ICD-10 implementation challenges will vary from organization to organization, depending on size, setting, and patient mix. Factor in physician buy-in and budget woes, and implementation seems overwhelming.
Consider the following: A beneficiary is admitted to a hospital pursuant to a physician order and receives medically necessary care spanning at least two midnights. CMS will consider this appropriate for payment under Medicare Part A, according to the FY 2014 IPPS proposed rule released April 26. Actuaries estimate that this proposal for what constitutes appropriate inpatient care would increase IPPS expenditures by $220 million due to an expected net increase in inpatient encounters. CMS proposes a 2% reduction to offset projected spending increases.
Our experts answer questions about hydration, excludes notes in ICD-10-CM, L codes for neurostimulator devices, physician supervision for hyperbaric oxygen therapy, E/M service with wound care, and pass-though drugs.
Auto manufacturers rely on them to make decisions about improving passenger restraints in vehicles. Industrial engineers may reference them when advocating for improved design of staircases to prevent falls. Drug companies use them to bolster support for child-resistant packaging.
Sometimes our patients are very sick, very injured, or undergo multiple procedures during their stay. So how do you pick your principal procedure code in ICD-10-PCS? The ICD-10-PCS guidelines offer...
Memorial Day kicked off the summer season and today we are seeing the first summer casualties here at the Fix ‘Em Up Clinic. Apparently not everyone’s holiday celebration went off without a hitch...
One of the advantages to coding in ICD-10-CM is how much information is packed into a single code. You’ll find combination codes throughout the ICD-10-CM Manual. In many cases, you are coding the...
Actress Angelina Jolie made headlines with her New York Times editorial explaining her decision to undergo a prophylactic double mastectomy to reduce her chances of breast cancer. She also plans to...
CMS not only redefines inpatient status in the 2014 IPPS proposed rule, but it also discusses the ‘why’ and ‘how’ physicians should document the defining characteristic of all admissions: medical necessity. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS, and Cheryl Ericson, MS, RN, CCDS, CDIP, explain how the proposals could impact inpatient admissions.
The accuracy and completeness of coded data can potentially affect physicians more as the healthcare industry becomes increasingly transparent to consumers. William E. Haik, MD, FCCP, CDIP, Timothy Brundage, MD, Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, Cathy Testerman, CCS, EMT, and Donna Walker-Thomas, MBA, RHIA, CPC, CMA, review how coded data relates to physician profiling and offer tips for engaging physicians in documentation improvement.
CMS has had a couple of busy months releasing various FY 2014 proposed rules. On May 1, CMS issued its proposed rule for skilled nursing facilities (SNF) . On May 2, the agency issued its proposed rule for inpatient rehabilitation facilities (IRF) . The two rules come in the wake of the IPPS proposed rule issued April 26.
CMS and auditors are increasing scrutiny of CCs and MCCs. William E. Haik, MD, FCCP, CDIP, provides tips that coders can use to look for clinical evidence in the record before querying for these targeted conditions.
The ICD-10-PCS codes for 2014 are now available on the CMS website. CMS also posted the 2014 ICD-10-PCS guidelines and an ICD-10-PCS reference manual. You will find four new codes under new...
The American Medical Association (AMA) may not push for CMS to move directly to ICD-11 without implementing ICD-10 after all, according to a report of the AMA’s Board of Trustees . The report will be...
In a perfect world, inpatient facilities would receive the same payments for diseases and procedures after the switch to ICD-10-PCS. We know that won’t happen, that facilities will see some shift in...
General equivalence mapping (GEM) is a good tool to use to convert ICD-9-CM codes to ICD-10-CM, but the maps are only a tool. Lori Andersen, MS, and Patrick Romano, MD, MPH, explain to use GEMs as part of your ICD-10 coding transition.
CMS is translating only 27% of its current National Coverage Determinations (NCD) from ICD-9-CM to ICD-10-CM, according to Janet Anderson Brock, CMS’ director of the Division of Operations and Information Management, Coverage and Analysis Group Center for Clinical Standards and Quality.
Q: A patient suffered a nontraumatic intracerebral hemorrhage six months ago and is now being seen for long-standing aphasia as a result of the stroke. How would we code this in ICD-10-CM?
Everyone in healthcare—providers and payers alike—faces the same problems when preparing for ICD-10 implementation . Stephen Spain, MD, CPC, Michael Miscoe, Esq., CPC, CPCO, CASCC, CCPC, CUC, and Annie Boynton, BS, RHIT, CPC, CCS, CPC-H, CCS-P, CPC-P, CPC-I, offer the physician, compliance, and payer perspectives on the ICD-10 transition.
