Monday, September 30, 2019

AHIMA 2019 House of Delegates Meeting

AHIMA held its 73rd House of Delegates (HoD) meeting on Sunday, September 15, 2019 in Chicago Illinois.  This is an all- day event that kicked off the AHIMA 19 Health Data and Information Conference.    The morning kicked off with a networking breakfast and welcome from Christopher Wheat, CSA President for ILHIMA.  Shawn Wells, Speaker of the House provided an overview of the agenda and plan for the day.

Dr. Wylecia Wiggs Harris, CEO of AHIMA also provided an update on the AHIMA strategy, highlighted the successes of the organization as well as spoke to the transformation plan.  Seth Jeremy Katz and Breian Meakens provided a financial of AHIMA.  Dr. Valerie Watzlaf, President of AHIMA provided an overview of the role of the House in regards to moving the strategies forward.

I attended Action Forum 2: Health Information Professional Champions facilitated by Shawn Ambruster, RHIA and Laura Douresseaux Collins, MSHCM, RHIA, CHPS.  This purpose of this session was to address advocating for health information professionals to keep us at the forefront of the industry and reference existing HIM Awareness and HIM Reimagined resources to redefine HIM as champions in transforming health and healthcare. 

During the forum we were broken up into five (5) groups and tasked with coming up with a thirty (30) second elevator pitch to be utilized if you as an HIM professional are asked what you do.  Each group worked together and came up with pitches.  Five elevator pitches were created.  As a group we then reviewed all of the elevator pitches with an end goal of creating one.  We struggled coming up with because the five that were created were really good.  As time started winding down we collectively took bits and pieces from each elevator pitch to create one.  

The facilitator presented the elevator pitch that we put together to all attendees of the HoD. Those of us that were in the forum felt that all of the pitches were viable and worthy of being utilized.  We decided to submit all six elevator pitches to the House.  The premise for this was that we concluded that the elevator pitch may vary dependent upon your audience.  This gives you options.  

Overall, the meeting was very informative and a great networking opportunity. 

About the Author 

Tonya L. Bates, RHIA is the currently Board President of the OHIMA FY 2020-21 Board of Directors.  She can be reached at

Tuesday, September 24, 2019

The Elephant in the Tense Room: Trust

As the 73rd AHIMA House of Delegates (HoD) meeting approached, I remembered the passionate discourse of last year’s meeting. Well, it appears I wasn’t alone. Last year’s meeting was the talk of this year’s meeting, especially since there were some new action items that could potentially foster the same level of discussion.

To prepare for the HoD 2019 meeting, Robert Rules of Order was provided and discussed, a parliamentarian was included in the meeting and AHIMA’s General Counsel was in attendance. As a result of these efforts, we had a very orderly meeting, discussion and voting process. People were able to ask questions, get answers and clarification without being insulted and belittled. The vote was a standing vote and each person standing, either for or against the issue, was counted.

Even with all the preparation to ensure an orderly discourse, there was still an elephant in the room that had to be discussed- trust.

AHIMA leadership talked about trust, the lack of confidence and lack of belief in the organization and its leadership. It is important that even during debate and discussion, everyone should feel appreciated and at a minimum heard. 

As a member of AHIMA and OHIMA, we have a responsibility to vote, engage, trust the process and articulate our value in a respectful manner. As AHIMA pivots into the new transition, we must prepare ourselves by staying updated to information and announcements regarding changes, sharing our voice and advocating for our profession. We must remember to trust the process as we navigate the upcoming years of change and beyond.


About the Author

Clarice Warner, RHIA, CCS-P, CPC, CHC is the Corporate Director of Corporate Responsibility for the Mercy Health Corporate Office in Cincinnati, Ohio.  She is also the Founder and Education Director for the Professional Reimbursement Network.  Clarice serves as a 1st-year Director and Delegate on the OHIMA FY 2018-19 Board of Directors, overseeing the Public Good strategy and Advocacy Committee.   

Tuesday, September 10, 2019

Cystoscopy and Ureteroscopy Procedures

Cystoscopy and ureteroscopy procedures will be discussed in this episode of “Spotlight on CPT”.  These procedures are similar as they both begin with the insertion of a scope through the urethra and into the bladder.  

When coding procedures that involve the urinary system, terminology is vital.  Organs have similar names and it is important for accurate coding that we differentiate between the terms correctly.  So let’s start this discussion with an overview of the urinary system beginning externally.

    1 Urethra
    Leads to
    1 Bladder
    Leads to
    2 Ureters
    Leads to
    2 Kidneys 

And the Urinary System looks like this:


When a cystoscopy or cystourethroscopy is performed, the catheter is inserted in the urethra and then into the bladder.  Inspection occurs there.  This is often done for patients that have bladder neoplasms.  Biopsies can be taken or fulguration/resection which can destroy/remove abnormal tissue.  These destruction or removal codes are based on the location and size of the lesion.  Biopsies taken from the same area that is being destroyed, in the same encounter, are not separately coded.  However, it the biopsy comes from a different area of the bladder, it can be coded with an appropriate modifier.

Ureteroscopy procedures may include a pyeloscopy as well.  A code from this section could be assigned for a ureteroscopy with lithotripsy and double-J stent insertion with a combination code of 52356.

If one is not careful, it would be easy to be in the wrong section of the CPT manual when assigning codes.  This could result in code 52204 cystourethroscopy with biopsy being assigned instead of 52354 for cystourethroscopy with ureteroscopy with biopsy. 

Now, light has been shed on coding cystoscopy and ureteroscopy procedures.


About the Author 

Dianna Foley, RHIA, CHPS, CCS  is OHIMA's Coding Education Coordinator. Dianna has been an HIM professional for 20 years. She progressed through the ranks of coder, department supervisor, and department director, to her current role as a coding consultant. 

She recently served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati subsequently achieving her RHIA, CHPS, and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and a a presenter at regional HIM meetings and the OHIMA Annual Meeting.

Tuesday, September 3, 2019

CSA Leadership Conference - Listening Session on AHIMA Election

During the 2019 CSA Leadership Symposium there were many options in regards to breakout sessions.  One of the many options was, “Listening Session-AHIMA Election”.  I attended this session out of curiosity.   This session was facilitated by Dr. Valerie Watzlaf, Shawn Wells and Ralph Morrison.  The purpose of this session was to discuss concerns from the CSAs represented in regards to the rationale for having only one (1) candidate for President of AHIMA on the 2019 ballot.  

When entering the meeting I was expecting the facilitators to just explain why there was only one candidate on the ballot and that would be the end of it.  That is not what happened.  The facilitators allowed the audience to drive the meeting.  The biggest area of contention was the fact that of some of those present felt as though they were being forced to select a president.

Every year the Nominating Committee are tasked with going through all submissions for those that are to appear on the ballot.  This year was a rather difficult year as the committee did not feel as though they had more than viable, well-qualified candidate for President.  The committee felt there was only one candidate that was exemplary in comparison to all other applicants.  The committee went to the AHIMA Board and asked for a change in the policy.  The policy calls for more than one candidate to be on the ballot.  The board agreed.  When Shawn Wells was asked if the board could do things over would they make the same decision?  He responded that they would not have made the same decision if given the opportunity do over. 

About the Author 

Tonya L. Bates, RHIA is the currently Board President of the OHIMA FY 2020-21 Board of Directors.  She can be reached at