When a procedure code isn’t detailed enough to tell your payer precisely what service or procedure was provided, Medicare or the private payer asks physicians to put a modifier next to the procedure code listed on their claim. This article reviews three modifiers commonly used by pain management practices.
Because encephalopathy is a broad and complex syndrome that encompasses a wide range of brain disorders, Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP , provides an in-depth review of the various forms of encephalopathy, their causes, clinical manifestations, diagnostic approaches, and treatment strategies, so that coders can effectively differentiate between the types and ensure accurate coding for optimal patient outcomes.
Our experts answer questions on reporting bronchiectasis and pneumonia with ICD-10-CM codes, coding diagnoses without clinical criteria, and documenting pressure injuries and wound care.
Although ICD-11 has not yet been adopted in the United States, various countries have implemented it to enhance their health data analysis, improve public health strategies, and foster international comparability. This article covers how other countries that have adopted ICD-11 are using their data.
Cheryl Ericson, RN, MS, CCDS, CDIP , explores why CMS will begin collecting data in 2025 to measure performance on the Hospital Harm from Acute Kidney Injury (HH-AKI) electronic clinical quality measures (eCQM), particularly for those who may be less familiar with eCQM.
Although advancements in treatment and early detection improve survival rates, the incidence of cancer diagnoses, including lymphoma, continue to rise. To reflect the growing number of cases and the complexity of neoplasms, new ICD-10-CM codes were introduced for fiscal year 2025. Learn how to capture each diagnosis with greater precision. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS recently published an update to the fiscal year 2025 ICD-10-PCS code set, available for discharges occurring from April 1 through September 30, 2025. Although CMS made no changes to the guidelines, the update includes 50 new codes, 12 deleted codes, and two new tables.
For fiscal year 2025, ICD-10-CM Chapter 19 saw an addition of 18 new codes for poisoning by, adverse effect of, and underdosing of immune checkpoint inhibitors and immunostimulant drugs. To properly apply these new codes, Nancy Reading, RN, BS, CPC, CPC-P, CPC-I , breaks down the purposes of these medications and explains how the coding guidelines address the complex range of side effects these drugs can cause.
Q: Consider a patient who is readmitted for postoperative pain control after a lung transplant two days prior. How would coders report this type of surgical complication in ICD-10-CM? In general, what are the guidelines for coding pain as a surgical complication of transplantations?
