ICD codes are the ultimate source of information for the healthcare industry. Coders in every setting-inpatient, outpatient, and physician services-report the exact same ICD codes to describe a patient's condition.
Our experts answer questions about NCCI edits for injections, modifier -25, modifier -59, laminotomy with insertion of Coflex distraction device, billing mammogram for needle placement, and auditing electronic orders.
CMS released its FY 2014 IPPS final rule in August, and with it comes a whole slew of changes for inpatient hospitals. Set aside a good amount of time to scroll through the 2,000-plus page document. Yes, that's right: There are more than 2,000 pages of information to absorb before the rule goes into effect on October 1, 2013.
CMS announced that it is postponing the eHealth Provider Webinar on ICD-10 compliance that was scheduled for October 1. CMS has not announced a reschedule date.
My head is going to explode. This is seriously epic, end of the world pain. It’s a 20 on the pain scale. It wouldn’t be so bad if I didn’t also feel like I was going to throw up. And the light is...
Acute kidney injury (AKI) is an abrupt decrease in kidney function that includes—but is not limited to—acute renal failure. Garry L. Huff, MD, CCS, CCDS , and Brandy Kline, RHIA, CCS, CCS-P, CCDS , explain the clinical indicators of AKI and offers tips for composing queries.
Q: A patient presents with altered mental status/encephalopathy due to a urinary tract infection (UTI). The patient has a history of dementia. The final diagnosis is encephalopathy due to UTI. Should we code the encephalopathy as a secondary diagnosis because it’s an MCC and not always a symptom of a UTI?
The best way to decrease denials or increase overturn rates begins with a compliant concurrent review of documentation. Marilyn S. Palmer, DO, and Jonathan G. Wiik, MSHA, MBA, review common Recovery Audit targets and provide tips for successfully appealing denials.
Hospitals are being incorrectly reimbursed for preadmission testing that occurs within the three days prior to admission, according to Recovery Audit findings.
ICD-10-CM and ICD-10-PCS present different challenges, but both will require better documentation. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, Kathy DeVault, RHIA, CCS, CCS-P, Donielle Bailey , and Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, discuss some of the areas where coders will need more information to code in ICD-10.
Ears are moving up in ICD-10-CM. In ICD-9-CM, they have to share space with the eyes. In ICD-10-CM, they get their own chapter. They also get a lot more codes. Fortunately, many of those additional...
We have just a little over a year remaining until ICD-10 implementation. How well do you know your ICD-10-PCS codes? ICD-10-CM shares a lot of similarities with ICD-9-CM. Sadly, ICD-9-CM procedure...
Modifiers are sometimes essential to ensure proper payment, but choosing the correct one can be tricky. Sarah L. Goodman, MBA, CHCAF, CPC-H, CCP, FCS; Katherine Abel, CPC, CPMA, CEMC, CPC-I; and Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, discusssome confusing modifiers and how to use them accurately.
Some providers are billing only add-on codes without their respective primary codes, resulting in overpayments, according to CMS. Add-on codes billed without their primary codes are considered an overpayment, with one exception.
CMS’ proposed 2014 OPPS rule is set to introduce many changes, such as more packaged services, including lab tests and add-on codes. Jugna Shah, MPH; Dave Fee, MBA; Kimberly Anderwood Hoy, JD, CPC; and Valerie A. Rinkle, MPA, offer their insight on what effect these changes could have for providers.
Q: A patient comes into the ED with chest pain. An EKG (CPT® code 93005) is performed. The patient goes directly to the catheterization lab for catheterization (code 93454). Is a modifier appropriate for the EKG?
Coding may not be brain surgery, but understanding brain anatomy can greatly help coders when reporting head injuries or disorders. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, reviews some major components of brain anatomy and the impact of ICD-10-CM on coding for some common diagnoses.
Last week, we looked at some strange causes of death in the ancient world and their associated ICD-10-CM codes. Let’s fast-forward to some odd Dark Ages deaths and see if we can code them. Some...
Death smiles at us all. All a man can do is smile back. (Kudos if you know I appropriated that from the movie Gladiator .) History is full of weird circumstances and odd injuries that lead to death...
