In December 2023, the Office of the Inspector General published a toolkit for Medicare Advantage organizations who submit high-risk diagnoses, and it announced in January 2026 that an audit will be conducted on high-risk codes that the organizations submitted for 2024. Nancy Reading, BS, CPC, CPC-P, CPC-I, reviews the high-risk codes and emphasizes what to look for in the documentation to support coding practices.
Immunoglobulin G4-related disease is a chronic immune-mediated fibroinflammatory disorder that often manifests with tumor-like masses and/or painless enlargement of multiple organs. Shontia Leon-Guerrero, CPC, CEDC, CEMC, CPC-I Educator, explores the general manifestations of the disease, its signs and symptoms, as well as key documentation tips and a coding scenario.
Q: A patient with dementia has not taken prescribed Lasix for one week due to forgetting and presents with worsening acute heart failure. What is going to be sequenced first: the underdose or the acute heart failure?
At the recent public ICD-10 Coordination and Maintenance Committee Meeting, the Centers for Disease Control and Prevention National Center for Health Statistics discussed 31 proposals involving procedure code topics. Review the updates for two proposals unrelated to the X tables for New Technology that are being considered for implementation on April 1, 2027.
Given the rising relevance of encephalopathy, getting a refresher on what the condition is and why it’s relevant to coding and CDI can benefit all professionals no matter their experience level. And because the clinical validation of encephalopathy is not contingent on a lab finding, but a long chain of events that require each link to be well established, organizations are still finding new ways to leverage innovative tactics in order to document it accurately.
For the 10 years we have been working with the ICD-10-PCS code set, these codes, used to report procedures provided to an inpatient, have required seven characters. Each character reports a very specific element of the service provided. Here, Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, is going to focus on character 6 for Device.
Accurate reporting of left-sided heart failure types relies on specific ICD-10-CM codes that align with the documented ejection fraction category, although ICD-10-CM also provides specific codes for other clinically important forms of heart failure, with and without other chronic conditions, that reflect distinct pathophysiologic mechanisms and coding considerations. Note : To access this free article, make sure you first register if you do not have a paid subscription.
Q: How are stroke intervention procedures like angioplasty, transfemoral carotid artery stenting, and transcarotid arterial catheterization coded using ICD-10-PCS, and how does ICD-10-PCS handle the coding of new technology devices?
A report published by the American Cancer Society found that colorectal cancer rates among adults younger than 65 continue to increase while rates for older adults continue to decline. The study found that the increase is being driven by a higher prevalence of rectal cancer, which now makes up 32% of all colorectal cancer diagnoses, up from 27% in the mid-2000s.
Porcelain aorta is a disease that is caused by severe and widespread hardening of the walls of the ascending aorta that reaches to the aortic arch and descending aorta. Although there are several methods used to diagnose porcelain aorta, Brandi Hutcheson, RN, MSN, CCM, CCDS, CCA, says there is not a clear consensus on how it should be diagnosed.
