In this month's issue, we review injection and infusion coding guidelines, take a look at some self-administered drug clinical examples, examine knee anatomy in preparation for the increased specificity of ICD-10, and answer your coding questions.
During the January injections and infusions audio conference, Jugna Shah, MPH, president and founder of Nimitt Consulting in Washington, D.C., and Valerie A. Rinkle, MPA, associate director with Navigant Consulting in Seattle, reviewed these scenarios.
Healthcare providers are used to regularly changing guidelines and regulations that drastically alter their processes for coding and billing. Despite few guideline changes since 2008, drug administration still frequently causes confusion because of all the necessary factors to properly document, code, and bill the services.
Editor's note: With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in anatomy and physiology. To help coders prepare for the upcoming transition, we will provide an occasional article about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation.
Ah, Black Friday, when shoppers go doorbusting for deals and then head to the Fix ‘Em Up Clinic for repairs. Today’s first wounded bargain hunter, Stephanie, comes in complaining of pain in her left...
Farmer Brown came in today to see Dr. Gobbler for some injuries sustained when he tried to prepare his Thanksgiving main course. It seems Farmer Brown’s turkey wasn’t interested in joining him as...
Coding for acute and chronic pain will not change greatly in ICD-10-CM, though coders will have some new options at their disposal. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , discusses some common pain diagnoses and how they will translate from ICD-9-CM.
Q: When a procedure is performed by laparoscopy, but only a code for the open approach is listed, do you use the unlisted procedure code? For example, the physician documented: laparoscopic pyloromyotomy, hypertrophic pyloric stenosis. We used CPT ® code 43520-22 (pyloromyotomy, cutting of pyloric muscle, Fredet-Ramstedt type operation, with the increased procedural services modifier) but the coding department corrected with 43659 (unlisted laparoscopy procedure, stomach). We are a pediatric surgical practice. I feel because the procedures are very common and performed often, our revenue will drop by using unidentified procedure codes, but I want to code them correctly.
CMS recently released five online resources to aid providers in their ICD-10 implementation efforts. Although CMS designed some of these resources with providers in mind, much of the information is applicable to hospitals, payers, and vendors as well.
ICD-10-CM codes may look unfamiliar, but many concepts are the same as those in ICD-9-CM, with a few notable changes. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC , look at some of the new conventions and guidelines for ICD-10-CM.
You may remember that the American Medical Association (AMA) has been pushing for an end to ICD-10 since 2012. During its recent House of Delegates meeting, the AMA reinforced its position that ICD-...
Conquest, War, Famine, and Death have nothing on the Four Horsemen of the ICD-10 Apocalypse: Accuracy Documentation Productivity Reimbursement How do you tame these terrors? With planning and...
A feral flock of wild turkeys has invaded New York City. Seriously. And with them, they bring all sorts ofcode-ready diseases and mishaps. First, turkeys can transmit fun infections such as...
CMS created a mini tempest in June when announced it would not conduct end-to-end testing for ICD-10. CMS has not reversed that decision, but will require MAC to conduct front-end testing in March...
Q: What recommendation would you give to the coder when the clinical indicators in the chart do not support sepsis but it’s in the final diagnostic statement?
Coders may find assigning codes for sepsis somewhat easier in ICD-10-CM, but they will still face some challenges. Ann Barta, MSA, RHIA, CDIP , and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CCDS, detail how to report sepsis in ICD-10-CM.
Clinical queries serve a definitive purpose when documentation in the medical record is ambiguous, inconsistent, lacking specificity, or contradictory. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, CCDS, C-CDI, explains why documentation improvement initiatives and heightened coder awareness of the need to query can be an asset or liability.
Some hospitals are incorrectly reporting lymphoma and leukemia MS-DRGs for patients who are admitted and treated for anemia and dehydration, according to the Medicare Quarterly Provider Compliance Newsletter .
