We want your coding and compliance questions! The mission of Coding Q&A is to help you find answers to your urgent coding/compliance questions. To submit your questions, contact Briefings on Coding Compliance Strategies Editor Amanda Tyler at atyler@hcpro.com .
The 30-day all cause acute myocardial infarction (AMI) mortality outcome measure has been linked to hospital payments since the inception of the Hospital Value-Based Purchasing Program (HVBP) in fiscal year 2013. In February 2016, CMS announced that 70% of commercial payers have agreed to use this measure as one of the cardiology outcomes linked to payment.
The world didn’t end on October 1, 2015. After years of postponement, the proverbial “deal with the devil” made between CMS and the AMA to push ahead with ICD-10-CM/PCS implementation was a year’s grace period during which physician practices could continue using unspecified codes without worrying about Medicare denials or auditor reviews.
Now that we’ve had over a year to get comfortable with our ICD-10-PCS manuals, the 2017 updates to the guidelines and tables turned a lot of what we learned onto its ear. The update brought 3,827 changes to ICD-10-PCS, with the majority of the changes occurring in the heart and great vessels section of the manual. Redefined body part characters, as well as additions of new device characters, left inpatient coders wondering: What does this all mean and how am I supposed to code it?
Bronchopulmonary infections, such as acute bronchitis and pneumonia, are frequent reasons for physician and facility encounters. These encounters result in ICD-10-CM code assignments that factor greatly in severity and risk adjustment inherent to the Patient Protection and Affordable Care Act and the recently implemented Medicare Access & CHIP Reauthorization Act of 2015.
This article is part two of a two-part series on the definition changes for sepsis. Reread part one in the October issue of BCCS. In my October Clinically Speaking column, we discussed the evolution of the definition of sepsis and its implications in clinical care (Sepsis-1, Sepsis-2, and Sepsis-3), quality measurement (CMS' SEP-1 core measure), and ICD-10-CM coding compliance.
The new guideline for code assignment and clinical criteria in the 2017 ICD-10-CM Official Guidelines for Coding and Reporting does not mean clinical documentation improvement is going away; instead it just upped the ante for continued improvement.
The recent adoption of a refined version of the Patient Safety Indicator (PSI) 90 composite by the Agency forHealthcare Research and Quality (AHRQ) has a significant impact on what discharges are included in PSI 15 (Unrecognized Abdominopelvic Accidental Puncture Laceration Rate).
As if coders and clinical documentation improvement specialists aren't under enough pressure as it is, the advent of the 2017 Official Guidelines for Coding and Reporting brings to the table new documentation requirements for pressure ulcer coding. The guidelines can be viewed here: www.cdc.gov/nchs/data/icd/10cmguidelines_2017_final.pdf .
In our computer-savvy tech world, the medical field has been notoriously slow to respond to newer technologies and applications of computer-assisted enhancements. However, in the HIM market, computer-assisted coding (CAC) has been touted to boost coding accuracy and productivity, in addition to being an important tool for the remote inpatient coder.
