Daniel E. Catalano, MD, FACOG, says that from the CDI perspective, the ability to communicate pediatric severity of illness is complicated by the fact that pediatricians have a lexicon that is not well captured in ICD-10-CM. This, he writes, is especially true for pediatric cardiology.
Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS , explains that as a coding manager, whether your inpatient team is on-site, off-site, or remote, creating the appropriate environment and selecting proper locations are key to any successful team. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
In June, CMS released the 2018 ICD-10-PCS Official Guidelines for Coding and Reporting which include various revisions from the 2017 guidelines. These changes come on the heels of the 2018 IPPS proposed rule and recently released ICD-10-PCS codes.
James S. Kennedy, MD, CCS, CDIP, writes that while you might have thought you’ve finally mastered coding compliance with DRGs and quality measures, now it is time to learn the compliance risks and opportunities with a new risk-adjustment method: Hierarchical Condition Categories.
Q: At my institution, all of our congestive heart failure exacerbations get at least one chest x-ray. Is that enough “diagnostic testing” to code the secondary condition in accordance to Coding Clinic ?
Many national organizations, such as the Centers for Disease Control, the American Liver Foundation, the Department of Health and Human Services, and the Food and Drug Administration have information and resources available to provide education and promote testing for viral hepatitis.
The Quality Payment Program proposed rule seems to bring relief to providers anticipating escalation of Medicare Access and CHIP Reauthorization Act (MACRA) requirements, but there are a plethora of reasons for coding professionals to start adapting their workflow for MACRA now. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Q: For a ureteroscopy intended as a procedure with a biopsy and double-J stent, if the procedure ends when only the scope was placed before a biopsy was taken, could you just code ureteroscopy instead of coding it with the biopsy and the modifier-74 (discontinued outpatient hospital/ambulatory surgery center procedure after administration of anesthesia)?
In ICD-10-CM, defining, diagnosing, and documenting the various forms of altered mental status and their underlying causes remains an ongoing challenge for physicians and their facilities, according to James S. Kennedy, MD, CCS, CDIP .
The American College of Obstetricians and Gynecologists is encouraging providers to decrease the number of cesarean section deliveries. According to Lori-Lynne A. Webb, CPC, CCS-P, CCP, COBGC, CHDA, this means coders should brush up on their knowledge of how to code fetal intervention procedures for babies who are in a breech position.
When someone decides to enter the world of medical coding, they usually start off coding for obstetric and newborn charts. After coding for a month or two, the newbie coder is transitioned to low-dollar queues; usually encompassing charts $10,000 and less. Gradually, he or she works toward the medium-dollar and moderate-procedure queues between $20,000-$39,000.
In late June, CMS released a major proposed rule that hospitals will need to pay attention to—and no, I don’t mean to say that CMS released the CY 2018 OPPS proposed rule early, though we’ve thought that might happen since it’s been at the Office of Management and Budget (OMB) for several months.
As CMS and third-party payers have looked for ways to treat patients in the outpatient setting and reduce inpatient volumes, CMS has used the 2-midnight rule, in addition to other methods, to treat patients as outpatients or in observation whenever possible.
Every now and then, the HCPro Boot Camp instructors are asked similar questions on a specific billing issue from students and clients across the country. The old saying “there must be something in the water” often holds true, and it does in this case, especially regarding recent OIG audits.
Q: I can't distinguish between "code first" and "in diseases classified elsewhere.” Both are used with manifestations and both can't be sequenced as principal diagnosis and both need etiology codes, so what is the difference?
