Gloria Miller, CPC, vice president of reimbursement services for Comprehensive Healthcare Solutions, Inc., located in Tacoma, Wash, created this quick reference for HCPCS Level 1 modifiers commonly used in wound care coding.
According to the Centers for Disease Control and Prevention, 31% of all American adults have high blood pressure, so odds are coders see the condition documented often. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, AHIMA-Approved ICD-10-CM/PCS Trainer , compares coding for hypertension in ICD-9-CM and ICD-10-CM.
CMS corrected edit 84, added five APCs to the I/OCE, deleted two APCs, and changed the description of another as part of the April updates to the I/OCE. In addition, CMS deleted all of the genetic testing modifiers, retroactive to January 1.
Q: If a patient has a spinal deformity on L5-S1 and we use the appropriate codes from 2280X and then the physician performs an arthrodesis/fusion on the same level, can we bill the appropriate fusion codes (225XX-226XX) as well? My impression is no, but I would love to get some insight into this question.
In February, AHIMA published an update to its 2010 query practice brief. The updated brief, Guidelines for Achieving a Compliant Query Practice, is the result of a joint effort between AHIMA and the Association for Clinical Documentation Improvement Specialists (ACDIS). ?
CMS corrected edit 84, added five APCs, deleted two APCs, and changed the description of another as part of the April updates to the I/OCE. Dave Fee, MBA, reviews the most significant changes CMS implemented
Our experts answer questions about modifiers for diagnostic interventional procedures, Medicare recognition of CPT ® code 9066, reporting add-on code for psychotherapy with interactive complexity, reporting G0378 for all payers, and wound care coding.
Coders should question the validity of coding advice and work collaboratively with physicians to develop sound coding guidelines. Last month, I addressed coding advice related to percutaneous endoscopic gastrojejunostomy and cardiorenal syndrome. This month, I’ll address coding advice related to several other conditions.
Successful appeals can actually lead to CMS policy changes. Facilities have been successfully appealing to receive Part B payments after a Medicare review contractor denied a Part A stay as not medically necessary. As a result, CMS is changing its policy on rebilling for Part B services.
Anesthesia coding in some ways is similar to evaluation and management coding—only easier. Chandra Stephenson, CPC, CPC-H, CPMA, CPC-I, CANPC, CEMC, CFPC, CGSC, CIMC, COSC, explained the 10 steps to coding anesthesia during the AAPC National Conference in Orlando, Fla., April 14-17.
In this month's issue, we examine CMS' Part A to Part B rebilling ruling and proposed rule, look at how facilities are being reimbursement for the new molecular pathology codes, review changes to the I/OCE for April, and answer your questions.
William E. Haik, MD, FCCP, CDIP, a practicing pulmonologist and director of DRG Review, Inc., in Fort Walton Beach, Fla., says he first became interested in coded data in 1986 after a local newspaper published his hospital’s costs, length of stay, and mortality rates for simple pneumonia. At the time, he was the only pulmonologist in the local area. The patients he treated were often those with multiple comorbidities as well as gram-negative bacterial pneumonia who had been transferred from two smaller facilities in the county.
When coders begin using ICD-10-PCS the second and fourth character definitions seem simple enough: Second character-Body system Fourth character-Body part However, when coders start assigning codes,...
You know what keeps you up at night thinking about the ICD-10 transition. Have you ever wondered what causes CMS officials to lose sleep? For Denise Buenning, MsM, director of CMS’s administrative...
It was almost inevitable. The possibility of another ICD-10 delay was brought up during the AHIMA ICD-10-CM/PCS and CAC Summit in Baltimore April 24. And just as quickly as it was raised, the...
Distinguishing between clinical and coding significance is often confusing. Joel Moorhead, MD, PhD, CPC, discusses how coders should differentiate between the two.
The three-day rule defines certain preadmission outpatient services as inpatient operating costs that are covered and paid under the IPPS. Kimberly Anderwood Hoy, JD, CPC, and Valerie A. Rinkle, MPA, unravel the complex conditions associated with the rule.
DRGs for procedures unrelated to the principal diagnosis should occur rarely. Robert S. Gold, MD, and Cheryl Ericson, MS, RN, CCDS, CDIP, explain when it is appropriate to report an unrelated DRG.
