CMS is reexamining inpatient criteria because it has seen a significant increase in the number of patients spending more than 24 hours in observation. Providers are worried that a Recovery Auditor will deny a short inpatient stay for lack of medical necessity and recoup payment years later. So instead, some facilities place patients in observation for longer time periods.
Coders will see plenty of changes when they start using ICD-10-CM codes. Many codes require more specific information, such as laterality, stage, or encounter.
A great storyteller understands that it’s all in the details. Perhaps it’s the back-story about a particular character or maybe it’s the little facts peppered throughout the tale, but it’s the details that convey the essence of the story. Likewise, some ICD-10-CM injury codes tell only part of a patient’s story. Lolita M. Jones, RHIA, CCS, and Donna M. Smith, RHIA, discuss how to report associated injuries and complications and also talk about why it’s so important to have a firm grasp on anatomy and physiology to ensure accurate coding.
The American Hospital Association does not plan to “convert” past issues of Coding Clinic for ICD-10-CM/PCS. Lynne Spryszak, RN, CCDS, CPC, discusses why this decision has caused concern among coders and clinical documentation improvement specialists, who for years have relied on the guidance published in Coding Clinic to assist with coding complicated diagnoses or procedures.
CMS issued Transmittal 1039 in the One-Time Notification Manual on February 3, which provides guidance on reporting claims submissions and date span requirements for 33X Type of Bill, which pertains to Home Health Agencies, containing ICD-10 codes with dates of discharge on or after October 1, 2013.
