CMS recently released the 2017 ICD-10-PCS code updates and guidelines, which include changes to certain root operations. Of the updates, the most notable modifications are the addition of root operation Perfusion, and edits to the current definitions of Control and Creation.
Q: When a patient presents with acute respiratory failure, as well as an overdose, is it ever appropriate to assign the acute respiratory failure as principal diagnosis, since it is an acute condition that would have occasioned the admission to the hospital?
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, address the inpatient side of bariatric surgery, and how obesity and body mass index play a role in coding.
Choosing the correct E/M level can be difficult enough, but coders may also face scenarios where it’s necessary to append a modifier to the code. Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, reviews when to report modifiers -25 and -27 and instances when the modifiers would not be appropriate.
Q: We operate a partial hospitalization program (PHP) and just heard from our billing office that there are new requirements for submitting claims. They want us to close out accounts weekly in order for them to bill them. We have done 30-day accounts prior to this and don’t see why they want to change things. Is there a certain timeframe required for billing these services? This is a huge inconvenience to make this work for the business office.
Choosing an E/M level code depends on three components—history, exam, and medical decision-making. History itself has four further components that coders will need to look for in physician documentation. Review what comprises these components to aid in choosing the correct levels.
Comprehensive APCs (C-APC) have added another complication to coding and billing for outpatient services. Valerie A. Rinkle, MPA, writes about recent changes that could impact the reporting of physical and occupational therapy and speech-language pathology services provided in support of or adjunctive to a C-APC.
Anatomical modifiers qualify a HCPCS/CPT® code by defining where on the body the service was provided. These modifiers are especially helpful to indicate services that would normally be considered bundled but were actually performed on different body sites.
When compared to data from past surveys, HCPro's 2016 HIM director and manager salary survey revealed a harsh truth that many HIM professionals already know: There has been little movement in HIM manager and director salaries over the years.