If you are a fan of American Horror Story (I’m not) or carnival sideshows (again, not my thing, but I’m not judging), you’ve seen some odd creatures. Maybe you’ve wondered if they are real. After all...
You’ve probably heard that you need to beef up your clinical knowledge for ICD-10-CM and ICD-10-PCS coding. And you’re probably wondering when you have time to do that. We’re here to help. We’ve...
Jeff, an 18-year-old male, came into the Fix ‘Em Up Clinic with complete left oculomotor palsy. Jeff stated he had a severe, throbbing headache around his eye yesterday. He took some aspirin and went...
Saturday marks the 165th anniversary of the death of Edgar Allan Poe, but sadly, we’re still not sure of the cause of Poe’s demise. We do, however, have plenty of theories. First is the popular “he...
Today we’re going to look at a real-life injury, but I will say up front that I don’t have all of the information about this particular patient’s injuries. F1 racecar driver Jules Bianchi was...
Q: My colleagues and I continually wrestle with this question: Must all diagnoses on an inpatient chart be listed in the discharge summary for them to be coded?
The four Cooperating Parties released the 2015 ICD-10-CM guidelines and, in the process, deleted a guideline that affects inpatient coding. Both the Centers for Disease Control and Prevention and CMS posted the new guidelines on their websites.
Clinical auditors are often not able to translate from ICD-9 to CPT ® to determine a procedure is inpatient-only, which leads to denials. Kimberly A.H. Baker, JD, CPC, and Beverly Cunningham, MS, RN, reveal common causes of denials and what hospitals can do to overturn incorrect denials.
The Workgroup for Electronic Data Interchange’s (WEDI) most recent survey on ICD-10 readiness included a particularly alarming (at least to me) statistic: Approximately 25% of the 324 providers who...
We’re still living under a code freeze as we (eagerly) await ICD-10 implementation. However, the four Cooperating Parties are still tweaking the ICD-10-CM guidelines. Both the Centers for Disease...
I don’t know about you, but I’m starting to feel a little like Chicken Little, yelling, “ICD-10 is coming!” instead of “The sky is falling!” And we’re all probably being met with the same polite (or...
CMS officially declared October 1, 2015, the new ICD-10 implementation date with the publication of a final rule, "Administrative Simplification: Change to the Compliance Date for the ICD-10-CM and ICD-10-PCS Medical Data Code Sets," in the August 4 Federal Register .
Changes to the codes for musculoskeletal injuries goes beyond just increased codes for fractures. Find out how to code for sprains, strains, and disclocations in ICD-10-CM.
Evaluation and management services continue to be a major target for auditors. In the second part of a series, Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, writes about frequently targeted areas providers can review in order to protect against audits.
CMS designates a certain set of procedures as inpatient-only, meaning it will only reimburse facilities for these procedures when they are performed in the inpatient setting. Inpatient-only procedures present numerous problems for hospitals.
CMS has instructed MACs to reprocess claims and providers to reimburse beneficiaries due to a miscalculated copayment for stereotactic radiosurgery, according to the October update to the OPPS and Integrated Outpatient Code Editor (I/OCE).
In this issue, we review coding for sprains, strains, and dislocations in ICD-10-CM, exmine how to audit for denials of inpatient only procedures, and offer tips for identify documentation shortcomings. Robert S. Gold, MD, discusses how to handle situations when what the physician says he or she did is not what the physician actually did.
