Top 10 changes in our industry in the last 10 years

10. More mergers and acquisitions creating larger health care institutions.

University of Pittsburgh Medical Center acquires Hamot Medical Center in Erie, PA
University of Pittsburgh Medical Center acquires Mercy Hospital in Pittsburgh, PA
Highmark Insurance partners with West Penn Allegheny Health System to create Allegheny Health Network
Pfizer acquires Wyeth pharmaceuticals
Sanofi-Synthelabo acquires Aventis
9.  The emergence of Ebola back into American vernacular.
Two healthcare mission workers were transported back to the United States with state of the art technology in order to treat and cure them. Amazing healthcare teams worked together to establish workflow and protocols that successfully treated them and they were both discharged in terrific condition.

8.  Concussions take center-stage in healthcare.
Providers and facilities developed concussion clinics. The NFL and the FIFA recognize the long-term effects of head-to-head contact. The institute rules are regulations around this.

7.  The Ice-Bucket Challenge
Amyotrophic Lateral sclerosis, (also known as Lou Gehrig's disease)  ICD-9 335.20 and ICD-10 G12.21, was brought into the spot-light via Facebook and other social media outlets when friends, colleagues, and relatives challenged each other to the "ice bucket challenge". The ALS foundation raised more money in the six month span of time than ever with donations over $94 million.

6. Medicare no longer recognized consultation codes (99241-99245 and 99251-99255)
Effective 1/1/2010 CMS (Center for Medicare and Medicaid Services) published its new policy stating that with services on or after 1/1/2010, the consultation codes will no longer be recognized, thus reimbursed. Instead, providers should use the applicable office service codes or initial hospital care codes. For more in-depth information about this, please see .
5. Salary increases were seen across the board.
Office managers were making around $44,000 (according to the salary survey sent out by the AAPC). Coding specialists, $34,000.00; Physician Based coders were making $32,380.00. As compared to salaries now of Coders just under $40,000 with physician based coders in at around $42,000 per year. Office managers closer to $60,000.

Responsibility 2004-2006 2013-2014
Office manager $44,000 per year $60,000 per year
Coding specialist $34,000 $40,000
Physician-based coder $32,380 $42,000

4. The development of ACOs
We saw the creation of Accountable Care Organizations linking the reimbursement of services to provider quality metrics. These measures were designed to better understand and reduce the costs of care to certain patient populations. In these models everyone is involved from the patients, to the providers and then also the payers. Reporting and participation is vital to the successful ACO.

3. Emergence of more and more Electronic Medical Record users
As part of the "meaningful use" legislation, Electronic Medical Records are being adopted at a heighten rate of speed. Use this link to CMS to read more about Meaningful Use.

2. ICD-10 is on the horizon.
ICD-10 was to be implemented in October, 2013. It was postponed until October 2014. The healthcare community welcomed this postponement to further educate providers and insurers. Testing between the providers and the insurers could be done more thoroughly as well. In the eleventh hour, CMS added an additional year to this postponement. This is calling into speculation that actual implementation of ICD-10 or perhaps America goes right to ICD-11. The debate continues as education and testing also continue. The coding community is poised and ready for ICD-10; eager to implement and adjust to the new code set.

1. Obamacare
The national healthcare program now known as Obamacare was approved by President Barack Obama on March 23, 2010. It was confirmed into law by the Supreme Court on June 28, 2012. For more facts about Obamacare you can use the link Obamacare changed the entire landscape of how the American people could get health insurance where they may never had it in the past, stay in family plans up to the age of 26, and require employers to offer insurance to their workers where they hadn't before.

Suzan Hauptman MPM, CPC, CEMC, CEDC
Director of Coding Operations-HIM
Allegheny Health Network
Allegheny Clinic
412-709-8897 (cell)