In 2013, “Guidelines for Achieving a Compliant Query Practice,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. The 2019 update reinforces the information set forth in the preceding practice briefs while also introducing some newer guidelines reflective of today’s healthcare environment.
Before starting an ambulatory or outpatient CDI program, those tasked with the project must first create some universal definitions so everyone is on the same page and speaking the same language.
CMS recently released two quarterly updates effective July 1: Medicare Claims Processing Transmittal 4313 , which is the July update to the OPPS, and Medicare Claims Processing Transmittal 4314 , which is the related July update to the Integrated Outpatient Code Editor (I/OCE) Specifications, Attachment B.
ED physicians commonly treat fractures. A fracture can be the result of a traumatic injury, such as a fall, or may be pathologic (i.e., due to a disease process). In general, fractures can be classified as open or closed, displaced or nondisplaced.
Keeping up with coding changes in the circulatory system chapter in the ICD-10-CM manual is an ongoing process. Almost every fiscal year coders are met with new codes for myocardial infarctions (MI), changes to congestive heart failure codes, and updates to the guidelines for reporting cerebrovascular diseases.
This summary, organized by major diagnostic category (MDC), highlights some of the changes to the IPPS proposed rule affecting MS-DRG and ICD-10-CM/PCS code assignment.
Acute kidney injury (AKI) and acute tubular necrosis (ATN) remain targets for both coding and clinical validation. Over the years, we’ve gleaned valuable insights from appealing hundreds of coding and clinical validation denials for AKI and ATN.
CMS recently released the fiscal year (FY) 2020 ICD-10-PCS changes and Official Guidelines for Coding and Reporting for the procedural coding system which will affect discharges occurring from October 1, 2019, through September 30, 2020.
Correct documentation and coding are key to accurate reimbursement, but according to the Office of Inspector General, organizations aren’t hitting the mark on either when billing for inpatient rehabilitation facility (IRF) services.
Treatment options for spinal conditions are varied and may include pain management with medications, injections, or surgical interventions. Adrienne Commeree , CPC, CPMA, CCS, CEMC, CPIP , breaks down spinal anatomy and ICD-10-PCS coding for spinal fusions and laminectomy procedures.
The fiscal year 2020 IPPS proposed rule includes nearly 1,500 CC/MCC designation changes, which impact MS-DRG groupings used to calculate pricing for inpatient hospital claims. Rhonda Butler, CCS, CCS-P , reviews noteworthy proposed changes to MS-DRG assignment for the coming fiscal year. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS recently released quarterly updates to the OPPS and Integrated Outpatient Code Editor (I/OCE), effective July 1. Judith Kares, JD , summarizes key coding and billing policy updates, including changes to APCs, status indicators, revenue code changes, and more.
The skin maintains homeostasis by generating new tissue in response disease or damage. Sometimes, however, surgical interventions are used lessen the severity of the wound and prevent infection. Review integumentary system anatomy and CPT coding for removals and repairs used to facilitate wound healing. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A clinician documented "combination Type 1 and Type 2, diabetes mellitus in poor control." This condition is sometimes called Type 1.5 diabetes. What is the correct ICD-10-CM code assignment for Type 1.5 diabetes?
The July 2019 quarterly update to the OPPS, released by CMS in late May, announces an effective date of July 1 for 20 CPT Category III codes and revises status indicators for CPT codes used to report imaging by magnetocardiography.
The use of ultrasound at the bedside, or within the office practice, has become more common in provider-based clinic settings. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , details documentation requirements and CPT and ICD-10-CM coding for diagnostic ultrasound services.
Q: We have a patient who received a pancreas transplant for the treatment of diabetes. The patient was later admitted to the hospital for treatment of an unrelated kidney stone. Would it be appropriate to assign the ICD-10-CM code for diabetes as a chronic condition based on the patient’s medical history?
