When Congress passed the Protecting Access to Medicare Act of 2014, it mandated at least a one-year delay in ICD-10 implementation. Members of the Briefings on Coding Compliance Strategies editorial board, who represent a wide range of industry stakeholders, offered their thoughts on two questions related to the delay.
In an ideal world, all coders and CDI specialists would get along well and work together with minimal conflict. No one is going to agree all of the time, nor should they. A healthy, respectful dialogue can lead to a better understanding of the patient's clinical condition and result in more accurately coded records.
The January 2014 quarterly I/OCE update included nearly 400 new HCPCS Level II codes, but the most significant changes for providers may center on relatively few codes, as a result of modifications CMS made in the 2014 OPPS final rule.
ICD-10-CM root operations excision and resection are sometimes hard to differentiate. ICD-10-PCS defines excision (B) as cutting out or off, without replacement, a portion of a body part. Resection (T) is almost identical, but involves cutting out or off the entire body part.
The number of patients using Medicare Advantage (MA) is rapidly growing, making Hierarchical Condition Categories (HCCs) an increasingly important concept for revenue cycle staff to understand in order to guarantee reimbursement.
Different studies using different methodologies all point to the same conclusion: Coder productivity will decrease after the switch to ICD-10. However, no one knows what will happen to coding accuracy.
Healthcare providers are used to regularly changing guidelines and regulations that drastically alter their processes for coding and billing. Despite few guideline changes since 2008, drug administration still frequently causes confusion because of all the necessary factors to properly document, code, and bill the services.
ICD-10-PCS is a whole new ball game for inpatient coders. Everything will change. Coders have been hearing that almost constantly since CMS announced the first ICD-10 implementation date in 2009.
