Below is a complete listing of all Ask the Expert articles that have appeared in JustCoding News.
December 20, 2010
QUESTION: Now that ICD-10 implementation is well under way and practically right around the corner, what are other hospitals doing at this point to prepare coders for the change? What type of education are you providing to coders?
December 14, 2010
QUESTION: With regards to ED observation coding, how many chief complaints should I code? I always thought you chose the chief complaint that best matched the final diagnosis and if there were other chief complaints you coded them as secondary codes to support any tests performed. Is this incorrect?
December 7, 2010
QUESTION: If a physician documents depression in the history and physical and a few diagnoses down also documents anxiety, should we separately code these two diagnoses or should we code this as dysthymic disorder? The question arose because the physician does not link depression and anxiety together.
November 30, 2010
QUESTION: Since laterality will be identified in ICD-10-CM diagnosis codes, will we still need to use HCPCS II/CPT® modifiers such as -RT (right side) or -LT (left side) or -50 (bilateral procedure)?
November 16, 2010
QUESTION: A patient presents to the emergency department (ED). After performing a medical screening exam, the provider determines that a prefabricated “off-the-shelf” splint needs to be applied. Is it appropriate to code both an ED evaluation and management (E/M) code and a HCPCS L-code to describe the device, fitting, and adjustment? If not, how should we code this type of billing encounter?
November 9, 2010
QUESTION: Our physician provided an illegible diagnosis of malnutrition, and when we queried him regarding the specific type of malnutrition, he provided protein malnutrition. The ICD-9-CM Manual directs us to assign ICD-9-CM code 260; however, a consultant told us this is incorrect because this code represents Kwashiorkor. In your opinion, what should we do?
November 2, 2010
QUESTION: I have been involved in numerous discussions regarding how much time has to elapse before you can charge CPT® code 96361 and no one can seem to give a clear answer. Some say 31 minutes, but others believe fluids have to hang for 91 minutes in order to charge 96361. Which is correct?
October 26, 2010
QUESTION: I’ve seen some ICD-10-CM codes that contain an “x” in the code, and I’m confused about whether the “x” is necessary, or does it mean I need to choose the appropriate character for that digit? I’ve also seen “x” used in ICD-10-PCS. Does the “x” mean the same thing as it does in ICD-10-CM?
October 19, 2010
QUESTION: Can you address accurate coding for arthroscopic knee chondroplasty? A lot of the physicians are performing chondroplasty of the trochlea. To my knowledge coders should only code chondroplasties when a physician performs it in one of the three compartments (i.e., medial, lateral, patella).
October 12, 2010
QUESTION: I am coding a record for a patient who was 21 weeks estimated gestational age (EGA). This patient had a fetal intracardiac potassium chloride injection at 20 weeks, four days EGA due to multiple lethal limb body wall malformations with amnion/chorion disruption secondary to amniotic band syndrome. The injection was administered at another hospital, as we do not provide that service here. The patient came to this hospital in preterm labor and delivered.
I am not sure how to code this because the patient had the fetal intracardiac injection four days prior to admission to our facility. Would I report a diagnosis code related to this injection? If so, what code should I report? Or should I just code the amniotic band syndrome, preterm labor, and any other problems she had?