Rule changes regarding cellular tissue–based products restructured Medicare’s reimbursement strategy for these products. This article covers some related challenges.
An angiography is a surgical intervention involving the vessels. In angiography procedures, catheters are manipulated into the body to the site of the procedure, dyes are injected, and images are taken.
While you and your team prepare for the new ICD-10-CM codes that will go into effect October 1, make sure you’re also ready for changes to coding instructions for existing codes.
Comorbid conditions or complications (CC) and major comorbid conditions or complications (MCC) indicate a higher level of severity of illness, an elevated risk of mortality, and an above average intensity of resource utilization. Given their impact on reimbursement and quality reporting, Nancy Reading, BS, CPC, CPC-P, CPC-I, emphasizes how success in coding CCs and MCCs requires a delicate balance of documentation specificity and clinical clarity in diagnosis assignment.
Services provided in an inpatient setting are reported using two different coding systems. The facility reports procedures using ICD-10-PCS codes while the individuals providing the care report professional services using CPT codes. Terry Tropin, MSHAI, RHIA, CCS-P, provides a glimpse into how these two coding systems can work together in order to fully report inpatient services.
This article examines two examples—bone marrow transplantation and lung transplantation—to illustrate the similarities and differences in coding transplant encounters. These examples demonstrate how transplant coding is largely driven by transplant status, the reason for the encounter, and the presence or absence of transplant-related complications, while highlighting the unique coding considerations associated with specific transplant types. Note : To access this free article, make sure you first register if you do not have a paid subscription.
Respiratory syncytial virus and COVID-19 are both types of respiratory viruses, and the symptoms can be very similar and overlap each other. Shontia Leon-Guerrero, CPC, CEDC, CEMC, CPC-I Educator, reviews the signs and symptoms of both conditions in infants and children as well as what coders need to know such as diagnosis codes, procedure codes for vaccine administration, and documentation expectations.
Kelly Rice, MSHI, BSN, RN, CCDS, CDIP, CCS, CRC, details how to differentiate and document between acute pulmonary insufficiency following surgery and acute respiratory failure following surgery. Identifying and discussing common clinical indicators for these diagnoses can help support documentation integrity efforts, reduced denials, and the inappropriate triggering of PSIs.
A newly released Office of Inspector General report concluded that unclear Medicare requirements continue to drive inconsistent interpretations of inpatient rehabilitation facility documentation, coverage, billing, and coding rules, contributing to significant payment errors and compliance challenges.
