Q: A diabetic patient is diagnosed with a gangrenous decubitus ulcer of the left heel and admitted to the hospital for treatment. If the provider documents an association between diabetes and the decubitus ulcer, which condition should be sequenced as the principal diagnosis?
Even if a hospital is not a teaching hospital, it may have services that require National Clinical Trial (NCT) reporting. It is logical for revenue integrity leadership to own this issue, but an explanation of the requirements for NCT reporting should be shared with all staff within the revenue cycle so there is a better appreciation of the fact that clinical trial billing rules apply more broadly than merely just to research or clinical trial studies.
Behavioral health is a highly specialized area of coding that many coders and billers are unfamiliar with. There are hundreds of ICD-10-CM codes for mental disorders with unique characters to specify symptoms and complications.
The American Hospital Association (AHA) released Coding Clinic, Second Quarter 2019, just in time for summer vacation. If Coding Clinic didn’t make your summer must-read list, then be sure to review this article, which summarizes coding updates discussed in the quarterly newsletter and their impact on severity and DRG assignment
When you work in the CDI program of a medical facility, you are continually thinking of ways to elicit improved documentation from the medical staff. You also spend a fair amount of time lamenting why some physicians or service lines seem to ignore all educational efforts regarding the importance of explicit and accurate documentation. “If it is important to us,” you might say, “why is it not to them?”
We have come a long way in our understanding of post-traumatic stress disorder (PTSD) but still have a lot to learn about the condition’s prevalence and impact.
Sepsis is a potentially fatal condition that affects nearly 1.7 million adults in America each year, according to the Centers for Disease Control and Prevention (CDC). Nearly 270,000 Americans die each year from sepsis-related complications.
CMS released the calendar year (CY) 2020 Medicare Physician Fee Schedule (MPFS) and OPPS proposed rules on July 29, introducing new CPT codes and extensive changes to documentation requirements for E/M office visits, and seeking commentary on how to overhaul MIPS and potentially undo its payment policy for drugs purchased through the 340B discount program.
Physician coders need to know when it’s appropriate it apply modifier -25 for significant, separately identifiable E/M service. Lori A. Cox, MBA, CPC, CPMA, CPC-I, CEMC, CGSC, CHONC , reviews the correct application of this frequently misused modifier. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
