Physicians often use different terms interchangeably when documenting sepsis. Robert Gold, MD , and Gloryanne Bryant, RHIA, RHIT, CCS, CDIP, CCDS, define the different terms and review when to query for additional clarification.
Jeanne L. Plouffe, CPC, CGSC , and Jennifer Avery, CCS, CPC-H, CPC, CPC-I , review procedures performed on the gallbladder and how to determine the correct ICD-9-CM diagnosis codes.
CMS added modifier -AO (provider declined alt payment method) and new HCPCS codes to the I/OCE as part of the October 2013 quarterly update found in Transmittal 2763.
The best way to decrease denials or increase overturn rates begins with a compliant concurrent review of documentation. Marilyn S. Palmer, DO, and Jonathan G. Wiik, MSHA, MBA, review common Recovery Audit targets and provide tips for successfully appealing denials.
CMS’ proposed 2014 OPPS rule is set to introduce many changes, such as more packaged services, including lab tests and add-on codes. Jugna Shah, MPH; Dave Fee, MBA; Kimberly Anderwood Hoy, JD, CPC; and Valerie A. Rinkle, MPA, offer their insight on what effect these changes could have for providers.
The 2014 IPPS Final Rule contains two significant changes that will impact coders: the 2-midnight inpatient presumption and the Part A to Part B rebilling. Marc Tucker, DO, FACOS, FAPWCA, MBA, and Kimberly Anderwood Hoy Baker, JD, CPC, review the key provisions of these changes.
After a cerebrovascular accident (CVA, also known as stroke), a patient may suffer additional health problems, lasting after the event has passed. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, compares coding for these lasting effects, known as sequela, in ICD-9-CM and ICD-10-CM.
When it comes to ICD-10-CM/PCS, coders may be the hardest and most directly hit employees. Yet some experts say that aside from technical training, hospitals may be lagging behind in terms of actually managing the change for these individuals.
The 2014 OPPS proposed rule is shorter than normal at 718 pages, but the proposed changes are significant and probably the most sweeping changes since the inception of OPPS, says Jugna Shah, MPH, president and founder of Nimitt Consulting.
