The additions and revisions to the ICD-10-CM Official Guidelines for Coding and Reporting in 2012 include some new information that coders should be aware of in preparation for ICD-10-CM/PCS implementation. Sandy Nicholson, MA, RHIA, and Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I, CHA, explore some of the biggest guideline changes.
As charges become more specific to provide additional concrete and transparent cost data, providers must consider what procedures they routinely provide to patients and what procedures are specifically related to the patient's condition. Denise Williams, RN, CPC-H, and Kimberly Anderwood Hoy, JD, CPC, reveal tips for determining when to separately bill for ancillary bedside services provided to inpatients.
As you run down your mental to-do list for the rest of the afternoon, you realize you're double-booked for multiple meetings, and you're having trouble prioritizing because your phone keeps buzzing with new e-mail notifications. If you're a health information management (HIM) director, this scenario likely repeats day in and day out. Luckily Monica Pappas, RHIA, Patti Reisinger, RHIT, CCS, and Tesa Topley, RHIA, provide tips and strategies for HIM directors to help manage all that they juggle, and prevent stress from getting out of control.
The transition to ICD-10-CM is coming. The only question is when. Despite the delay, coders and other HIM professionals must continue to prepare for the transition.
How does medical necessity get “overlooked” on the physician side as well as the inpatient side? Case managers, utilization review staff, physician advisors, CDI specialists, and coders, each carry out specific duties and responsibilities when reviewing medical records. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDIS, CCDS, examines contributing factors and takes a closer look at guidelines Trailblazer Health recently issued defining specific joint replacement (DRG 470) documentation that both hospitals and physicians should follow to support medical necessity.
The transition to ICD-10-CM is coming. The only question is when. Despite the possible delay, coders and other HIM professionals must continue to prepare for the transition. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, Sandy Nicholson, MA, RHIA, Robert S. Gold, MD, Jennifer Avery, CCS, CPC-H, CPC, CPC-I, and Kim Felix, RHIA, CCS, provide information on how ICD-10-CM will—and will not—differ from ICD-9-CM.
What should inpatient coders remember about the three-day payment window requirements? Although it may seem counterintuitive, Debbie Mackaman, RHIA, CHCO, and Marion G. Kruse, RN, MBA, explain that inpatient coders need to be aware of certain outpatient services that they may need to include on inpatient claims, as well as when they need to alert billers to assign condition code 51.
The January update to the Integrated Outpatient Code editor generally includes a large number of changes and the January 2012 update is no exception. Dave Fee, MBA, highlights the most significant changes including the addition of modifier –PD, which he calls one of the real sleepers in this release.
