Inpatient coders will have a new coding system on October 1, but they won’t have to learn new MS-DRGs. They aren’t changing. However, coders will see some shift in MS-DRG assignment in ICD-10. Donna M. Smith, RHIA, and Lori P. Jayne, RHIA, reveal why the MS-DRG shifts will occur.
Q: Does the physician have to document the stage of a decubitus ulcer or can it be a wound care nurse? Does that person have to document stage 1 or can he or she describe the wound?
Recovery Auditors have identified substantial overpayments for inpatient psychiatric services directly following an acute care stay within the same facility, according to CMS’ MLN Matters® SE1401 .
Information that is not important for ICD-9-CM will take on new significance in ICD-10-CM. Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC, and Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, review areas when specificity comes into play in ICD-10-CM.
CMS created a 2-midnight presumption and benchmark as part of the 2014 IPPS Final Rule as a way to clarify its guidelines for inpatient admission. However, the American Hospital Association (AHA) and American Medical Association (AMA) believe the clarification creates more confusion.
Some hospitals are incorrectly reporting lymphoma and leukemia MS-DRGs for patients who are admitted and treated for anemia and dehydration, according to the Medicare Quarterly Provider Compliance Newsletter .
Recovery Auditors are data mining for sepsis MS-DRGs and then focusing in on those with a short length of stay. Robert S. Gold, MD, and Gloryanne Bryant, BS, RHIA, RHIT, CCS, CDIP, CCDS, provide tips for correct sepsis coding to avoid auditor takebacks.
Approach is the fifth character in the ICD-10-PCS code. Laura Legg, RHIT, CCS, AHIMA-approved ICD-10 CM/PCS trainer , reviews the seven approaches used in ICD-10-PCS.
Although ICD-10-CM resolves some problematic areas of coding, it isn't a panacea. Robert S. Gold, MD reviews how respiratory insufficiency will continue to challenge coders.
