The second quarter edition of Coding Clinic included questions and answers for coding very specific situations not easily found using the Alphabetic Index. Review some of the noteworthy scenarios.
Practices turned to two of the X-series modifiers in place of modifier -59 (Distinct procedural service) more than 7 million times in 2023 and saw mixed results with denial rates on the top-billed codes.
With advancements in artificial intelligence (AI) and augmented intelligence enabled healthcare, the American Medical Association provided guidance outlined in Appendix S taxonomy for describing and classifying various AI applications. This article will help coders understand the AI taxonomy.
Reporting aneurysm repairs can appear almost as complex as the procedure itself. However, Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , shows how taking it one character at a time and using the helpful guidelines and descriptors provided within ICD-10-PCS will allow coders to master this accurately and quickly.
Our experts answer questions on organizing clinical validation queries, the difficulty of diagnosing skin failures, and establishing an organizational definition of sepsis.
We are just entering summertime and meteorologists are already warning about increased heat indexes all over the country. Staying hydrated is important advice because serious maladies can take place when the body becomes dehydrated.
With its enhanced specificity and comprehensive structure, ICD-11 offers a more detailed and accurate framework for documenting cancer diagnoses. Karla VonEschen, MS, CCDS-O, CPC, CPMA , explores how precise documentation and the coder’s ability to capture all the diagnosis codes to fully describe the condition will be crucial for healthcare organizations.
Alba Kuqi, MD, MSHIM, CDIP, CCS, CCDS, CRCR, CICA, CSMC, RHIA, CCM , walks through the evolution of sepsis definitions that reflect the growing sophistication in our understanding of how the body responds to infection. Understanding the history not only helps contextualize definition variations in provider documentation but also has important implications for coding and reimbursement.
Our experts answer questions about medical decision-making, locating procedure codes, and coding a revision of a unicompartmental knee arthroplasty to a total knee arthroplasty.
Review the FY 2026 ICD-10-CM tabular addenda for codes that you regularly report so you don’t miss additional information that can augment coding through more guidance or alert you to potential pitfalls.
Pain management providers primarily perform radiology services from the diagnostic imaging and radiologic guidance sections of the CPT code book, so specialty coders must know when these services can be separately reported and their documentation requirements. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
We are just entering summertime and meteorologists are already warning about increased heat indexes all over the country. Staying hydrated is important advice because serious maladies can take place when the body becomes dehydrated.
Make sure you incorporate current CMS coding guidance for three preventive services into your workflow and check for denials that might be candidates for an appeal. Review the latest rules for HIV PrEP, hepatitis vaccine, and CRC screens.
ICD-10-CM codes for Parkinson’s disease differ based on the primary neurologic diagnosis and any complications or comorbidities involved, as PD can manifest in various forms, each with unique characteristics.
CMS recently announced plans to enhance its auditing efforts for Medicare Advantage plans by increasing the number of audits it conducts and expanding its team of medical coders.
While much of the focus on AI implementation in HIM centers around billing and coding for operational efficiency and error reduction, its value extends far beyond those boundaries. Looking ahead, the stakes involve deeper questions about how automation might ultimately influence clinical decision-making.
Differentiating between acute kidney injury and acute tubular necrosis is particularly critical due to their implications on medical complexity and coding classification, so Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP , explores the clinical foundation and diagnostic criteria of AKI and ATN, emphasizing their distinctions and significance for clinical documentation integrity and accurate ICD-10-CM coding.