Coding Clinic won't be updating its ICD-9-CM guidance for ICD-10-CM, but that doesn't mean none of the previous answers will be applicable in the new code set. Nelly Leon-Chisen, RHIA, Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I, and Anita Rapier, RHIT, CCS, review various tricky coding situations that can be resolved now, ahead of implementation.
Our friends at the Association of Clinical Documentation Improvement Specialists are putting the final touches on their conference preparations. They have sent off the final shipment to San Antonio (...
We love surveys, especially about ICD-10. Seriously, how many ICD-10 surveys have you been asked to fill out in the past year alone? It’s very easy to look at survey results and think things look...
As coders have prepared for ICD-10-CM, they have raised questions about how to select the correct seventh character. Nelly Leon-Chisen, RHIA, and Jennifer E. Avery, CCS, CPC-H, CPC, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer, offer tips for determining the correct seventh character.
If nothing else, Rep. Ted Poe, R-Texas, is consistent. He again introduced legislation to kill ICD-10. (The bill is H.R.2126 if you are interested.) Poe has tried this trick before. He introduced an...
In case getting allergic rhinitis from your dog wasn’t bad enough, a Colorado man contracted the plague from his pit bul l. And then he may have passed it on to another person. Person-to-person...
And the flowers bring pollen. Achoo! Allergies are a fact of life for millions of Americans—approximately 30% of adults and 40% of children suffer from allergies, according to the American College of...
Many coders rely on the AHA's Coding Clinic advice to resolve sticky situations with ICD-9-CM coding. However, AHA will not be transitioning its current guidance to ICD-10-CM. Instead, in January 2014, AHA began focusing solely on ICD-10-CM questions to help clear up confusion prior to implementation.
Our friends at the Association of Clinical Documentation Improvement Specialists hold their annual conference next month in San Antonio , Texas. And like everything in Texas, it’s going to be BIG ...
You learn something new every day. Today’s new fact: you can be a professional video game player. I’m not sure why that surprises me. After all, video games have come a long way from the Atari and...
Primary care providers see patients for a wide variety of conditions, meaning coders in those settings may have to learn many of the new concepts and terms in ICD-10-CM. Annie Boynton, BS, RHIT, CPCO, CCS, CPC, CCS-P, COC, CPC-P, CPC-I, and Rhonda Buckholtz, CPC, CPC-I, CPMA, CRC, CHPSE, CGSC, CENTC, COBGC, CPEDC, discuss three common conditions seen in these settings and what information coders will need to look for in documentation to code them in ICD-10-CM.
You may recall that Steve’s super streak at the Vegas craps table ended with a torn right ulnar collateral ligament. On the recommendation of his primary care physician, Steve consulted an orthopedic...
You know us and the staff at the Acme ED, Fix ‘Em Up Clinic, and the Stitch ‘EM Up Hospital. Now, we want to get to know a little bit about you, our readers. Please complete this short survey to tell...
I spent the weekend reading the 2016 Inpatient Prospective Payment System (IPPS) proposed rule. Not the most thrilling reading ever (government-ese should be classified as a foreign language). I did...
Last week, Steve spent some serious time at the craps table in Las Vegas. He was on a real roll with those dice, racking up a 14-hour winning streak. However, on that last throw, something went very...
The endless last-minute patches for the Sustainable Growth Rate (SGR) are almost history. Late last night, the Senate overwhelmingly passed H.R. 2, which repeals the SGR. The House overwhelmingly...
CMS is asking for some social media help in support of ICD-10. The agency is planning a social media rally to encourage the healthcare community to get ready for the ICD-10 transition. You can sign...
I’m always fascinated by new medical research and information about diseases I’ve never heard of. They also make great fodder for this blog. I recently came across an article on REM sleep behavior...
Fifteen-month-old Finn is back at the Fix ‘Em Up Clinic today to see Dr. Spock. Finn is currently suffering from a fever, reduced appetite, and sore throat, according to his mom Melissa. Finn just...
As we continue to move closer to ICD-10 implementation (still set for October 1, 2015), I keep finding more reasons why we need better documentation. I am not trying to pick on physicians (really),...
The seventh character in an ICD-10-CM code represents either the fetus (for pregnancy codes), or the encounter (for injuries and burns). Jennifer E. Avery, CCS, CPC-H, CPC, CPC-I, Gretchen Young-Charles, RHIA, and Nelly Leon-Chisen, RHIA, review guidelines for correct seventh character selection.
In ICD-10-CM, coders will use a seventh character, not an aftercare code, to identify follow-up treatment for an injury. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, CCDS, C-CDI, C-DAM, Kristi Pollard, RHIT, CCS, CPC, CIRCC, and Anita Rapier, RHIT, CCS, explain how aftercare coding will change in ICD-10-CM.
Ruth and Gary thought it would be great fun to give their nieces Amanda and Rachel some peeps for Easter. Amanda and Rachel thought they were getting marshmallow treats (so did their parents) so it...
No joke this time. We have six months left until ICD-10 implementation. That’s a good news/bad news proposition. The good news is that all of the hard work we’ve put into training and implementation...
Mental health disorders are common in the United States, with an estimated 19% of Americans 18 or older suffering from a diagnosable mental disorder, according to a 2012 survey from the National Institute of Mental Health (NIMH).
One of the great things about healthcare and medicine is you can always learn something new. Today’s odd but true condition is exploding head syndrome. (I love the Internet.) If you have ever...
Jeff went on vacation to Hawaii three weeks ago to enjoy some sun, sand, and surfing. He came back with some cool photos and a broken ankle. Apparently, the parking lot at the beach did him in even...
Poor Wendy. Shortly before Christmas, she stubbed her toe, really hard. However, no bruise appeared and her toe didn’t swell up, so she thought nothing of it. Three weeks later, she stretched her...
You have one more chance to participate in CMS’ end-to-end testing. The agency is currently looking for approximately 850 volunteers for the June 1-5 testing week. You can volunteer on your MAC’s...
Q: Our electronic health record system only provides for a "yes/no" choice under smoker. How can we capture the additional details necessary for an ICD-10-CM code assignment?
Cardiovascular coding can be challenging even without the introduction of new codes and concepts in ICD-10-CM. Laura Legg, RHIT, CCS, and Shelley C. Safian, PhD, RHIA, CCS-P, CPC-H, CPC-I, review the anatomy of the cardiovascular system and highlight some of the key changes in ICD-10-CM.
Jennifer E. Avery, CCS, CPC-H, CPC, CPC-I, and Betty Hovey, CPC, CPC-H, CPB, CPMA, CPC-I, CPCD, look at frequently diagnosed mental disordersand note changes for reporting them in ICD-10-CM.
Shelley C. Safian, PhD, RHIA, CCS-P, CPC-H, CPC-I, discusses how to code for burns and corrosions in ICD-10-CM, which requires at least three codes to indicate the site and severity, extent, and external causes.
Liam spent this St. Patrick’s Day on a fruitless quest for a pot of gold. He powered up for his quest by having a few glasses of green Guinness beer for breakfast. Turns out it’s not a good idea to...
Poor Wile E. Coyote is headed for surgery. As you might recall, Wile E. suffered a subdural hematoma following a collision with a cliff on Friday the 13th. Dr. Frankenbean decided to try conservative...
Poor Wile E. Coyote, Friday the 13 th has not been kind to our favorite super genius. Wile E. arrived at the Acme ED decidedly the worse for wear after his latest encounter with a certain speedy bird...
Melissa took her four nephews sledding over the weekend to the boys’ delight. They had a great time. Aunt Melissa, however, didn’t escape the adventure unscathed. While descending the (not really)...
We want physicians to be very clear in their documentation about what’s wrong with the patient and what the physician did to make that patient better. Our friends over at the Association of Clinical...
A new article in the Journal of the American Medical Association (JAMA) Psychiatry shows a strong link between genetics and autism. That’s not an unusual or completely unexpected outcome. Scientists...
Just when we were starting to feel really good about ICD-10’s chances of being implemented, AHIMA has learned that Chairman of the House Rules Committee Pete Sessions, R-Texas, is looking to draft...
Editor's note: With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in anatomy and physiology. To help coders prepare for the upcoming transition, we will provide occasional articles about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation. This month's article addresses the anatomy of the urinary system.
Joe came into the Stitch ‘Em Up Hospital for a colonoscopy and therapeutic polypectomy. Once Joe was under, Dr. Ben E. Full performed a digital rectal exam, which showed good sphincter tone. Dr. Full...
The Workgroup for Electronic Data Interchange (WEDI) is conducting an ICD-10 readiness survey to find out how ready the healthcare industry is for the October 1, 2015 implementation date. Providers,...
Add another nail in the “delay ICD-10 because the industry isn’t ready” coffin. CMS d eclared its end-to-end testing week from January 26 through February 3 a success . A total of 661 volunteers...
Tobie comes into the Acme ED Tuesday complaining of stomach cramps, nausea (but no vomiting), light-headedness, and chest pain. What in the world could be wrong with Tobie? Dr. H.M. Lock examines...
Quick, what’s the ICD-9-CM code for diabetes? I bet you knew it was 250.00. What’s the ICD-10-CM equivalent? Does ICD-10-CM even have an equivalent, since 250.00 is very vague? Yes, we do have a...
Ah, Fat Tuesday (AKA Mardi Gras), the last big blowout before Lent begins. For those not of a religious bent, it’s still a good reason for an all-day party. Here at the Fix ‘Em Up Clinic, we have...
My true love did his best over the weekend to make up for the 12 days’ worth of bad gift giving at Christmas. Alas, the best(?) laid plans of mice and men often go astray. My true love’s first...
Implementation costs and plans took center stage at The House Energy and Commerce Committee’s subcommittee on health’s ICD-10 Implementation hearing today. Seven witnesses testified before the...
Most coders will spend their time reporting codes from the Medical and Surgical section (first character 0) and the Obstetrics section (1). Each character in those sections has the same meaning:...
“Practice makes perfect” is a well-known adage. How many people can do any new task requiring specific skills successfully without practicing? We can’t consider the transition to ICD-10-CM/PCS...
Don’t look now, but Congress is examining ICD-10 implementation again. The House Energy and Commerce Committee’s subcommittee on healthcare will hold a hearing at 10:15 a.m. Wednesday, February 11 ,...
Curious about how CMS’ end-to-end testing for ICD-10 is going? Want to know how you can sign up? CMS is hosting a National Provider Call on ICD-10 implementation and Medicare testing from 1:30-3 p.m...
And a chilly one it is. It’s also the day after the Super Bowl, which means patients with a variety of injuries arrived at the Fix ‘Em Up Clinic today. First is Phil, who is convinced he is a...
Since portions of the reproductive system use some of the same structures as the urinary system, including the urethra, codes for conditions involving both male and female reproductive systems appear in Chapter 14 of ICD-10-CM, Diseases of the Genitourinary System.
We’re into dig out mode here in Anytown and apparently, not everyone got the memo about proper snow shoveling techniques. Richard came into the Fix ‘Em Up Clinic complaining of intense pain in his...
Here in Anytown we are getting blasted by a big winter storm, which means we’re also seeing lots of patients with storm-related injuries at the Fix ‘Em Up Clinic. Doug came into the clinic...
We can choose from 31 root operations in the ICD-10-PCS Medical and Surgical section, but biopsy isn’t one of them. So which root operation do we use when a physician performs a biopsy? The answer is...
Some diseases can cross between species, which can presents a significant problem. Just think back to how quickly avian flu spread starting in 2003. It turns out that diseases have been crossing that...
Blood tests are a common diagnostic tool for providers trying to determine a patient's condition. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, reviews the components of blood, detailing key terms and conditions coders should know to prepare for ICD-10-CM.
ICD-10 implementation requires organizational coordination from a variety of departments. Chloe Phillips, MHA, RHIA, and Kayce Dover, MSHI, RHIA, discuss how organizations can overcome challenges regarding staffing, productivity, and data analytics as they prepare for the change.
Every have one of those days when you feel like you’ll never be warm? I’m having one of those. One of the downsides to have a window cube is the cold seeps in with the sunshine. Or with the dreary...
Oh, the joys of being an 8-year-old with a snow day. Joey spent the weekend playing in his newly built snow fort without a hat, scarf, or pair of sunglasses. Now he’s complaining of hot, tender,...
Well, it’s not quite the polar vortex of 2014, but it’s definitely polar bear weather out there. As in, polar bears are the only ones who appreciate this kind of cold. We’re starting to see some...
The nervous system consists of the brain, spinal cord, sensory organs, and other specialized cells throughout the body, and is involved in nearly every bodily function. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, reviews the anatomy of the nervous system and some guidelines changes for it in ICD-10-CM.
Ready to test your ICD-10 systems with CMS? The agency is currently accepting applications for its second end-to-end ICD-10 testing week, scheduled for April 26-May 1. Each MAC (and Common Electronic...
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...
In part two of a series, Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , reviews ICD-10-CM Z codes, explaining how and when to use them and how they differ from ICD-9-CM V codes.
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...
The added detail found in ICD-10-CM may require coders to brush up on their anatomy and physiology training to select the most appropriate codes. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , reviews the anatomy of the male reproductive system and how coding for it will change in ICD-10-CM.
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...
ICD-10-CM introduces new requirements for coding skull fractures and brain injuries. Kim Carr, RHIT, CCS, CDIP, CCDS , and Kristi Stanton, RHIT, CCS, CPC, CIRCC, explore how coding for these conditions changes in ICD-10-CM.
The advantages offered by ICD-10-CM can directly affect providers, patients, and third-parties alike. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer, discusses this history of ICD-10-CM and the improvements the new system offers.
The endocrine system, which consists of many glands located throughout the body, is responsible for producing hormones and releasing chemicals into the bloodstream. These glands help maintain many important bodily functions, including metabolism, growth, and reproductive functions.
The ICD-10 implementation delay mandated by Congress this spring granted providers an extra year to prepare their coders and clinicians on the requirements of the new code set, but a recent survey has found some organizations heading in the wrong direction.
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...
Q: We have a patient diagnosed with neuropathy due to poorly controlled insulin-dependent Type 1 diabetes mellitus. What should we report in ICD-10-CM?
The majority of providers either stopped or slowed their ICD-10 preparations as a result of the latest implementation delay, but now providers have less than a year to become ready. CMS' Denesecia Green and Stacey Shagena offer advice on how providers can create an action plan to be ready by October 1, 2015—even if they haven't started yet.
With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in anatomy and physiology. Review the anatomy of the endocrine system and how to code for conditions affecting it.
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...
