We’ve come to the end of another year filled with ICD-10 in the spotlight, for good and bad reasons. First the bad—we’re still waiting to implement ICD-10. We thought we were all set for October 1,...
On the 12th day of Christmas my true love gave to me 12 drummers drumming and the noise is unbelievable. I’ve got a migraine. I didn’t see any lights or odd visual disturbances beforehand, so this is...
On the 11th day of Christmas my true love gave to me 11 pipers piping. You know that saying about being careful what you wish for? It’s very true. I jokingly told my true love we needed musicians for...
On the 10th day of Christmas my true love gave to me 10 lords a-leaping. My house isn’t big enough for all of these dancers. Several of them mistimed their leaps and collided midair and they’re down...
On the ninth day of Christmas my true love gave to me nine ladies dancing. Um, ladies, this isn’t Radio City Music Hall. Please watch where you’re kicking. Don’t look now, but Great Aunt Edna has...
On the eighth day of Christmas my true love gave to me eight maids a-milking. Why, exactly, has a herd of cows taken up residence in my backyard, True Love? What are we going to do with them and more...
On the seventh day of Christmas my true love gave to me seven swans a-swimming. To be completely accurate, he took a group of us on a road trip to a pond where the swans swam in blissful ignorance of...
On the sixth day of Christmas my true love gave to me six geese a-laying. My favorite Uncle Ted was so excited about this gift that he rushed right over to relieve those geese of their eggs. Bad idea...
On the fifth day of Christmas my true love gave to me five golden rings. Hey wait, there are only four rings here. Where did the other one go? Oh no, little Andrew shoved it up his nose. Time to...
On the fourth day of Christmas my true love gave to me four calling birds. I’m starting to think he raided a pet shop. Or maybe he captured these in the park. He says they’re calling birds. They look...
On the third day of Christmas my true love gave to me, three French hens. Awesome, more birds. My house is starting to look like an aviary. I’m also not sure why my true love thought it necessary to...
On the second day of Christmas my true love gave to me, two turtle doves. Hmm, you think he would have learned his lesson with the partridge. Apparently not. And apparently Mr. Whiskers isn’t hungry...
On the first day of Christmas, my true love gave to me, a partridge in a pear tree. How…nice. Fortunately, the tree is way too big for the living room (it also clashes with my real Christmas tree)...
Usually in this blog, I talk about ICD-10 implementation and coding from the coder or HIM point of view. But I wanted to share some suggestions from James S. Kennedy, MD, CCS, CDIP, president of...
Poor Finn. He’s heading for his first birthday, but he may not be in a partying mood. After Finn developed his fifth ear infection in six months, mom Melissa decided it was time to put tubes in his...
I’m almost afraid to read my email these days. It seems like every day brings a new group trying to delay ICD-10 or another piece of legislation that ICD-10 opponents might slip delay language into...
We’ve survived the holiday feast and decided to skip the doorbusting to head out and visit the cute and fluffy animals at the Anytown Zoo. Of course, no outing would be complete without some injuries...
Tom Turkey has come in to the Stitch ‘Em Up Hospital for a little work before Thanksgiving. Dr. Carver is going to first take out Tom’s guts, then replace them with stuffing. How would we code Tom’s...
In its November issue, the Journal of AHIMA published an article citing significantly lower costs for physician practices to transition to ICD-10 than the numbers supplied by Nachimson Advisors in a...
Oh, that Jose Canseco. Such a kidder. Turns out, his claim that his finger fell off during a poker game was a joke. He did actually shoot part of it off “cleaning” his gun and did indeed have it...
Baseball fans may remember Jose Canseco as part of the Oakland A’s slugging duo, the Bash Brothers. He made a lot of money hitting the ball very, very far. I hope he saved some for his medical bills...
As healthcare professionals, we’re all familiar to some degree with HIPAA. You know, the law that makes it illegal to release protected health information, among other things. Hospital employees have...
One of the biggest stumbling blocks for ICD-10 implementation by small physician practices was the estimated cost of the transition. Those costs may not be as high as originally estimated, according...
Ever play with a Magic 8 Ball? (If not, there’s an app for that.) Ask it a question, shake it up, and get an answer. Usually something vague (and vaguely ominous) like, “Reply hazy try again.” Asking...
You may have noticed that the ICD-10 manuals have the word “draft” splashed all over them. (If you have an actual paper ICD-10 manual that is. The PDFs don’t include the word draft.) I had someone...
Welcome to OR 13 at the Stitch ‘Em Up Hospital, where Dr. Hack N. Slash is preparing for today’s procedure. And what is today’s procedure? Dr. Slash is performing a cut down and suturing of a...
Gerri Walk, senior manager of technical training for HRS in Baltimore, had the absolute best reason for learning to code in ICD-10. During the 2013 AHIMA National Conference in Atlanta, Gerri...
Ghosties and ghoulies and long-legged beasties are parading through the Fix ‘Em Up Clinic. It must be Halloween and the staff Halloween party. Even the best planned Halloween party can go astray (...
Once upon a midnight dreary, as I labored on a query To send to the doc whose documentation was a source of constant woe As I nodded, nearly napping (that darn G47.411 again) Suddenly there came a...
Ewww, I don’t think so. Your feet stink. What could be causing that foul odor to emanate from your feet? The most common cause is sweat. Just sniff your old gym sneakers and you’ll see what I mean...
When coders run into a tough coding question, they often look for guidance in the AHA’s Coding Clinic . Coding Clinic is a resource, but it’s not always the final word. The AHA publishes Coding...
Poor Mr. Frank N. Stein. He just coughed up a lung. Literally. While it is possible to survive on one lung, it’s generally not recommended, so Frank is here at the Stitch ‘Em Up Hospital to get a new...
If I hear one more person poke fun at ICD-10-CM code V97.33XD (sucked into a jet engine, subsequent encounter), I am going to develop a very strong case of R45.850. (That’s homicidal ideation in case...
If you are a fan of American Horror Story (I’m not) or carnival sideshows (again, not my thing, but I’m not judging), you’ve seen some odd creatures. Maybe you’ve wondered if they are real. After all...
You’ve probably heard that you need to beef up your clinical knowledge for ICD-10-CM and ICD-10-PCS coding. And you’re probably wondering when you have time to do that. We’re here to help. We’ve...
Jeff, an 18-year-old male, came into the Fix ‘Em Up Clinic with complete left oculomotor palsy. Jeff stated he had a severe, throbbing headache around his eye yesterday. He took some aspirin and went...
Saturday marks the 165th anniversary of the death of Edgar Allan Poe, but sadly, we’re still not sure of the cause of Poe’s demise. We do, however, have plenty of theories. First is the popular “he...
Today we’re going to look at a real-life injury, but I will say up front that I don’t have all of the information about this particular patient’s injuries. F1 racecar driver Jules Bianchi was...
The Workgroup for Electronic Data Interchange’s (WEDI) most recent survey on ICD-10 readiness included a particularly alarming (at least to me) statistic: Approximately 25% of the 324 providers who...
We’re still living under a code freeze as we (eagerly) await ICD-10 implementation. However, the four Cooperating Parties are still tweaking the ICD-10-CM guidelines. Both the Centers for Disease...
I don’t know about you, but I’m starting to feel a little like Chicken Little, yelling, “ICD-10 is coming!” instead of “The sky is falling!” And we’re all probably being met with the same polite (or...
Coders and clinical documentation improvement (CDI) specialists have different perspectives and priorities even on common diagnoses. HCPro boot camp instructors Shannon E. McCall, RHIA, CCS, CCS-P,...
With flu season just around the corner (hey, where did summer go?), Melissa took her 4-year-old son Andrew to Dr. Spock, the pediatrician, for his flu shot Wednesday. With a minimum of fuss (and a...
Some days I swear I have the attention span of a hyperactive hummingbird or Dug the talking dog from the movie “Up.” Maybe what I really have is attention deficit disorder (ADD). How would you code...
CMS is currently hosting an ICD-10 "Code-a-thon" (a title which instantly brings to mind all of the PBS pledge drives I’ve unwittingly watched). One of the questions that has come up repeatedly is...
Ebola has been in the news quite a bit recently and it’s actually a good global case study for why we should be using ICD-10-CM codes. ICD-9-CM does not include a specific code for Ebola. It gets...
CDI programs are essential to an organization’s efforts to move forward with ICD-10 implementation and training. Join us at 1 p.m. September 10 for the live 90-minute webinar, Dual Coding/CDI:...
The truth is often stranger than fiction because fiction has to make sense. Apparently a panda in China figured out that pregnant pandas get better treatment, so she pretended to be expecting ...
Labor Day marks the unofficial end of summer, and hopefully, the end of patients with picnic-induced problems at the Fix ‘Em Up Clinic. The first patient in on this Tuesday after Labor Day is Sam...
Summer is almost over, and so are the summer road trips. Clark, for one, will be very happy about that. Clark and his family just returned from a week-long road trip across the country with some...
The ICD-10 transition has been nothing if not contentious. We’ve had delays mandated by both CMS and Congress, as well as ongoing attempts by the AMA to kill ICD-10 altogether. Another discordant...
ICD-10-PCS requires coders to possess strong clinical knowledge as well as a solid foundation in anatomy and physiology. Coders need to understand what physicians are actually doing in certain...
We hear a lot about the projected productivity declines after ICD-10 implementation. And coders will be less productive initially. That only makes sense because ICD-10 is new, coders will need to...
What constitutes good documentation? The next physician treating the patient should be able to pick up the medical record and know exactly what happened in the previous encounter. How often does this...
LOL BTW K+ BP↑ It’s a texting world, and more and more we use shorthand in our everyday lives. What about shorthand in a medical record? Can you code from it? First, let’s look at what kind of...
Take it from today’s victims, er, patients, at the Fix ‘Em Up Clinic: not every idea is a good idea. First in today is Jeff. He took part in a s’more eating contest at camp last night. I’ve...
ICD-10-CM includes 68,000 codes and ICD-10-PCS features 71,924 code choices. Scary numbers, right? Not according to Sue Bowman, RHIA, CCS, senior director of coding policy and compliance for AHIMA in...
The new ICD-10 implementation date gives us more than a year to finish preparing for the big transition. So why learn about how to code diabetes in ICD-10-CM now? “It’s never too early to start...
Well, we once again have an official ICD-10 implementation date. HHS released a display copy of Administrative Simplification: Change to the Compliance Date for the International Classification of...
We were expecting October 1, 2015, to be the new ICD-10 compliance date and CMS made it official with the release of a final rule, Administrative Simplification: Change to the Compliance Date for the...
Ah, the joys of camping. The fresh air, the beautiful scenery, the friendly forest creatures. Sounds like a great way to escape from the urban jungle and the daily grind. Nice in theory, not so nice...
Inpatient coders and clinical documentation improvement specialists are very familiar with CCs and MCCs. After all, they help determine the MS-DRG assignment for a particular inpatient stay. ICD-10-...
Put on your deerstalker hat and grab your magnifying glass. It’s time to do our best Sherlock Holmes impersonation. We just received a chart from Dr. Doolittle and we need to code the procedure...
Julie comes into the Fix ‘Em Up Clinic with a seriously broken arm. Her son Jay left his toy fire engine on the stairs and Julie tripped over it. She threw her arms out to brace her fall. And then...
Have you started dual coding for ICD-9 and ICD-10? Two facilities shared their experiences today during the AHA’s webinar, Lessons Learned on Dual Coding–A Provider’s View. The first thing you need...
It turns out that not all eponyms are going away in ICD-10-PCS. The Alphabetic Index still includes an entry for a Roux-en-Y operation. The entry directs you to see bypass of the gastrointestinal...
Holly spent the weekend hanging out at the beach, enjoying the sun. The sand was so warm that she slipped off her shoes to stroll near the water. And disturbed a crab in the process. The crustacean,...
A lot of people are starting their Fourth of July celebrations early. At least it seems that way at the Fix ‘Em Up Clinic. Shannon took her dog Damian to the park to watch some fireworks last night...
Go to your local bookstore, pick up a copy of Gray’s Anatomy (the book, not the television show), and flip though the illustrations. Alternately, you can Google “Gray’s anatomy illustrations.” They...
CMS and Obamacare have increasingly been moving healthcare toward a more value-based model. They want to pay physicians for how well they treat patients and not by the volume of services they provide...
More healthcare providers would have been ready for an October 1, 2014 ICD-10 implementation date than people may have realized, according to a survey by Edifecs, eHealth Initiative (eHI) and AHIMA...
Composers lead pretty safe lives, right? They compose music, conduct the symphony, and hang out at post-show parties. And we’re not talking rock star parties. Sometimes, though, that job isn’t so...
Poor Finn is having a rough week. It started out well as he spent Sunday with his folks and older brother at an amusement park being as amused as a 6-month-old can be. Things started going downhill...
Jeff comes in to the Fix ‘Em Up Clinic complaining of shortness of breath, a persistent cough, tightness in his chest, and frequent respiratory infections. He tells Nurse Nosey that he smokes a pack...
Dodge ball is not a game for wimps or the uncoordinated. Even master ball dodgers can end up in the Fix ‘Em Up Clinic. Steve engaged in a spirited game of dodge ball over the weekend, which resulted...
What do you get when you combine a full moon and Friday the 13th? Some really odd injuries at the Fix ‘Em Up Clinic. Fortunately, we here at the clinic suffer from neither paraskevidekatriaphobia (...
I recently spoke with Barbara Hinkle-Azzara, RHIA , vice president of HIM operations for HRS Coding in Baltimore about preparing for ICD-10 and, more specifically, about the anticipated MS-DRG...
A patient comes into the ED following an automobile accident. The physician documents that the patient has an open, displaced fracture of the lateral condyle of the right tibia. The physician also...
We all know that ICD-10 codes will require more complete documentation. We’ve been telling physicians that, but maybe we’re not explaining it well or correctly. What makes documentation better? It’s...
If you’ve glanced through the ICD-10-CM Manual, you likely noticed all of the codes for fractures, strains, and dislocations. We’re going to have a lot more choices in ICD-10-CM, which means we’re...
Ah, Memorial Day, the unofficial start of summer. And the day after Memorial Day is the unofficial start of summer injury season at Fix ’Em Up Clinic. Jackee took advantage of the long weekend by...
We won’t need to learn any new ICD-10-PCS codes or guidelines for 2015. CMS released the draft codes and guidelines and they include not much of anything. That’s not really a surprise since the code...
Recently I have seen many articles casting a negative outlook on ICD-10. They scare everyone into believing that added specificity to the codes will create more work for everyone, especially the...
I’m going to pick on our friends from the Association of Clinical Documentation Improvement Specialists for one more day because I’ve heard some really good stories about the doings in Las Vegas last...
Our friends from the Association of Clinical Documentation Improvement Specialists came back from the desert with some minor maladies. Apparently everything that happens in Vegas doesn’t stay in...
We’re still waiting for CMS to release the interim final rule on the new ICD-10 implementation date, but we did get some news on the ICD-10 front this week. The Office of Budget and Management...
Today I will focus on the chronological transition to ICD-10 readiness. My intent is to dispel myths and compare real-world experience in the ICD-10 planning space with the commonly disseminated...
Our good friends at the Association of Clinical Documentation Improvement Specialists (ACDIS) have descended on Sin City for the seventh annual ACDIS conference. And while what happens in Vegas might...
One day after an apparent stealth announcement of the new ICD-10 compliance date, CMS confirmed October 1, 2015, as the new implementation date. According to a CMS statement: On April 1, 2014, the...
We may have a new ICD-10 implementation date…or maybe not. In the IPPS proposed rule , released April 30, CMS states on page 648, “The ICD-10-CM/PCS transition is scheduled to take place on October 1...
During AHIMA’s two-day ICD-10-CM/PCS and Computer-Assisted Coding Summit April 22-23, AHIMA ran some real-time polls with attendees texting in their responses. The results of the polls provide some...
Some body parts just need a little reinforcement. Or maybe a little augmentation. Use root operation Supplement (third character U) to report procedures that involve putting in or on biological or...
Rose Dunn, MBA, RHIA, CPA, CHPS, FACHE, FAHIMA, chief operating officer of First Class Solutions, started the second day of the AHIMA ICD-10 and CAC Summit with a rundown of ways HIM professionals...
The first day of AHIMA’s ICD-10 and CAC Summit is in the books and although attendance is down this year, the speakers have provided some good food for thought. Here are some briefs highlights from...
Don’t blame the AMA for the most recent ICD-10 delay, says Steven Stack, MD , immediate past chair of the AMA Board of Trustees. Stack gave the keynote address at the AHIMA ICD-10 and CAC Summit in...
Coding for pressure ulcers in ICD-10-CM requires precise documentation of the ulcer’s location, which really shouldn’t surprise anyone. ICD-10-CM includes increased specificity for almost every...
Here comes Peter Cottontail, hopping down the bunny trail—and right into a gopher hole. Stupid rodents. Poor Peter limped his way into the Fix ‘Em Up Clinic to see Dr. Hop A. Long for an initial...
A patient undergoes a hysterectomy and experiences post-procedural bleeding. The surgeon cauterizes the bleed and evacuates a blood clot. In ICD-10-PCS, how do you code the cauterization? With the...
Don’t look now, but mumps are making a comeback . How do we code mumps in ICD-10-CM? Pretty much the same way we code them in ICD-9-CM. The codes just look a little different. In ICD-10-CM, we can...
