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November 2011

Inside this Edition:
Are you willing to share sample electronic progress note templates that have built in your facility’s electronic health record?   If so, please send to

President's Message

Greetings THIMA Members,

On behalf of the THIMA Board of Directors, we appreciate the overwhelming response to the AHIMA House of Delegates Zoomerang survey!  Over 140 THIMA members responded with valuable feedback regarding the five action items to be voted on at the 2011 AHIMA House of Delegates meeting on October 1 – 2 in Salt Lake City, UT.

The THIMA Board of Directors would like to provide the membership with the following summary/results of action items from the meeting:
AHIMA Bylaws Revision

The proposed AHIMA bylaws were passed with no debate or discussion during the House of Delegates voting forum.

97.1% of THIMA Members who responded to the survey agreed with the AHIMA Bylaw revisions.

Proposed Changes to AHIMA Code of Ethics

The proposed AHIMA Code of Ethics changes were passed with no debate or discussion during the House of Delegates voting forum.

99.3% of THIMA Members who responded to the survey agreed with the proposed changes to the AHIMA Code of Ethics.

Diversity and Inclusion Resolution

There was much discussion surrounding this item during the AHIMA Best Practices/Standards House Team and during the House of Delegates voting forum. 

The resolution was passed with the addition of “gender identity” to the human diversity section of the Preamble.

The resolution was passed to alter the wording of “physical capabilities” to now read “capabilities” so that the human diversity section will include both mental and physical capabilities to be more in compliance with the ADA regulations.

91.4% of THIMA Members who responded to the survey agreed with the Diversity and Inclusion Resolution.

Managing the Master Patient Index in an Integrated Delivery System Resolution

This resolution was “tabled” and removed from the voting ballot due to concerns posted on the AHIMA CoP regarding the “narrow” scope of the resolution.

Some AHIMA members strongly felt the resolution should broaden its scope outside of just the MPI.

The resolution was transferred back to the AHIMA Best Practices/Standards House Team for further discussion/review.

97.9% of THIMA Members who responded to the survey agreed with the Managing the Master Patient Index in an Integrated Delivery System Resolution.

Health Information Management (HIM) Professionals Manage the Quality of Health Data Resolution

This resolution was passed with no debate or discussion during the House of Delegates voting forum.

99.3% of THIMA Members who responded to the survey agreed with the proposed changes to the Health Information Management (HIM) Professionals Manage the Quality of Health Data Resolution.
The THIMA Delegates were very fortunate to have THIMA membership feedback regarding the five action items in order to appropriately represent TN during the meeting.  If you have specific questions regarding any of the discussions surrounding the action items, please do not hesitate to contact me or any of the THIMA Delegates. THIMA continues to be a highly regarded group in the HIM field and our association should be very proud of the strong leaders that represent us at the national level!

On behalf of the THIMA Board of Directors, I wish to thank everyone for their hard work and continued commitment to advancing our profession – every year we say that “things are moving so rapidly” and I can’t think of a time when that is more true than now with ICD-10, ACOs, RACs, and RECs to name a few.  I encourage everyone to stay engaged and connected so that we may all learn from each other and share our valuable expertise to ensure that HIM remains at the core of valid, reliable, and protected patient care information!  
Kind Regards,
Stacy Jowers Dorris, MBA, RHIA, CPHQ
President, THIMA

ICD-10 Update

ICD-10 Planning Shows Progress with Two Years to Go
Sep 28, 2011 12:53 pm | posted by Kevin Heubusch | ICD-10

With the ICD-10-CM/PCS deadline two years away—almost to the day—results of a new AHIMA survey show that more organizations are getting their transitions in motion. In total, 85 percent of respondents to the August survey said that their organizations had begun work on ICD-10 planning and implementation, a significant jump from 62 percent one year earlier.

Inpatient facilities are far more likely to have begun work than other settings, according to the results. Overall, 86 percent of respondents in inpatient facilities reported progress, compared to 50 percent of those in other settings. Both categories showed significant gains over the preceding year, as shown in the figure below.

Respondents reported progress on planning, budgeting, and impact assessments, all essential first steps in the implementation.

Within inpatient facilities, 60 percent of respondents said their organizations were between half done and finished establishing an implementation planning team; 55 percent reported being between half and fully done developing a project plan. In other settings, 42 percent and 38 percent of respondents reported similar progress, respectively.

Within inpatient facilities, 45 percent of respondents said their organizations were between half done and fully finished with their impact assessments, with 32 percent of respondents in other settings reporting the same. The impact assessment is a key milestone because it establishes the scope of the project and must be completed before meaningful budgeting can be done.

With two years to go until the deadline, more than a third of respondents in non-inpatient settings (38 percent) said their organizations had yet to establish an implementation budget.

The survey found few organizations surging ahead. Just 25 percent of inpatient facilities were between half and fully finished making the changes they identified during their impact analyses; 24 percent had just begun, and 51 percent had yet to start.

Organizations are further along on detailed assessments of education needs for all staff. Forty-two percent were between half and fully finished; 33 percent had just started, and 25 percent had yet to begin.

These steps are among those that AHIMA recommends organizations begin this fall.

Among those facilities that have not begun work, inpatient facilities are more likely to be gearing up than other settings. More than half of respondents inpatient facilities that have not begun work said they expect their organizations to start within the next six months (52 percent), compared to a third of all other settings. Half of respondents in non-inpatient settings reported that they did not know when ICD-10 planning would begin.

Despite the delays in beginning work, a significant share of respondents did not cite barriers. Forty percent of respondents working in inpatient organizations said they were not aware of major barriers to starting work. A comparable share of respondents in other settings answered the same (37 percent).

Respondents in other settings were more likely to cite a lack of senior executive commitment than inpatient facilities (21 percent compared to 9 percent). A similar share of respondents in all settings cited a lack of resources (28 percent inpatient and 27 percent other).

The survey was conducted among AHIMA members in August 2011 with 639 respondents. The majority of respondents worked at the director and management level (86 percent), and the majority worked in inpatient organizations (70 percent).

AHIMA offers phase 1 and phase 2 checklists highlighting the top-10 steps organizations must take to move their programs through the early phases of the ICD-10 transition. The lists distill the first phases of AHIMA’s larger four-part ICD-10 implementation planning and preparation checklist.

Prepare now for the 537 procedural coding changes in 2012!  Have you gotten your 2012 Update for ICD-9-cm and CPT planned yet.  Now is the time and don’t wait too long! There will be 278 new, 139 revised, 98 deletedand 22 resequencedcodes in 2012.
ICD-10-CM, Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00-E89).
Type of Diabetes: The age of a patient is not the sole determining factor, though most type 1 diabetics develop the condition before reaching puberty.  For this reason type 1 diabetes mellitus is also referred to as juvenile diabetes. 
Also when coding diabetes mellitus and the use of insulin:  If the documentation in the patient’s chart doesn’t show the type of diabetes, but does show the patient uses insulin, code E11, Type 2 Diabetes Mellitus for a patient who routinely uses insulin, code Z79.4, long term insulin or current use of insulin should be assigned to show the patient uses insulin.  Remember, Z79.4 should not be used if the insulin is being given temporarily to bring a type 2 patient’s blood surgery under control during this visit or encounter.
Cystic fibrosis is an inherited condition caused by a defective gene that induces the body to product extremely thick, sticky mucus that can cause life threatening lung infections.  The mucus can also obstruct the pancreatic ducts and prevent the pancreatic enzymes that are absolutely necessary for the breakdown and absorption of nutrients from reaching the gastrointestinal.

Volunteer Spotlight…
Kay McMillan, M.Ed, RHIA
The CAHIMA has chosen Kay McMillan as their volunteer to spotlight.  Kay is currently employed as the Program Director for the Health Information Management Program (Associate Degree) at Chattanooga State.  She is an Associate Professor and holds a master’s degree in education, an RHIA, and is a certified ICD-10 Trainer.
Kay has extensive experience in HIM including serving as the HIM Director at a variety of hospitals including Memorial Hospital and Parkridge Hospital in Chattanooga, Tennessee.  Kay has provided consulting services to a variety of hospitals, including work in California and Alabama.
As an active member in THIMA for over 20 years, Kay has worked on the ICD-10 Task Force and served on the CAHIMA Educational Committee.  She works hard to participate in initiatives to serve Tennessee HIM students and THIMA members, as demonstrated by her work in the HITECH Program.
We are grateful for the time, dedication, and service of our THIMA and CAHIMA member like Kay!  We appreciate the time she makes for the improvement of our organization and benefit of our members through providing educational opportunities and training.  Thank you, Kay!
Kathy Hallock, RHIA, AHIMA Certified I-10 Trainer
The MTHIMA has chosen Kathy Hallock for their volunteer to spotlight.  Kathy is currently employed as a Coding Quality Consultant, involved in all RAC activities, and is currently ICD-10 trainer for Vanderbilt University Medical Center. She is a consultant to Williamson Medical Center in Franklin, Tennessee and is currently responsible for ICD-10 training for their coders as well.
Kathy is the THIMA Coordinator for the ICD-10 Committee where they have been working for over a year developing I-10 educational opportunities for all our members.  Several seminars and webinars have already been presented and they are continuing to develop more educational materials as we enter the last 24 months before I-10 implementation.
“We have partnered with many non-HIM associations with the goal of becoming the trainer of choice for the State of Tennessee.  We have been invited speakers and held joint seminars with organizations such as THA, TNHFMA and TNMGMA, and are working to develop education in hopes of partnering with other associations”, says Kathy.     
The ICD-10 Committee provides educational materials to all Tennessee local HIM councils, and is currently developing service specific educational materials to help in educating physicians and their office staff about ICD-10 and how it affects their practice.
Kathy was recently involved in the development of the new AHIMA credential for Clinical Documentation Improvement Practitioner (CDIP) defining the tasks and knowledge necessary for this credential and participated in writing tests questions. 
Her knowledge and background with Clinical Documentation Improvement and ICD-10 has given her the opportunity to be a speaker for the University Hospital Consortium (UHC) on these topics.
As a six-year breast cancer survivor, Kathy is very involved in volunteer activities in the cancer community serving as a patient and research advocate for Vanderbilt Ingram Cancer Clinic and Camp Bluebird, an adult cancer camp.  She is very involved with Gilda’s Club of Nashville and has been trained to assist with the Hope Connection program at Vanderbilt.
Kathy is married and has 3 children – Justin who is a third year medical student at UT Medical School in Memphis, TN, Daniel who lives in Nashville and works at V. Alexander and Mary Kate who is a junior at the University of Knoxville.
The MTHIMA is proud to spotlight Kathy Hallock for her dedication and volunteer spirit that reaches beyond her 30 year career as a HIM profession. Thank you, Kathy, for all that you do.

Legislative Update
Legal Handbook Web Portal

Be sure to stay informed on the latest regarding state and federal legislation, regulation and professional best practices. Access to the THIMA Legal Handbook is available via the Web Portal, ensuring of the moment information at your fingertips. Chapters include consents, subpoenas, release of information, behavioral health records, the medical record (including the legal EHR), and required reporting, in addition to many more. Visit the THIMA website for subscription details.

Local Association News

Memphis Health Information Management Association [MHIMA]
The Memphis HIMA will hold its 2011 Fall Update Meeting on Friday, November 18, 2011.  This year’s meeting will be held at the Woodland Hills Country Club in Cordova, TN.  For more information, visit the MHIMA Website at


The final in the Root Operations educational series will be presented at the end of the year meeting to be held at Stonecrest.  On November 7th MTHIMA sponsored a seminar at Vanderbilt 100 Oaks for 46 attendees for a 7.0 CE hour opportunity.  Topics covered were October 1 Updates for ICD-9-CM, Overview of ICD-10, Fraud and Abuse in High Risk Areas, CDI Best Practices, and Journey in to ICD-10.  The association members are looking forward to getting their website built and up and running.

WTHIMA is busy preparing its members for ICD-10-PCS.  WTHIMA is holding free monthly Anatomy and Physiology refresher courses for members. Each educational class is worth 1.5 CEUs toward fulfilling AHIMA ICD-10 certification maintenance requirements, as well as being AAPC approved.  November’s educational session will focus on the Eyes and Ears.  December’s session will focus on the Circulatory System.  For more information on these educational sessions, to register, and to download the presentation on the Nervous System, visit their website at
WTHIMA is also preparing for their upcoming CPT update by Karen Scott.  The CPT update will be held at Jackson-Madison County Hospital on December 2nd from 8:30-4:00.  Registration is still open. Visit for a link to register.

CAHIMA’s next meeting is scheduled for Thursday, November 17th from 4:00 PM to 6:00 PM.  We have two great speakers:  Senator Bo Watson and Wanda Johnson our THIMA Executive Director.  Our monthly meetings for 2012 will focus on ICD-10 education.
Mid-East HIMA

We are meeting every other month doing ICD-10 PCS Root Operations in conjunction the team presentations.  Beverly Cross is our AHIMA certified trainer, and she has been absolutely key to jump-starting our training.  “I think she would be a great choice to profile as an outstanding volunteer in the newsletter,” says Cindy Nixon. 

KAHIMA has had two presentations this fall of our Annual Coding Symposium. It was again a combination of ICD-9-CM 2012 Updates and ICD-10 education. Karen Feltner, RHIA, CCS was the speaker for both presentations held in September and November.  Karen is an AHIMA Certified ICD-10 Trainer. She is HIT Program Director for Roane State Community College. The ICD-10 education focused on ICD-10-PCS root operations.
The CPT Coding Symposium is scheduled for December 7, 2011.   Speaker will be Lynn Kuehn, MS, RHIA, CCS-P. Her presentation will include CPT updates for 2012 and an anatomy review in preparation for ICD-10. Lynn’s anatomy focus will be blood vessels, GI tract and other tubular body parts, and body structure with a focus on trauma.

New Certified Documentation Improvement Practitioner Credential


Now more than ever, a strong, highly respected clinical documentation improvement (CDI) certification program can help move the industry forward to achieve the goals of RAC audits, ARRA/HITECH, and other important initiatives with the overarching goal of improving the quality of healthcare. In response to industry demand, the Commission on Certification for Health Informatics and Information Management (CCHIIM) is developing a new credential focused upon CDI professionals. The new credential, launching this fall, is grounded in CCHIIM’s commitment to high certification standards and links directly to AHIMA’s mission of “Quality Healthcare through Quality Information.”
At the heart of AHIMA’s mission and vision is documentation that supports quality health information. Individuals who become AHIMA-certified in clinical documentation improvement will help provide a strong base of expertise in the industry. This certification will assure the competency of individuals who capture the documentation necessary to fully communicate the patient’s health status and conditions. These individuals will be positioned as leaders and role models in the health informatics and information management community. AHIMA certification can also help to improve earning potential, increase opportunity for career advancement, and provide a forum to connect with colleagues.
HIM professionals traditionally have analyzed existing documentation compared to regulatory requirements. As technology changes the way documentation is captured through the use of EHRs, AHIMA is leading the effort to ensure it is still clear, concise, and compliant. AHIMA has extensive expertise in clinical documentation improvement guidance, knowledge of the documentation requirements relative to compliant coding and billing, in addition to EHR functionality to support documentation capture. AHIMA uniquely has decades of experience in administering defensible examinations that identify an individual’s skill level.
AHIMA’s CDIP certification will confirm the commitment of AHIMA to globally improve and maintain quality information for those involved in healthcare as well as support the integrity of the patient’s health record. The certification will distinguish those professionals serving as clinical documentation specialists as knowledgeable and competent to provide guidance relative to clinical documentation in the patient’s health record, thus promoting the HIM profession overall. Watch for the new certification to launch this fall, with more details available later this summer.
“The AHIMA CDIP certification will identify professionals capable of fluently translating both the techno/clinical language of the electronic medical record as well as its marriage to ICD-10-CM/PCS coding." - Darlene Ridilla Shelffo, RN, CCDS
For more information visit
Upcoming Events

Anatomy and Physiology Refresher for ICD-10-CM/PCS Audio Conference Series

CAHIMA Meeting
November 17, 2011
Erlanger Medical Mall
Chattanooga, TN

MHIMA Meeting
November 18, 2011
Cordova, TN

Every Mighty Oak Stands on its Roots.....and so it is with the ICD-10-PCS System and Coding Inpatient Procedures
November 30, 2011

WTHIMA Meeting
December 2, 2011
Jackson, TN

KAHIMA CPT Coding Workshop
December 7, 2011
Rothchild's Catering
Knoxville, TN

Seminar: ICD-10 - Preparing for the Fallout
January 25-27, 2012

2012 THIMA Annual Meeting
March 12-14, 2012
Gatlinburg, TN


To learn more visit the job board 

HIM Manager
Methodist Le Bonheur Healthcare

CDI Specialist
SkyRidge Medical Center

Assistant Director of Health Information Services
Wellmont Health System