CMS recently released an ICD-10-CM resource for specialties and specific conditions and services that collects varied educational tools, including webcasts, case studies, and clinical concept guides.
Nearly half a million patients receive dialysis services each year. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, writes about the ICD-10-CM and CPT® codes providers will need to know in order to report these services accurately.
Linda Renee Brown, RN, MA, CCDS, CCS, CDIP, writes about the importance of tracking venous thromboembolism at hospitals and how to ensure physician documentation includes the correct level of detail to capture it.
The holidays can be a stressful time for coding departments, especially this year with the implementation of ICD-10. Raemarie Jimenez, CPC, CPMA, CPC-I, CANPC, CRHC, and Darice Grzybowski, MA, RHIA, FAHIMA, provide methods for HIM managers to keep coders engaged and productive this time of year and beyond.
Robert S. Gold, MD, reviews conditions such as sepsis, hypertension, and syncope and how the switch to ICD-10-CM clarifies reporting codes in some instances, while other issues from ICD-9-CM remain.
Q: We recently had attending physicians send back queries with responses by the physician assistant (PA) or nurse practitioner (NP) who documented for them. Is it acceptable for a PA or NP to answer queries after the patient is discharged?
ICD-10 implementation has gone smoothly for approximately 80% of attendees who responded to a survey during a recent webcast from audit, tax, and advisory firm KPMG.
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.
Coding for spinal arthrodesis procedures has always been a challenge given the complexity of these detailed surgeries. Coding them in ICD-10-PCS adds several elements that must be taken into consideration when looking to apply the proper code or codes.
The Hospital Readmissions Reduction Program (HRRP) is a CMS pay-for-performance program that links the amount hospitals are paid to risk-adjusted readmission rates. Measures included in the program are claims based, which simply means that the ICD-10 codes we submit on our claims for payment are also used to assess our performance; our performance then impacts our payment.
Provider-based clinics and departments are increasingly common, but the rules for provider-based billing can often be confusing, especially given recent changes to modifiers and place of service codes.
Providers need to be careful when reporting multiple services with status indicator J1 on the same claim, as NCCI logic could result in no payment for any of the reported comprehensive APC (C-APC) services.
Providers need to be careful when reporting multiple services with status indicator J1 on the same claim, as NCCI logic could result in no payment for any of the reported comprehensive APC (C-APC) services. Typically, when multiple J1 procedures or services appear on the same claim, the procedure with the highest rank according to CMS is assigned to the C-APC. Certain code combinations of J1 services will also lead to a complexity adjustment to a higher-paying C-APC.
CMS and Medicare Administrative Contractors are aware of certain issues regarding National Coverage Determinations and Local Coverage Determinations related to ICD-10 and working to resolve them as soon as possible, according to CMS.
Jugna Shah, MPH, and Valerie A. Rinkle, MPA, review newpolicies and regulations from CMS in the 2016 OPPS final rule, including a new comprehensive APC for observation.
