Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, looks at the different types of bariatric surgical procedures and documentation details providers may include for them. She also reviews which CPT codes can be used to report these procedures
CMS issued a final rule last week to revamp the way it pays for tests under the Clinical Laboratory Fee Schedule, though the agency has pushed the start date back a year and worked to ease administrative burden based on public comments.
Michelle M. Wieczorek, RN, RHIT, CPHQ, discusses how documentation and coding can impact your facility’s data reported for hospital-acquired conditions and present on admission indicators.
Shannon Newell, RHIA, CCS , AHIMA-approved ICD-10-CM/PCS trainer, writes about significant changes to PSI 90 in the 2017 IPPS proposed rule, one of which is a new name–The Patient Safety and Adverse Events Composite.
Q: I am never sure of correct sequencing when the admission is for flu, pneumonia, and asthma. Can you suggest proper sequencing, and if queries are needed?
Kimberly Cunningham, CPC, CIC, CCS , and other professionals comment on commonly seen MS-DRGs and inpatient conditions, including which terms coders need to look for in documentation to arrive at the most accurate MS-DRG and codes. Note: To access this free article, make sure you first register if you do not have a paid subscription.
CMS recently announced changes to require providers to report modifier -JW (drug amount discarded/not administered to any patient) when appropriate. Jugna Shah, MPH, looks at when providers will need to use the modifier and how to remain compliant.
Anatomical CPT modifiers aren’t used just to distinguish laterality. Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, reviews how to report modifiers –LC, -LD, -LM, -RC, and –RI for percutaneous coronary interventions.
The value modifier is having an increasing effect on physician payments and coding each patient’s severity is key to accuracy. Richard D. Pinson, MD, FACP, CCS, writes about how the value modifier impacts payment and conditions coders should be aware of that quality scores.
Providers should already be aware they will have to report more specific ICD-10-CM codes when CMS ends its grace period for physicians later this year, but the agency will also be excluding certain unspecified codes from reporting in 2017.
Shannon Newell, RHIA, CCS , AHIMA-approved ICD-10-CM/PCS trainer discusses modifications and expansions to claims-based quality and cost outcome measures in the 2017 IPPS proposed rule. Note: To access this free article, make sure you first register if you do not have a paid subscription.
As healthcare providers increasingly accept financial risk associated with patient management due to the transition from fee-for-service to risk-/value-based reimbursement, the traditional model of healthcare reimbursement has been flipped upside down.
CMS' coding modifiers are not always used to report clinical components of a service. Sometimes they can be used in order to provide information about how a service relates to Medicare coverage policies.
The April 2016 I/OCE update brought a host of code and status indicator changes, as well as corrections to CMS' large January update that instituted policies and codes from the 2016 OPPS final rule.
The FY 2017 IPPS proposed rule addresses MS-DRG classifications and relative weights pertaining to categories such as Excision of ileum, Bypass procedures of the veins, Removal and Replacement of knee joints, and pacemaker procedure code combinations.
Q: I have a patient with stage IV lung cancer that presented with fatigue, cough, and loss of appetite. Initially, they thought he had pulmonary nodular amyloidosis, but when they did an echocardiogram on day one they found a pericardial effusion. How would this be sequenced and coded?
Katy Good, RN, BSN, CCDS, CCS, Paul Evans, RHIA, CCS, CCS-P, CCDS, Laurie Prescott, MSN, RN, CCDS, and Gloryanne Bryant, BS, RHIA, CDIP, CCS, CCDS, all comment on how over-querying is a common concern in clinical document improvement, and how over-querying can cause delays in documentation and coding processes.
