staff members now regard medical record personnel as organized and effective record managers.
J Am Med Rec Assoc 1988 Jan
PMID:A professional approach to record completion. 1028 14

The program described enabled St. Mary's Hospital to recruit individuals with pre-requisite knowledge in anatomy, pathophysiology and medical terminology and then have them receive comprehensive training in ICD-9-CM coding which addressed the unique demands imposed by the medical record department and the PRO. In this way, the department's immediate and future needs for coders appears to have been satisfied. An evaluation on the success of this training program will be assessed in three months and reported upon at that time.
J Am Med Rec Assoc 1988 Oct
PMID:One hospital's solution to the shortage of coders. 1029 69

Eleven thousand Americans each year are affected by paralysis, a devastating injury that possesses associated annual costs of $7 billion (American Paralysis Association, 1997). Currently, there is no effective treatment for damage to the central nervous system (CNS), and acute spinal cord injury has been extraordinarily resistant to treatment. Compared to spinal cord injury, damage to peripheral nerves is considerably more common. In 1995, there were in excess of 50,000 peripheral nerve repair procedures performed. (National Center for Health Statistics based on Classification of Diseases, 9th Revision, Clinical Modification for the following categories: ICD-9 CM Code: 04.3, 04.5, 04.6, 04.7). These data, however, probably underestimate the number of nerve injuries appreciated, as not all surgical or traumatic lesions can be repaired. Further, intraabodominal procedures may add to the number of neurologic injuries by damage to the autonomic system through tumor resection. For example, studies assessing the outcome of impotency following radical prostatectomy demonstrated 212 of 503 previously potent men (42%) suffered impotency when partial or complete resection of one or both cavernosal nerve(s). This impotency rate decreased to 24% when the nerves were left intact (Quinlan et al., J. Urol. 1991;145:380-383; J. Urol. 1991;145:998-1002).
Anat Rec 2001 08 01
PMID:Peripheral nerve injury: a review and approach to tissue engineered constructs. 1150 Aug 17

The impending implementation of the ICD-10 coding system and burdensome regulations spur Austin Internal Medicine Associates to close its doors on Sept. 4, ending 40 years of service and more than 20 years together for its internists - Ace Alsup, MD; Isabel Hoverman, MD; R. Scott Ream, MD; and Frank Robinson, MD. The group set its closing date to avoid anticipated technical difficulties - specifically, the Centers for Medicare and Medicaid Services' requirement that all practices switch to the controversial ICD-10 medical billing and coding system on Oct. 1.
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PMID:Farewell to 40 Years of Service. 2636 Mar 37