Acute respiratory distress syndrome presents a significant clinical challenge due to its rapid onset, high mortality rate, and complex management. Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP , delves into the comprehensive aspects of ARDS to show how coders, alongside healthcare providers and CDI specialists, play an essential role in reporting the complete picture of the condition.
Trey La Charité, MD, FACP, SFHM, CCS, CCDS , invites a deeper understanding for diagnosing and documenting acute renal failure and any other related diagnoses—before exploring the plethora of denial strategies medical staff may face. Not to worry as there are opportunities for successful appeals!
Q: An elderly male patient has a rectal fistula with an abscess requiring complex packing of the wound. The most recent wound documentation reports “complex persistent rectal fistula with underlying abscess present, cultures show positive for E. coli and Klebsiella.” The patient will be administered daily IV antibiotics via a PICC line that has been placed. How would this encounter be reported in ICD-10-CM?
An upcoming audit reviewing Medicare inpatient hospital billing for sepsis underscores the critical importance of accurate coding and clinical validation. With guidance from Leigh Poland, RHIA, CCS, CDIP, CIC , coders can help prevent costly coding errors, reduce the risk of audits, and ensure hospitals are appropriately reimbursed for the care they provide. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS implemented modifier -FS (Split [or shared] E/M visit) as part of a major revision to its rules for split/shared services on January 1, 2022. This article provides tips for using modifier -FS from top reporters as it approaches its third year of active status. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The concept of social determinants of health (SDOH) has transformed significantly, advancing from increased awareness to data integration and the development of tools and frameworks. This article explores the importance of integrating SDOH into the healthcare framework and the coding process, as well as best practices for leveraging this data to inform health interventions.
With CMS publishing annual updated versions of its Medicare National Correct Coding Initiative (NCCI) Policy Manual, as well as quarterly updates to the individual NCCI edit files, it is often hard for facilities to keep up with the changes. This article details the latest updates, as well as provides insights on implementing NCCI-associated modifiers and tips for preventing and overriding common edits.
To align subcategories for diagnosis coding with the DSM-5 classification subcategories for feeding and eating disorders, new ICD-10-CM codes were added in the FY 2025 update. Nancy Reading, RN, BS, CPC, CPC-P, CPC-I , reviews the clinical criteria for affected disorders, including anorexia nervosa, bulimia nervosa, binge-eating disorder, pica in adults, and rumination disorder.
