In ICD-10-PCS, coders assign the root operation bypass (third character 1) when the surgeon’s objective in the procedure is to reroute the contents of a tubular body part. Bypass procedures includes...
In the medical and surgical section of ICD-10-PCS, character 5 refers to the approach or method used to reach or expose a body part during a procedure. As a result, coders will need to look for...
CMS recently posted a file that identified duplicate codes within the ICD-9-CM and ICD-10-CM systems. The list isn’t terribly extensive, but in this atmosphere of transitioning from one system to the...
Looking for the 2012 ICD-10-CM code updates? Want to see what's included in the final regular update before implementation? Check the CMS’ ICD-10-CM and GEMS website. CMS posted the 2012 ICD-10-CM:...
Get ready to say goodbye to Coding Clinic for ICD-9 , and hello to Coding Clinic for ICD-10 . The AHA will cease publication of its ICD-9 guidance, but is already planning for an ICD-10-CM/PCS...
For those who work in environments where codes from category V57 (care involving use of rehabilitation procedures) are a staple, you be surprised to learn that when it comes to ICD-10-CM, all V57...
Late effects are considered to be the residual effects after the acute phase of an illness, disease, or injury. Typically, late effects are considered chronic conditions and can result from the...
CMS’ Office of E-Health Standards and Services (OESS) won’t enforce compliance with the HIPAA 5010 transaction set until March 31, 2012, the agency announced November 17 . The 90-day delay will not...
The American Medical Association (AMA) House of Delegates voted to “work vigorously to stop implementation of ICD-10” during the closing session of its semi-annual policy-making meeting November 15...
Coders are sharpening their knowledge of anatomy and physiology and honing their ICD-10-CM/PCS skills. The HIM department is getting ready for the transition, but did you remember to explain it to...
I had the opportunity to attend the American Health Information Management Association convention this year in Salt Lake City, and I helped work in HCPro's exhibitor booth. As a former HIM director...
Will the new ICD-10-CM concept of using seventh character code extensions to identify initial encounters vs. subsequent encounters cause additional confusion in relation to professional services, for...
Representatives from the American Hospital Association (AHA), the American Health Information Management Association, and the Centers for Disease Control and Prevention will discuss ICD-10...
As I continue to learn more and work with ICD-10-PCS codes, I find myself questioning the ancillary service codes in ICD-10-PCS. In my experience as an inpatient facility coder, I know that there are...
Coders will use the root operation division when the physician plans to cut into, transect, or otherwise separate all or a portion of a body part. Do not use division if the physician plans to cut or...
2013 is right around the corner. Learn how to kick start your hospital-wide ICD-10 educational plans. During this live 90–minute audio conference, our expert speakers will walk you through two...
As an AHIMA ICD-10 certified trainer, I have been doing a lot of work on various ICD-10 projects. When it comes to working with the new coding system, I find myself wondering whether the first ICD-10...
Coders should focus on chest pain, among other areas, as part of a larger review of ICD-9-CM codes and in preparing for ICD-10-CM. Coding chest pain in ICD-9-CM requires the physician to document the...
5010. That’s the cool way of saying Version 5010 of the Accredited Standards Committee (ASC) X12. It is the next version of the HIPAA electronic transaction standards that providers and all HIPAA...
Coders will find they need more information to select the appropriate code in chapter 13 (Diseases of the Musculoskeletal System and Connective Tissue [M00–M99]) of the ICD-10-CM Manual. Most of the...
Over the summer, I was in the process of going through the American Health Information Management Association Academy for ICD-10-CM for trainers. I had completed the online, self-paced part of the...
Another new term coders will need to know for ICD-10-PCS root operations is fragmentation. Fragmentation is breaking solid matter in the body into pieces. Note that in a fragmentation procedure, the...
When should a coder report multiple procedures performed during a single operative session in ICD-10-PCS? Look to the official guidelines for information. According to the guidelines, coders should...
These days it seems like a new ICD-10 tool is waiting for you around every corner. Be sure to periodically check different organization's websites, as many of them are constantly updating information...
Do you remember the Y2K scare? Vendors and information technology staff were entranced with making upgrades to computers and information systems months in advance to make sure that the internal...
Some of the removal root operations can easily be confused with other root operations that involve taking out solids, fluids, or gases from a body part (e.g., drainage, extirpation, and fragmentation...
The CDC updated the terminology used to describe asthma in ICD-10-CM to reflect the current clinical classification of asthma. In ICD-9-CM, asthma is described as extrinsic or intrinsic. In ICD-10-CM...
Given the many differences between the ICD-9-CM and ICD-10-CM/PCS system and the thousands of new codes that will be used, all skilled-nursing facility (SNF) and homecare agency staff members...
A step-by-step approach to code assignment is helpful when trying to understand the complexity of ICD-10-PCS. Step one: Determine the first character, which denotes the general category of the...
When I hear "YouTube," I think of video clips of babbling babies, stupid pet tricks, and “don’t try this at home” stunts. But did you know that CMS is now on YouTube? Who’d a thunk it! They even have...
I’m not really crazy about the title of this blog post, but that’s how the adage goes. Once you get used to something, like ICD-9-CM for example, change is met with resistance. I don’t want to think...
When we think of all of the steps we have to take to get ready for ICD-10 implementation, missing one step in the planning process could cause chaos in your facility. Don’t forget about 5010! Your...
If an excision involves cutting out a portion of a body part, and a resection involves cutting out all of a body part, what then is an extraction? According to the ICD-10-PCS guidelines, an...
Will physician documentation be specific enough so coders can select the most appropriate code in ICD-10-CM/PCS or will coders be defaulting to unspecified codes? For starters, don't dwell on details...
With ICD-10-PCS, coders will have 31 root operations to choose from and not all of them are clear cut. Start learning the root operations now to prepare you for the switch to ICD-10-PCS. The ICD-10-...
One of the things that has concerned me about ICD-10-CM is the lack of guidance regarding sequencing. Since the American Hospital Association announced that it would not be converting Coding Clinic...
If you haven’t already done so, now is a good time to look at your system capabilities and see what you need to update or upgrade before the transitions to HIPAA Version 5010 and ICD-10-CM/PCS. Start...
As a kid, do you remember playing the game where you sat round in a circle and one person whispered a phrase in the ear of the person sitting next to them, and that person passed it along until...
CMS created the following four podcasts based on the January 12 national provider call, “Preparing for ICD-10 Implementation in 2011:” Welcome and ICD-10 Overview Implementation Strategies for 2011...
So the transition to ICD-10-CM/PCS is still more than two years away, and it’s too early to start learning actual codes. But you can start reviewing some of the major concepts of ICD-10-CM/PCS with...
ICD-10-PCS codes include one digit for the root operation that the provider performs. The root operation is always the third character is the seven-character code. The definitions of these root...
Well, CMS apparently wants to make sure everyone tests the HIPAA Version 5010 transaction sets. CMS previously announced two national testing days, and is adding 5010 testing week. CMS scheduled 5010...
CMS recently posted the 2012 ICD-10-PCS codes and coding guidelines . A summary of the major changes for 2012 states that there are 1,182 new codes, 381 revised titles, and 1,345 deleted codes. In...
You’ve probably heard that it’s too early to start learning ICD-10-CM/PCS codes. After all, the codes are still in draft format. However, it’s not too early to start learning the root operations for...
With 2013 seemingly so far away, many post-acute care organizations, including long-term care facilities, homecare agencies, and hospices, have not started their ICD-10 coding training. Many want to...
The complexity and costs of the switch to IDC-10-CM/PCS will vary by the size of the organization. A large, multi-facility health system needs to review more areas and plan more changes than a five-...
I attended the live portion of the American Health Information Management Association ICD-10-CM training in Baltimore last week. It is definitely not for the faint-hearted! It was a good overview...
As I look at the ICD-10-CM codes and take into consideration some of the possible documentation issues we might face, one of the questions that comes to mind is are we actually taking a step backward...
General Equivalency Mappings (GEMs) are crosswalks between ICD-9-CM and ICD-10-CM codes. They are a helpful way to start looking for a code when you move from ICD-9-CM to ICD-10-CM. But GEMs are not...
Right now only one in five hospital claims is fully paid without a payer request for more information, according to a RAND Corporation report. With the upcoming transition to ICD-10-CM/PCS, providers...
One of the things that I like about the ICD-10-CM manual is use of the vertical gray bars in the Volume II “Alphabetical Listing for Diseases.” This greatly enhances the ability to see how far the...
Certification in this day and age has become a vital part of obtaining and proving proficiency in coding and other related fields. Many years ago, coders did not have to be certified to secure...
Just when I thought that ICD-10 would resolve those annoying coding guideline and definition inconsistencies, I have discovered that some will still exist in ICD-10, too. Oh no—say it ain’t so! The...
Small rural facilities that haven’t yet started planning for ICD-10-CM/PCS shouldn’t panic yet, but they also shouldn’t delay much longer, says Jeff Wieters, RHIA, senior technical advisory...
I have been doing this workout program called P90X. It’s a challenge, and I’m not nearly as faithful to it as I should be. There is one segment called “Ab Ripper X,” during which our fearless leader...
CMS will host a national provider teleconference, "CMS ICD-10 Conversion Activities," on May 18, 1 - 2:30 p.m. EST. Presenters will discuss the ICD-10 conversion process currently taking place within...
When teaching ICD-9-CM coding, I often use a little ditty, “sprains and strains are the same,” to remind myself that when a physician documents “strain,” I need to start with the main term of “sprain...
Many of the speakers at the AHIMA’s ICD-10 Summit April 11-12 in Baltimore stressed the importance of working together. Physicians, coders, and information technology folks all need to work together...
Getting clinicians onboard and trained for the transition to ICD-10-CM/PCS will be one of the biggest challenges for most facilities, according to Patricia A.C. Hildebrand, MSN, RN, AHIMA-approved...
Coding productivity will decrease at least initially with the switch to ICD-10-CM/PCS. But do you know how productive your coders are now? If the answer is no, consider following the example of Mary...
As most people in the healthcare industry know, the conversion to ICD-10-CM/PCS isn’t the only initiative organizations are trying to implement. So where does the ICD-10 conversion fit within your...
When it comes to training staff members for the upcoming transition to ICD-10-CM/PCS, not everyone has the same needs or characteristics. They don’t even belong to the same group of shareholders...
The current versions of the X12 Version 4010/4010A1 transaction standards lack certain functionality that are pertinent to the healthcare industry. By now, health plans, healthcare clearinghouses,...
Coders are discussing whether they need to be trained in ICD-10-CM only or should they also receive training in ICD-10-PCS. Well, the answer may depend on what setting you are currently employed in,...
One of the things I have always liked about ICD-9-CM is that no matter how poor the documentation, if a code requires a fourth and/or fifth digit the manual always gives what I call the “out” by...
The 2011 ICD-10-CM Official Guidelines include several changes relating to the correct coding for neoplasms. Chapter 2 of the ICD-10-CM contains the codes for most benign and all malignant neoplasms...
I saw a question posted recently regarding the inclusion or exclusion of Workers Comp, property, casualty, and auto under the CMS mandate to implement ICD-10. My first reaction was why wouldn’t they...
HCPro is conducting research into how organizations are assessing their ICD-10 readiness. Click the link below to participate. http://www.zoomerang.com/Survey/WEB22C5AE44S33/
The American Health Information Management Association (AHIMA) recently posted on its ICD-10 webpage a Top 10 List: Phase One . In early 2011, Phase I (first quarter 2009–second quarter 2011) of the...
ICD-10-CM/PCS now has guidelines for reporting conditions that are present on admission (POA). As part of the 2011 guidelines updates, CMS and the National Center for Health Statistics added Appendix...
As we work toward the implementation of ICD-10 in 2013, strategic opportunities for change abound. Remember all those items that have remained static on your operational wish list? Perhaps you can...
As a regulatory specialist, I find myself asking my students, fellow coders, and other colleagues (e.g., clinical documentation improvement specialists) where they are in terms of preparation for ICD...
The Centers for Disease Control (CDC) posted the new 2011 guidelines for ICD-10-CM on its website. You won’t find many significant changes to conventions, general coding guidelines, and chapter...
CMS has posted two new frequently asked questions (FAQs) about ICD-10 national provider teleconferences and the partial code freeze. To access these FAQs, please visit the CMS ICD-10 webpage , click...
Before you can think about implementing ICD-10, you need to be sure your numerous Hospital Information Systems (HIS) and Practice Management Systems (PMS) are upgraded for the change. It can be a...
As many of you know, before we switch to ICD-10-CM/PCS, we first will be transitioning to HIPAA Version 5010. In fact, that date is less than one year away. By January 1, 2012, providers need to be...
This series of entries will not follow a random bi-weekly topic but will focus on the chronological transition to ICD-10 readiness. My intent is to dispel myths and compare real-world experience in...
CMS recently posted agendas for what will be the last ICD-9-CM Coordination & Maintenance Committee meeting to address code updates for ICD-9 and ICD-10 before the partial code freeze is...
A common question I have been asked lately is whether coders should receive ICD-10 training now, or should they wait until much closer to the implementation date of October 1, 2013? Comments by some...
I was talking with a friend of mine recently about the transition to ICD-10. He is a very good doctor who prefers to leave the “administrative details” to his capable office manager. Although he...
In previous versions of the ICD-10-CM Draft Manual , we were all under the impression that certain conditions, such as malignant versus benign hypertension and uncontrolled versus not stated as...
CMS included nine topics related to ICD-10-CM/PCS on its tentative agenda for the ICD-9-CM Coordination and Maintenance Committee meeting March 9-10. This is the final meeting to address ICD-9-CM and...
So you still think you have plenty of time before the switch to ICD-10-CM/PCS happens, right? After all it’s still too early to start learning the codes. But what have you done to prepare? According...
Physicians who are part of a practice do go to the hospital to deliver babies, provide consults, and perform surgeries. So does that mean coders in a physician’s office will need to learn ICD-10-PCS...
We should all be in the middle of our plans to transition from ICD-9-CM to ICD-10-CM and ICD-10-PCS. From planning and budgeting to training and auditing to process and technology changes, the...
I know there are some of you out there who missed the recent CMS national provider call. For anyone looking to catch up on this recent information session, CMS posted to its ICD-10 webpage a...
You can expect ICD-10 updates to follow the same timeline that you are already accustomed to for ICD-9—almost. An ICD-9-CM Coordination and Maintenance Committee Meeting was held September 15-16,...
When coders are looking at scenarios in ICD-10-CM/PCS, where the X is located within the code matters. When X is in the fifth and/or sixth character, X is a placeholder. ICD-10-CM codes can be up to...
As many may be aware, laterality has been added in ICD-10-CM to increase specificity. Codes assigned for conditions such as fractures, burns, and pressure ulcers will indicate right side versus left...
On November 23, 2010, the North Carolina Healthcare Information & Communications Alliance (NCHICA) and the Workgroup for Electronic Data Interchange (WEDI) published what they call an "...
Can’t wait to learn more about ICD-10? Want to get some basic training and experience in using ICD-10? Not enough money in the budget to go get training? Take a look at the World Health Organization’...
CMS will host a national provider teleconference January 12 at 1 p.m. that will focus on ICD-10 implementation in 2011. CMS representatives will discuss implementation strategies for this year...
As the New Year starts, where are you at in terms of your ICD-10 implementation plans? This might be a good time to sit down and identify any gaps in your preparation to ensure a smooth transition to...
Expert predictions for industry costs for the upcoming move to ICD-10-CM/PCS vary from $6 billion to $14 billion (Robert E. Nolan Company), to $1.15 billion (RAND Corporation). Regardless of where...
CMS has released the 2011 versions of the ICD-10-CM/PCS crosswalks, also known as the General Equivalence Mappings (GEM) on its ICD-10 website . In addition, CMS also posted a document titled “ICD-10...
It may come as a surprise, but CMS has an excellent website to help with the transitions to 5010 and ICD-10. This site is actually easy to use and fairly comprehensive compared to some of their...
ICD-10. The biggest change to happen in health information management in more than 20 years is on your doorstep. You’ll need a step-by-step plan to educate and train staff across multiple departments...
At the annual American Health Information Management Association's (AHIMA) convention in September, AHIMA practice resources managers Kathy DeVault, RHIA, CCS, CCS-P, and Ann Zeisset, RHIT, CCS, CCS-...
One of the challenges in ICD-9 is teaching the difference between coding for adverse effects and poisonings. You have to understand the difference between the two, and you have to also understand the...
The meanings of the seventh character for ICD-10-CM codes vary across chapters and categories. Fracture codes include additional information that can be provided by the extension. When coding for a...
