Accurate coding and billing data is important for both providers and CMS. Jugna Shah, MPH, writes about challenges providers have faced with providing that data to CMS and what the agency can do to ease provider burden.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, reviews anatomic details related to hernias and how to use operative report details to report the appropriate procedure codes for hernia surgeries.
Q: Our facility is developing clinical definitions regarding types of atrial fibrillation (afib) given the specificity changes in ICD-10. Could you provide suggestions for these definitions? Do you think it is appropriate to query for persistent atrial fibrillation for the period of more than seven days and chronic afib sustained for more than 12 months Are you aware of any strategies other institutions are using when querying regarding afib?
CMS is reporting that the Quality Improvement and Evaluation System (QIES) will be down for five days in March due to extended systems maintenance. The QIES will be unavailable starting at 8 p.m. Eastern on March 16, and returning March 21 at 11:59 p.m., according to CMS.
Root operations are the fundamental building block of ICD-10-PCS codes, but providers may not use the same terminology coders are familiar with. Review these root operations that involve taking out all or some of a body part.
Beginning April 1, approximately 800 hospitals will be required to participate in CMS’ new joint replacement payment model. Shannon Newell, RHIA, CCS, outlines the requirements and what providers need to do in order to prepare.
Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Peggy Blue, MPH, CPC, CEMC, CCS-P, explain when to report the new codes introduced in the 2016 CPT Manual for genitourinary procedures.
Q: Our radiation oncology department is having some angst about some updated guidance provided by CMS regarding reporting of planning services. These services are provided prior to the actual intensity-modulated radiation therapy (IMRT) service in order to know how to deliver the IMRT. We are not sure if we have been reporting this correctly.
As the healthcare industry acclimates to using ICD-10, coders can rest assured it will still be several years until ICD-11 becomes a reality. Originally pegged for a 2015 release to the World Health Assembly, the World Health Organization (WHO) has quietly pushed ICD-11’s debut to 2018.
The AMA introduced new CPT codes for 2016 to report intracranial therapeutic interventions. Stacie L. Buck, RHIA, CCS-P, CIRCC, RCC, reviews the changes and provides examples on how to use them in a variety of procedures.
Post-traumatic stress disorder isn’t only reported for military personnel. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer, writes about when PTSD may be reported and which diagnosis and procedures codes should be included.
Per CPT, modifier -52 is used when a service or procedure is partially reduced or eliminated at the provider's discretion. Such a situation is identified by using the service's usual HCPCS/CPT code and adding modifier -52, signifying that the service is reduced.
Some interesting tidbits of information can be gleaned from the most recent release of the AHA Coding Clinic for ICD-10-CM/PCS to help coders as they work in the new code set.
Perhaps recognizing the massive undertaking for coding and HIM departments in 2015 with the implementation of ICD-10, the latest CPT® update includes a relatively small 367 changes for 2016.
To charge or not to charge--that is the question. Determining whether a hospital can charge for certain services and procedures provided at a patient's bedside is a task often fraught with confusion and uncertainty.
Approximately 800 hospitals across the country that perform inpatient total hip and knee joint replacements will be required to participate in the latest value-based payment initiative launched by CMS, the Comprehensive Care for Joint Replacement (CJR) model, which becomes effective April 1.
