CMS released updated I/OCE specifications in January with several changes that could require providers to examine claims submitted early in 2015 that include comprehensive APCs (C-APC) to ensure proper payment.
Primary care providers see patients for a wide variety of conditions, meaning coders in those settings may have to learn many of the new concepts and terms in ICD-10-CM. Annie Boynton, BS, RHIT, CPCO, CCS, CPC, CCS-P, COC, CPC-P, CPC-I, and Rhonda Buckholtz, CPC, CPC-I, CPMA, CRC, CHPSE, CGSC, CENTC, COBGC, CPEDC, discuss three common conditions seen in these settings and what information coders will need to look for in documentation to code them in ICD-10-CM.
Reporting procedures for the skin can require a variety of documented details, such as location, severity, and size. John David Rosdeutscher, MD, and Gloria Miller, CPC, CPMA, CPPM, explainwhich details coder should look forto accurately report excisions, closures, and other wound care services.
Each year, the AMA updates the Vaccines, Toxoids section of the Medicine chapter in the CPT ® Manual to add or revise descriptions of newly available products. In 2015, the AMA added two new product codes (90651, 90630) and revised four (90654, 90721, 90723, and 90734).
Even through ICD-9-CM and ICD-10-CM/PCS are currently under a code freeze, c oders and CDI specialists still need to pay attention to what conditions are considered CCs and MCCs, as well as sequencing rules which could affect MS-DRGs.
Cardiovascular coding can be challenging even without the introduction of new codes and concepts in ICD-10-CM. Laura Legg, RHIT, CCS, and Shelley C. Safian, PhD, RHIA, CCS-P, CPC-H, CPC-I, review the anatomy of the cardiovascular system and highlight some of the key changes in ICD-10-CM.
Physician coders won't be able to just report the CPT ® code that best describes the procedure for some digestive system services in 2015. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC, explain why some payers, including CMS, may require new G codes for certain procedures and how the G codes map to related CPT codes.
The January quarterly I/OCE update includes new modifiers, changes related to expanded packaging, and continued refinement of CMS' skin substitutes categories, but the biggest change for outpatient hospitals is the implementation of comprehensive APCs (C-APC).
CPT ® codes in 2015 for cardiovascular procedures include the ability to report several new technologies and procedures. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC, explain the procedures and what coders will need to look for in documentation to select the correct code.