Organization and Management

6 June 2016

SNOP is the Systematized Nomenclature of Pathology. Published by the American College of Pathologists, it has been “useful in classifying pathological specimens” (McWay, 2008). Although SNOP was commonly used in pathology departments, it has gradually lost favor because focus was placed on standardized nomenclatures by accrediting agencies (McWay, 2008).

2. What are the four approaches taken by HIM professionals to address the complexities brought on by the introduction of PPS and DRGs?

Organization and Management Essay Example

The four approaches taken by HIM professionals to address the complexities brought on by the introduction of PPS and DRGs are the use of encoders, the use of new resources in coding guidelines, the focus on ethical aspects of coding and develop a compliance program (McWay, 2008).

3. What are some differences between DRGs and MDCs?

DRGs are known as Diagnosis-Related Groups and MDCs are known as Major Diagnostic Category (McWay, 2008). DRGs is a model that classifies groups of patients with medically related diagnosis, treatment, length of stay, age, and sex (McWay, 2008). DRGs “classify hospital stays in terms of what was wrong with the patient and what is done for the patient” (McWay, 2008). MRGs “cluster patients according to medical and surgical categories” (McWay, 2008).

4. Why are consequences of healthcare professionals not using common terminology, vocabularies, and classification systems?

Vocabularies, classification systems, and clinical terminologies were “created to describe the medical care process in a standard manner” (McWay, 2008). Healthcare professionals need to clearly understand and apply these vocabularies, classification systems, and clinical terminologies in order to facilitate patient care as well as comply with requirements of the accrediting agencies (McWay, 2008).

References

McWay D C 2008 Today’s Health Information Management: An Integrated ApproachMcWay, D. C. (2008). Today’s Health Information Management: An Integrated Approach. Clifton Park, NY: Delmar Cengage Learning.

!. SNOP gradually lost favor when focus was placed by accrediting agencies of standardized nomenclatures that could cross fields of specialization. 2. The four approaches taken by HIM professionals to address the complexities brought on by the introduction of PPS and DRGs are: Encoders- software tools that incorporate the text and logic of coding systems into an automated form. Another approach is the use of new resources in the form of coding guidelines.

Examples are ICD-9CM coding handbook, the coding clinic for ICM-9-CM, and the coding clinic for HCPCS. A third approach is to focus on the ethical aspect of coding., and an approach related to coding guidelines and ethics, is to develop a coding compliance program. 3.The differences between DRGs and MCDs are DRG is a classification system that groups patients who are medically related by diagnosis, treatment, and length of stay, using the International Classification of Diseases, ninth edition, clinical modification codes. MDC is the first level of a decision tree to reach a diagnosis-related group, generally based on an organ or system.

Today’s Health Information Management An Integrated Approach, McWay, D.C., JD, RHIA. pgs. 126-33 4. The consequences of health care professionals for not using common terminology, vocabularies, and classification systems are Clinical vocabularies, terminologies or coding systems, are a structured list of terms which together with their definitions are design to describe unambiguously the care and treatment of patients. T cover diseases, diagnoses, findings, operations, treatments, drugs, administrative items, etc., and can be used to support recording and reporting a patient’s care at varying levels of detail, whether on paper or, increasingly, via electronic medical record (EMC). A large number of coding and classification systems have been developed for healthcare. Many standards have been proposed butwidespread spread adoption has been slow.

Current standards tend to compete. Many classifications overlap. Historically, vocabulary and classification systems have been designed to meet different and specific goals. Many codes have been designed mainly to support administration (e.g. billing) so have typically included only a limited number of diagnosis code for each encounter. Widely-used, but essentially administration-oriented system, such as ICD, have been mandated by government agencies and /or payor organizations but capture clinical data at an insufficient level of detail to support clinical needs that lie outside the limited range of activities they were designed to support. Coding systems can lose clinical information. It can be difficult to compare clinical coding systems. Interoperability is a significant problem. Content, structure, completeness, detail, cross-mapping, taxonomy, definitions, clarity vary between existing vocabularies.

-Why did SNOP fall out of favor with the healthcare field? SNOP, the Systematized Nomenclature of Pathology was published by the American College of Pathologists and was useful in classifying pathological specimens. SNOP lost favor with the healthcare field when focus was placed by accrediting agencies on standardized nomenclatures that could cross-fields of specialization (McWay, 2008).

2.-What are the four approaches taken by HIM professionals to address the complexities brought on by the introduction of PPS and DRGs? The four approaches are: Use of encoders, Coding guidelines, Ethical aspect of coding – up coding and coding compliance program (McWay, 2008).

3.-What are some differences between DRGs and MDCs? Diagnosis Related Group (DRG) A patient classification system, defined by the federal Department of Health and Human Services. It provides a means of relating the type of patients a hospital treats to the costs incurred by the hospital. According to this classification system, patients who have similar diagnoses and undergo similar procedures are placed together in the same diagnosis-related group.. DRGs are used by the Medicare program to reimburse hospitals at fixed amounts for all similar patients, regardless of thelength of stay or actual cost incurred. The DRG system is also widely used in many types of health data analysis.

Major Diagnostic Category (MDC) A grouping based on the organ or system involved. The MDCs cluster patients according to medical and surgical categories, that are subdivided by principal diagnosis (McWay, 2008).

4.-Why are consequences of healthcare professionals not using common terminology, vocabularies, and classification systems? According to AHIMA, the healthcare industry is looking to IT to reduce costs, assess quality of care, and deliver services more efficiently. The core components of these IT tools are classification and terminology systems, the common medical languages used to encode clinical data such as a patient’s physical signs, symptoms, medication sensitivities, treatment plans, and diagnoses. Terminologies and classifications promise to provide the common medical language necessary for electronic health records and population health reporting, quality reporting, personal health records, safety, clinical trials, biosurveillance, and reimbursement. According to McWay (2008), vocabulary, clinical terminology, and classification systems were created to describe the medical care process in a standard manner.

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