Inpatient-only procedures are those that CMS has determined providers must perform on an inpatient basis. Kimberly Anderwood Hoy, JD, CPC, and Beverly Cunningham, MS, RN, unravel the complexities of coding for these procedures.
Beginning January 1, 2015, physicians will no longer need to provide certification for an inpatient admission unless the admission is expected to last for at least 20 days or the case is an outlier.
In times of increased auditor scrutiny, it's important for coders to remind themselves of their strengths. Assigning the POA indicator is one of them, according to an OIG report released in November 2012.
CMS proposed that a new HCPCS modifier be appended to every code for a service furnished in a hospital's off-campus provider-based department on both the CMS-1500 claim form for physicians' services and the UB-04 form (CMS Form 1450) for hospital outpatient services in the 2015 OPPS proposed rule. Despite many detailed comments opposing this change, no consensus emerged; therefore, CMS is moving forward with implementing a slightly modified policy.
Q: In ICD-10-PCS, which root operation would we report for an obstetrical delivery? Would it change for a cesarean section versus a manually assisted vaginal delivery?
Coding Clinic's Third and Fourth Quarter 2013 issues focus considerable attention on ICD-10-PCS procedure coding. On p. 18, Coding Clinic Third Quarter 2013 states that the coding of a peripherally inserted central catheter (PICC) depends on the end placement of the PICC line?that is, where the device ends up.
Respiratory failure, whether acute or chronic and whether following surgery or not, is one diagnosis that is always an easy target for those who abuse the documentation and assignment of ICD codes.
Cheryl Ericson, MS, RN, CCDS, CDIP, discusses the difference between “after study” and “due to” when it comes to choosing the correct principal diagnosis .
Q: How specific does the physician have to be for the location of the acute myocardial infarction (MI) in ICD-10-CM? We don’t do catheterizations at my facility .
