Our experts answer questions on port reassessment, laparoscopies, reporting multiple biopsies, rejected drug claims, post-reduction film, nipple revisions, and more.
Coders live in a very difficult world. They want to do what is best for their organization based on the documentation they have, but sometimes the documentation is incomplete. The patient’s clinical picture can help coders decide when a condition rises to the level of a CC.
The number of patients using Medicare Advantage (MA) is rapidly growing, making Hierarchical Condition Categories (HCCs) an increasingly important concept for revenue cycle staff to understand in order to guarantee reimbursement.
Different studies using different methodologies all point to the same conclusion: Coder productivity will decrease after the switch to ICD-10. However, no one knows what will happen to coding accuracy.
In this month's issue we explain why accuracy is as important as speed when coding in ICD-10, review clinical indicators for CC assignment, and provide an index of all 2013 articles. Dr. Gold discusses areas where code choices are insufficient. In addition, our experts answer your coding questions.
Recently, Dr. Seuss saw the Grinch for a variety of health concerns. Today, he’s seeing some others who are not in the holiday spirit. First is Mr. Scrooge, who complains he is being harassed by...
Christmas decorating can be a drag, especially when you get tangled in the string of lights and they literally drag you off the roof. Just ask poor Clark. First, he tripped over a root in the forest...
Documentation for vertebral augmentation procedures (VAPs) must adhere to Local Coverage Determination (LCD) policies in order to be paid by Medicare. CMS recently provided guidance for these claims in the Medicare Quarterly Provider Compliance Newsletter .
With the added specificity available in ICD-10-CM, coders have many more options for reporting malignancies of the skin. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , compares ICD-9-CM codes with their ICD-10-CM counterparts and notes where more documentation may be needed to select the proper code.
Q: When we send in a claim for CPT ® code 29898 (arthroscopy, ankle, surgical; debridement, extensive) to Aetna with modifier –AS (non-physician assisting at surgery) for our physician’s assistant, Aetna will deny the claim saying “assistant not covered.” However, that procedure code says it is covered for an assistant surgeon. I have sent appeal after appeal and printouts from the American College of Surgeon’s (ACOS) Coding Today website showing this procedure code is payable to Aetna, and Aetna still denies the claim. Medicare pays on this claim, why wouldn’t Aetna?
More than 330 codes have been added, deleted, or revised in the 2014 CPT ® Manual . Almost one quarter of those changes appear in the digestive system. Joanne Schade-Boyce, BSDH, MS, CPC, ACS , notes important code and guideline changes to be aware of for 2014.
Hydration services, located on the bottom of the drug administration hierarchy, present challenges for coders due they are used with other injections and infusions. Jugna Shah, MPH, and Valerie A. Rinkle, MPA, review how to code hydration, along with other special considerations for drug administration.
Today’s rehearsal for the children’s Christmas play at Anytown Middle School was unforgettable for all of the wrong reasons. Just look at the waiting room at the Fix ‘Em Up Clinic. First in to see Dr...
Information that is not important for ICD-9-CM will take on new significance in ICD-10-CM. Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC, and Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, review areas when specificity comes into play in ICD-10-CM.
Q: In ICD-10-PCS, which root operation would we report for an obstetrical delivery? Would it change for a cesarean section versus a manually assisted vaginal delivery?
CMS released version 31 of the MS-DRG grouper for ICD-10 in November. Providers can use the grouper to identify MS-DRG shifts and payment changes under ICD-10. The Final ICD-10 MS-DRG v32 logic, which will be implemented on October 1, 2014, will be subject to rulema
In ICD-10-PCS, coders will need to find details they currently don’t use. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, AHIMA-approved ICD-10-CM/PCS trainer, offers tips for locating the necessary information in the body of the operative report.
ICD-10-PCS implementation is less than a year away, so the pressure is on coders to learn the new system and maintain productivity. Gerri Walk, RHIA, CCS-P, AHIMA-approved ICD-10-CM/PCS trainer, discusses how to overcome some of the challenges inpatient coders will face in ICD-10-PCS.
