E/M coding and reimbursement for hospital outpatients could change dramatically if CMS finalizes its proposal to replace current E/M CPT ® codes with three G-codes.
Do you ever feel like everything is on YouTube? In some cases, it’s more than you want to see, but the video site can be extremely helpful for coders who want to watch procedures. For example, search...
Paracelsus, the father of toxicology (among other things), once wrote: “Everything is poison, there is poison in everything. Only the dose makes a thing not a poison.” Cheery thought, right?...
Does the DRG accurately depict the patient’s story? Does the length of stay and severity of illness correlate with what actually happened? Heather Taillon, RHIA, and Cheryl Collins, BS, RN, offer tips to selecting the correct principal diagnosis.
Q: Our facility has a question about how other hospitals address this scenario: Patient is discharged to home (discharge status code 01). No documentation exists in the medical record to support post-acute care. Several months later, our Medicare Administrative Contractor (MAC) notifies us that the patient indeed went to post-acute care after discharge. The MAC retracts our entire payment. We need to resubmit the claim with the correct discharge status code. We are reluctant to do so because nothing in the medical record supports the post-acute care provided. Are other hospitals amending the record? If so, which department is adding the amended note?
Diagnostic conclusion statements don’t sufficiently capture the clinical context and medical necessity for inpatient admission. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS, discusses the importance of clinical context and quality of clinical documentation in the medical record.
Ah, the dogs days of summer. An evil time when, according to the ancient Romans, the sea boils, dogs grow mad, and men contract, among other diseases, burning fevers, hysterics, and frenzies,...
In ICD-9-CM, we know not to code solely from the Alphabetic Index. After all, the code could have additional digits or excludes notes or other coding directions (such as “code first” or “use an...
Evaluation and management (E/M) coding and reimbursement for hospital outpatients could change dramatically if CMS finalizes its proposal to replace current E/M CPT ® codes with three G codes. Dave Fee, MBA, Peggy S. Blue, MPH, CCS-P, CPC, Jugna Shah, MPH, Kimberly Anderwood Hoy, JD, CPC, Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Valerie A. Rinkle discuss the possible impact if CMS finalizes its proposal.
One of the bigger challenges with the birth of the new ICD-10-CM coding system is the assignment of the letter O as the leading indicator for OB/GYN codes. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, ICD-10-CM/PCS AHIMA-accredited trainer, delivers a comparative look at coding for OB/GYN coding in ICD-9-CM and ICD-10-CM.
Q: The patient comes in for a cardioversion, but the international normalized ratio results were unsatisfactory. The physicians canceled the cardioversion. Would modifier -73 (discontinued outpatient/hospital ambulatory surgery center procedure prior to the administration of anesthesia) be appropriate?
Medical necessity establishes the foundation for evaluation and management (E/M) code selection and supports the need to services provided to the patient. Peggy Stilley, CPC, CPMA, CPC-I, COBGC, ACS-OB , and Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, AHIMA-approved ICD-10-CM/PCS trainer, explain how to define, determine, and defend medical necessity for E/M codes.
CMS added three new HCPCS C codes and one G code to the integrated outpatient code editor (I/OCE) as part of the October quarterly update. The new codes are effective October 1.
CMS added additional ICD-10 MLN educational resources to its website and will be hosting an ICD-10 National Provider Call August 22. The new MLN educational resources include two fact sheets and a...
It’s baby day at Fix ‘Em Up Clinic and Stitch ‘Em Up Hospital as we prepare to deliver new codes and guidelines for reporting pregnancy and delivery in ICD-10-CM and ICD-10-PCS. Our first patient,...
At first glance, codes for insertion, removal, and revision of pacemakers look quite different in ICD-10-PCS. Kimberly J. Carr, RHIT, CCS, CDIP, and Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, compare and contrast pacemaker procedure coding in ICD-9-CM and ICD-10-PCS.
