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JustCoding.com provides coders, coding supervisors, and health information management (HIM) directors with educational resources to test their coding knowledge, employ correct coding guidelines, and stay abreast of CMS transmittals. To learn about the different levels of access to this site, click here.
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Sequence codes properly for appropriate DRG assignment
Robert S. Gold, MD, illustrates the importance of reporting codes in the proper sequence to achieve accurate DRG assignment by analyzing two case studies. Dr. Gold also discusses the challenge of selecting the appropriate procedure code when reviewing operative notes.
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When CMS released its May 1 proposal, hospitals received a mixed bag of news: There are minimal changes related to coding, MS-DRGs, hospital-acquired conditions, and the present-on-admission indicator. However, the 2.1% increase in payment to accound for inflation will likely be offset by a negative 1.9% documentation and coding adjustment (DCA). DeAnne W. Bloomquist, RHIT, CCS, Leatrice Ford, RN, BSN, CCS, Gloryanne Bryant, BS, RHIA, RHIT, CCS, and Shannon McCall, RHIA, CCS, CCS-P, CPC, discuss the DCA, noteworthy code changes, and other proposed modifications for 2010.
Sometimes a physician documents a congenital anomaly in the history and physical, discharge summary, or consultation report. But often, it is necessary to look at the procedure notes, radiology reports, and operative reports. Joel Moorhead, MD, PhD, explains what to look for in the medical record to ensure accurate coding of congenital anomalies.
Coders must be cognizant of medical necessity as it relates to record review and evaluation and management (E/M) code assignment. To evaluate medical necessity, coders must determine whether physician documentation meets requirements for assigning particular codes. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, discusses a case study to illustrate what physician documentation should clearly demonstrate to support medical necessity.
Despite the fact that the American Health Information Management Association updated guidance for physician queries in October 2008, hospitals still struggle to draft a comprehensive query policy. Diana McWaid-Harrah, MS, RHIA, CCS, CPC, and Melissa Ferron, RHIA, CCS, discusses important factors to consider when establishing your facility’s query policy.
Many providers and coders are unaware that the CPT Manual includes a series of codes to address special services. These services could include, but are not limited to, specimen handling, emergent care, after-hour care, or weekend and holiday care. Dawson Ballard Jr., CCS-P, CPC, explains when it is appropriate to report these codes.
When billing for pain management procedures, Stephanie Ellis, RN, CPC, explains that it is important to be as specific as possible when coding these complicated conditions. Ellis discusses a number of conditions related to pain management procedures and addresses reporting for bilateral procedures.
Check out AHIMA ICD-10 resources
June 30, 2009
To prepare for the transition to ICD-10-CM and ICD-10-PCS, it may be helpful to have a list of resources that are currently available either online or in print through the American Health Information Management Association (AHIMA): The association’sofficial ICD-10-CM and PCS Web site Educational sessions on anatomy and physiology Checklist for preparation Articles such as the [...]
Understand excludes notes in ICD-10
June 24, 2009
ICD-10 will bring a lot of welcome changes and correct many of the issues and shortcomings with ICD-9. One particular source of confusion with ICD-9 relates to the excludes notes. In ICD-9, the excludes notes can mean two things: 1. Do not code both of these codes together under any circumstances (e.g., a non-obstetrics code such [...]
Look for ICD-10 sessions that go beyond the basics
June 18, 2009
You might be far enough along in your ICD-10 implementation timeline to attend some informational sessions that go beyond the basics. “You’re going to see more companies advertising functional learning as opposed to theoretical sessions,” says Shannon E. McCall, RHIA, CCS, CCS-P, CPC, director of coding and HIM at HCPro, Inc., in Marblehead, MA. Just to [...]
Healthcare News: CMS alerts providers of scam to request account updates
July 1, 2009
On June 18, CMS released an alert through its fee-for-service provider listserv to warn physician practices of a scam in which perpetrators send faxes to physician offices posing as a Medicare carrier or Medicare Administrative Contractor.
Healthcare News: CMS posts new ICD-10 fact sheet and information about HIPAA Version 5010
June 24, 2009
On June 3, CMS posted the second in its series of articles about the ICD-10 general equivalency maps (GEM) that provides basic information, including who will use the maps, why they are needed, and how the files are formatted. The article also outlines information about reimbursement mapping.
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August 11, 2009
Benchmark Coder Productivity to Improve Efficiency and Justify FTEs
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