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March 30
Challenges are plenth for updating a 40-year-old medical code system - from 13,000 to 68,000

​Yakima Herald Republic
March 30, 2015
By Molly Rosbach

Say you find yourself in a spacecraft, and all of a sudden, you crash and hurt yourself.

In ICD-10, there’s a code for that.

ICD-10 — the International Statistical Classification of Diseases and Related Health Problems, version 10 — is scheduled to be the new national standard for medical coding come Oct. 1, six months from now, as mandated by the Centers for Medicare and Medicaid Services, or CMS.

Medical coding is the system by which medical providers document patients’ various illnesses and injuries, and which allows them to bill specifically for office visits and procedures. Without accurate coding, they don’t receive reimbursement from Medicare or Medicaid or private insurers. Theoretically, the more detailed and specific the coding, the more providers will be properly reimbursed for patient services.

“The people who pay for health care want to be sure you’re doing the right thing, for the right reason, at the right time,” said Dr. Carl Olden, chief medical information officer at Yakima Valley Memorial Hospital and a primary care physician. “You have to tell the story in more detail. We don’t want the CliffsNotes; we actually want the novel.”

The existing coding system, ICD-9, has been in place since 1975 and contains 13,000 diagnostic billing codes.

ICD-10, adopted by many countries worldwide in the 1990s, has 68,000, more than five times as many — and that’s not counting procedure codes, for the treatment side. So obviously, it includes a lot of codes that aren’t available in ICD-9, and providers and payers alike are feeling anxious about the transition.

“It’s going to be rocky,” Olden said. “It really is an entirely different system,” with alpha-numeric codes up to seven digits long, compared to three- to five-digit codes in ICD-9.

(The Healthcare Dive, an online publication, last year posted a list of the “16 most absurd ICD-10 codes,” including, but not limited to, “Struck by duck,” “Burn due to water-skies on fire,” and “Walked into lamppost.” These are real codes.)

While the volume of codes is daunting, ICD-10 is meant to improve medical documentation and, in the long run, allow providers and payers to have a more comprehensive understanding of population health, which should in turn lead to more preventive health care and reimbursement based on providers’ ability to keep patients healthy.

Industry urges caution

ICD-10 has been delayed several times since it was first mandated by CMS in January 2009, prior to and separate from the Affordable Care Act. Most recently, it was postponed for a year last March, to 2015.

Another delay is still possible, but providers here say the October date looks solid and they’re proceeding under the assumption that Oct. 1 will be go-live day.

In fact, many local providers have been preparing and training for ICD-10 for the past few years, regardless of recurring delays.

“We’re ready to go with it,” said Dr. Mike Maples, CEO at Community Health of Central Washington. “Our concern is that the people to whom we transmit that information are not going to be ready to deal with it.”

Industry consultants are urging clinics and hospitals to build up cash reserves or lines of credit so they can sustain their practice for up to six months, in case the payers or other vendors don’t sort out their end in time.

The fear is that if providers like Community Health start billing an insurance company using ICD-10 codes, but the insurer isn’t prepared to process claims with the new codes, it will block the cash flow of reimbursement back to the provider.

A March 4 letter to CMS from the American Medical Association and 99 other groups expressed concern that recent testing showed the claims acceptance rate in Medicare would fall from 97 percent to 81 percent if ICD-10 were implemented today. The AMA has long opposed the transition to ICD-10.

“Those revenues are crucially important to supporting hospitals” and other providers, said Bob Perna, policy director at the Washington State Medical Association. “If you can’t get those to function in the near term, you could see some serious cash crunches in the provider community.”

Other anticipated costs from the new system include some lost productivity as providers struggle to incorporate the new codes into their everyday practice; lost reimbursement if they code incorrectly; and software upgrades to keep the program functioning over time.

Individual organizations’ electronic health records systems will play a big part in how easily providers make the transition; some will prove better than others at generating shortcuts or suggesting codes based on the provider’s notes, experts say.

Practice, practice, practice

At Community Health, Maples said, providers are already coding in ICD-10, with ICD-9 mirrored in the electronic health records system so the codes will automatically transition in October.

Memorial is dual-coding as well, and testing by sending ICD-10 codes to payers able to accept them, vice president and chief information officer Jeff Yamada said. Training started in earnest in January 2014. Memorial will hire extra staff to help with coding during the transition, he said, but it plans to be fully prepared for the switch.

Perna said WSMA has been holding work groups with providers and insurers to do “as much pre-planning and problem-avoidance issues as we can.”

Yakima Valley Community College’s Medical Billing and Coding program has been teaching ICD-10 alongside ICD-9 since 2012, instructor Sandy Erlewine said, and will probably continue teaching ICD-9 at least through next spring so students can still learn to handle older claims that haven’t been processed by the Oct. 1 changeover date.

The school’s Allied Health Center of Excellence offered discounted online workshops on ICD-10 in 2013 and 2014 to community members, aiming to provide the local health care workforce with more resources to prepare for the new system.

“I would say that they are in high demand,” Erlewine said, adding that the demand for certified medical coders will only grow as baby boomers age and require more health care.

Perna said small providers might face more challenges in adapting to the new system than bigger organizations, like hospitals or community clinics, that have more resources to dedicate solely to coding and billing, as well as to analyzing the vast amounts of new data they’ll have on patient populations.

However, he said, smaller offices should also have a more limited scope of codes that they’ll need for patients, whereas hospitals or multi-specialty clinics will have to be familiar with a wide range of codes.

A lot of the buzz around ICD-10 has been negative, doomsday forecasting, as providers brace for the vastly more complicated system. It’s hard to see the benefits, experts say, especially when the medical community is already weighed down with documentation requirements for things like electronic health records and patient-centered medical homes.

“I think in the future-future, it will be transformative; I think right now, everybody views it just as another change,” Yamada said. “Us that are kind of more in the industry, we can see the gradual evolution and steps moving forward, but no one has really communicated well what’s the bigger picture of this moving forward.”​

March 24
Truck driving course offered through YVCC

​KIMA TV - published: March 24, 2015

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February 25
YVCC offering biology lecture series Feb 24

​Grandview Herald
February 11, 2015

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February 23
Sounds of science

​Yakima Herald Republic
February 23, 2015

Photo Gallery: Sounds of science
Click to view photos by Kaitlyn Bernauer​

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An Engineering Day for Kids was held Saturday in the HUB at Yakima Valley Community College in Yakima. The free event was put on by Yakima Valley Community College Engineering Department in partnership with the Yakima branch of the American Society of Civil Engineers.

February 22
YVCC men fall to Blue Mountain

​Yakima Herald Republic
February 22, 2015

YAKIMA, Wash. — Yakima Valley started strong but couldn’t maintain that momentum in the second half as Blue Mountain rallied for a 73-70 victory over the Yaks in an NWAC East Region men’s basketball game Saturday at Sherar Gym.

Tra Satterwhite had 19 points to lead Yakima Valley (3-9, 5-21), which built a 37-32 halftime lead. But the Yaks shot just 37 percent in the second half (13 of 35) and Blue Mountain outscored the home team 11-4 from the foul line after intermission to mount the comeback.

Demetrius Trammell added 11 points and Shawn Dobovan had 10, with both players grabbing five rebounds apiece.

One problem for Yakima Valley was that it collected just 10 assists, compared to 20 for the visitors.

Max Mueller led the Timberwolves (2-10, 6-18) with 19 points. Coleman McElroy added 16 points and Jared Schultz had 14 points and a team-best seven rebounds.

BLUE MOUNTAIN — Williams 1-1 0-0 3, Schultz 6-13 1-3 14, McElroy 4-11 4-4 16, Bell 0-2 0-0 0, Mueller 8-15 3-3 19, Rivas 0-2 0-0 0, Martin 0-0 0-0 0, Christensen 1-5 3-4 5, Wells 1-1 0-0 2, Meyers 7-11 0-0 14. Totals 28-60 11-14 73.

YAKIMA VALLEY — Clark 2-4 0-0 4, Satterwhite 9-15 1-4 19, Cleveringa 2-8 1-1 6, Gill 1-2 0-0 2, Dobovan 2-12 1-2 6, Bussey 4-6 2-2 10, Wood 3-5 0-0 8, Robbs 1-4 2-2 4, Williams 0-3 0-0 0, Trammell 3-7 2-3 11. Totals 27-66 9-14 70.

Halftime — YVCC 37, BMCC 32. 3-point goals — BMCC 6-17 (Williams 1-1, Schultz 1-2, McElroy 4-9, Mueller 0-1, Chistensen 0-1, Meyers 0-3), YVCC 7-22 (Satterwhite 0-1, Cleveringa 1-6, Dobovan 1-7, Wood 2-2, Trammell 3-6). Fouled out — None. Rebounds — BMCC 35 (Schultz 7), YVCC 40 (Bussey 5, Williams 5, Trammell 5). Assists — BMCC 20 (Schultz 4), YVCC 10 (Williams 3). Turnovers — BMCC 14, YVCC 12. Total fouls — BMCC 16, YVCC 13.​

February 22
YVCC women fall to Blue Mountain

​Yakima Herald Republic
February 22, 2015

YAKIMA, Wash. — Mar’Shay Moore scored 33 points Saturday to power Blue Mountain to a 90-77 victory over Yakima Valley in an East Region women’s game in Sherar Gym.

The Yaks, with their seventh straight loss, fell to 2-10 in the East and 5-21 overall.

Myleah Musgrave scored 16 points and Dakota Marshall had 15 for YVCC, which was without starters A.J. Yarlott, Monica Villegas and Salome Yates.

Riley Gerlinger added 21 points for the Timberwolves (8-4, 15-8).

Yakima Valley concludes its season with games Wednesday at Spokane and Saturday at home against Wenatchee Valley.

BLUE MOUNTAIN — Jada Desautel-Ootsey 5-8 0-0 10, Riley Gerlinger 8-16 5-7 21, Mar’Shay Moore 12-18 8-8 33, Chung 3-3 0-0 7, Heugly 4-12 1-2 9, Reyna 3-7 0-0 8, Gregory 1-2 0-0 2. Totals 36-66 14-17 90.

YAKIMA VALLEY — Dakota Marshall 7-11 0-0 15, Tassia Merkle 5-11 0-0 11, Myleah Musgrave 4-13 7-8 16, Malika Kasumu 5-7 0-0 10, Leilua Iosia 7-17 3-4 17, Ceja 3-7 2-2 8, Lass 0-0 0-0 0. Totals 31-66 12-14 77.

Halftime — BMCC 43-40. 3-point goals — BMCC 4-11 (Gerlinger 0-2, Moore 1-3, Reyna 2-4, Chung 1-1, Heugly 0-1); YVCC 3-4 (Marshall 1-1, Merkle 1-1, Musgrave 1-2). Fouled out — None. Rebounds — BMCC 35 (Gerlinger 7, Moore 7); YVCC 33 (Merkle 8). Assists — BMCC 15 (Desautel-Ootsey 7); YVCC 17 (Musgrave 5). Turnovers — BMCC 12, YVCC 9. Total fouls — BMCC 15, YVCC 12.​

February 21
YVCC women fall to TVCC

​Yakima Herald Republic
February 21, 2015

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February 21
YVCC men win in overtime

​Yakima Herald Republic
February 21, 2015

YAKIMA, Wash. — Demetrius Trammell and Marshaun Williams scored 15 points apiece Friday night as Yakima Valley outlasted Treasure Valley 94-88 in overtime in an East Region men’s game at Sherar Gym.

Blake Cleveringa added 12 points, Mac Wood had 11 and Tra Satterwhite 10 for YVCC, which won for the second time in three games. The Yaks are 3-8 in the region and 5-20 overall.

Thadius Galvez scored a game-high 34 points for Treasure Valley (6-5, 1-13), which trailed 47-28 at halftime.

Yakima Valley shot 57 percent during the first half but only 33 percent in the second before hitting 3 of 5 field goals and 7 of 9 free throws in overtime.

“Somehow,” YVCC coach Ray Funk, “we went from being up 19 at halftime to being down four with about four minutes left. But we came back to tie it, then had enough in overtime to win.”

The Yaks host Blue Mountain today, visit Spokane on Wednesday and then conclude their season next Saturday at home against Wenatchee Valley.

TREASURE VALLEY — Youngblood 3-8 3-3 9, Hooper 2-6 4-4 8, Brendan Guzman 4-16 6-7 15, Thadius Galvez 9-19 12-13 34, Ingram 1-8 0-0 2, Dontese Tower 5-11 9-12 20, Pennock 0-0 0-0 0, Wess 0-0 0-0 0, Alip 0-1 0-0 0. Totals 24-70 34-39 88.

YAKIMA VALLEY — Clark 4-8 0-0 9, Blake Cleveringa 3-7 4-7 12, Dobovan 2-7 2-2 8, Bussey 2-5 0-0 4, Demetrius Trammell 5-6 4-5 15, Tra Satterwhite 3-8 3-4 10, Fuller 2-4 1-2 6, Gill 0-0 0-0 0, Mac Wood 2-10 6-8 11, Robbs 2-3 0-0 4, Marshaun Williams 4-4 7-10 15. Totals 29-62 27-38 94.

Halftime — YVCC 47-28. Regulation — 80-80. 3-point goals — TVCC 6-25 (Alip 0-1, Hooper 0-3, Guzman 1-8, Tower 1-2, Galvez 4-8, Ingram 0-3); YVCC 9-24 (Clark 1-1, Satterwhite 1-3, Cleveringa 2-4, Fuller 1-2, Dobovan 2-6, Wood 1-6, Trammell 1-2). Fouled out — Hooper, Williams. Rebounds — TVCC 40 (Guzman 7); YVCC 46 (Williams 6). Assists — TVCC 6, YVCC 16 (Cleveringa 4). Turnovers — TVCC 10, YVCC 9. Total fouls — TVCC 23, YVCC 25.​

February 20
Engineering Day for Kids

​Daily Sun News
February 20, 2015

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February 20
YVCC to stage "You're a Good Man, Charlie Brown' musical

​Daily Sun News
February 20, 2015

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