Q: When I started as a coder, I learned that the complication code, such as from ICD-9-CM series 998 or 999, takes precedence as the reason of admission when present with another contributing condition. Is this correct, and is there any written guidance from AHA Coding Clinic for ICD-9-CM/ICD-10-CM/PCS that discusses this?
CMS provided plenty of proposed refinements to quality measures in the 2016 IPPS proposed rule, but did not suggest any changes to the 2-midnight rule. Kimberly A.H. Baker, JD, CPC, James S. Kennedy, MD, CCS, CDIP, and Shannon Newell, RHIA, CCS, highlight the most significant proposed changes.
CMS declared its second week of ICD-10 end-to-end testing , held from April 27 through May 1, a success. Approximately 875 participants submitted 23,138 test claims during the week and CMS accepted...
Are you currently dual coding to prepare for ICD-10 implementation? Or are you double coding? Do you know the difference? When you dual code, you assign both ICD-9-CM and ICD-10 codes to the same...
The April quarterly I/OCE update from CMS did not defy convention?featuring the typically small number of updates following extensive changes in the previous quarter?but CMS did continue to clarify the logic for comprehensive APC (C-APC) payments.
In the third part of our series on Patient Safety Indicator 90, we focus on inclusions, exclusions, and coding and documentation vulnerabilities for PSI 7.
The April quarterly I/OCE update from CMS did not defy convention?featuring the typically small number of updates following extensive changes in the previous quarter?but CMS did continue to clarify the logic for comprehensive APC (C-APC) payments.
Taxonomy codes play a very important role in medical billing and credentialing for providers or group specialties.HIPAA-standard code sets specify a "standard" for transactions. In many cases, a taxonomy code is required to reimburse a claim; however, the reporting requirements for a taxonomy code may vary between insurance carriers and your third-party payers.
The 2016 OPPS proposed rule is likely to continue CMS' trend of expanded packaging and feature refinements and expansion of comprehensive APCs based on comments CMS has made in prior rules.
In this month’s issue, we explore queries for ICD-10-PCS, review CMS’ proposed changes to the IPPS, and focus on inclusions, exclusions, and coding and documentation vulnerabilities for PSI 7. Robert S. Gold, MD, highlights areas of confusion involving PSI 15 guidance.
ICD-10-CM will still allow coders to report unspecified codes. However, coders will not have that option in ICD-10-PCS. Every character has to have a value, which will lead to an increase in surgical queries.
Ah, summer—sand, surf, and…ICD-10 education? That’s right. Summer, especially this summer, is no time to stop your ICD-10 education. We have 125 days left until ICD-10 implementation, so we need to...
Our friends at the Association of Clinical Documentation Improvement Specialists (ACDIS) held their 8 th annual conference last week. Aside from a few mishaps involving their crack team of CDI...
This sample case study is an excerpt from HCPro’s ICD-10 Competency Assessment for Coders , which is a resource included in the ICD-10 Training Toolkit . The toolkit provides the building blocks for your training programs for physicians as well as coding, HIM, documentation, and billing professionals in both inpatient and outpatient settings.
Q: We have a patient with chronic severe low back pain, etiology unknown, on MS Contin®, an opioid. Due to the patient’s history of drug-seeking behavior and cannabis abuse, the physician orders a drug screen prior to refilling the prescription. With the changes to drug testing codes in 2015, what would be the appropriate laboratory CPT ® codes to report?
