Some conditions, such as gangrene due to diabetes, require two codes to correctly report in ICD-9-CM. In ICD-10-CM, coders will only need one code. Jennifer Avery, CCS, CPC-H, CPC, CPC-I, and William E. Haik, MD, FCCP, CDIP, explain how these combination codes act as their own CC or MCC in ICD-10-CM.
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...
Coders are very familiar with the diagnosis codes they use frequently, but the look of those codes will change in ICD-10-CM. Betty Hovey, CPC, CPC-H, CPB, CPMA, CPC-I, CPCD , reviews common dermatology conditions and how they will be reported with the new code set.
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...
Congress needed just a week to throw a huge monkey wrench into the healthcare industry's plans for ICD-10 implementation. On March 26, House leadership introduced H.R. 4302, "Protecting Access to Medicare Act of 2014." By April 1, the bill had passed the Senate and been signed into law by President Obama.
The ears--more formally, the auditory system--have their own chapter in ICD-10-CM, no longer relegated to the end of the neurology codes. Codes in Chapter 8, Diseases of the Ear and Mastoid Process (H60-H95), are located between the chapters for the optical system and the circulatory system.
When Congress passed the Protecting Access to Medicare Act of 2014, it mandated at least a one-year delay in ICD-10 implementation. Members of the Briefings on Coding Compliance Strategies editorial board, who represent a wide range of industry stakeholders, offered their thoughts on two questions related to the delay.
At the time of this publication, the Protecting Access to Medicare Act of 2014 bill was recently passed. The status quo regarding physician reimbursement from Medicare has been maintained. So what? That system has been broken for 20 years. ICD-10 will be postponed for provider billing for another year. So what? Life will go on as it has for the past 36 years with ICD-9-CM. In other words, nothing has changed. We're good for another year. Pressure's off! ...Right?
A diabetic patient is admitted with gangrene. The physician does not specifically link the diabetes and the gangrene, but also does not document any other potential cause of the gangrene. Should you code both conditions?
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...
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...
On the surface, you may think that transitioning from ICD-9-CM to ICD-10-CM for reporting schizophrenia, schizoid personality, and bipolar disorders is a dramatic change. However, Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, reveals that with some minor adjustments, the change can be a smooth one.
Plenty of uncertainty surrounds the ICD-10 implementation delay, but healthcare organizations shouldn’t put the brakes on their plans. Cheryl Ericson, MS, RN, CCDS, CDIP , William E. Haik, MD, FCCP, CDIP , Monica Lenahan, CCS , Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and James S. Kennedy, MD, CCS, CDIP, offer thoughts on how to keep moving forward with ICD-10.
Sometimes a physician just needs to take a look around a body part and see what’s what. If the physician’s sole objective is to examine a body part, either visually or manually, report the procedure...
We know we're facing at least a one-year delay in ICD-10 implementation. What you with that time? will directly affect how prepared you are for the eventual ICD-10 implementation. Here are some...
What a wild 12 days. On March 25, we were all preparing for the six-month-to-implementation milestone April 1. Some people were looking forward to that milestone more than others, but we had a plan...
If you code for pregnant patients and newborns, you may occasionally wonder which record to code a condition on. Is it something you code for the mother or for her offspring? ICD-10-CM divides the...
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, explains how reporting multiple gestations will change in ICD-10-CM, including greatly expanded specificity and replacements for V codes from ICD-9-CM.
Coding Clinic's Third and Fourth Quarter 2013 issues focus considerable attention on ICD-10-PCS procedure coding. On p. 18, Coding Clinic Third Quarter 2013 states that the coding of a peripherally inserted central catheter (PICC) depends on the end placement of the PICC line?that is, where the device ends up.
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 an occasional article about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation. This month's column addresses the anatomy of the thigh.
The Senate passed HR 4302 designed to patch the Sustainable Growth Rate that included a provision to delay ICD-10 implementation until at least October 1, 2015. The bill, approved by the House in a...
The fate of the October 1, 2014 ICD-10 implementation date will remain in limbo until Monday. The House of Representatives passed HR 4302 Thursday as a one-year fix to the Sustainable Growth Rate (...
The House of Representatives passed HR 4302 today using a controversial surprise voice vote, bringing another ICD-10 delay closer to reality. HR 4302 focuses on patching the Sustainable Growth Rate (...
CMS may be committed to an ICD-10 implementation date of October 1, 2014, but Congress may think otherwise. House of Representatives bill H.R. 4015 is designed to patch the Sustainable Growth Rate...
ICD-10-CM provides many more combination codes for drug- and alcohol-related diagnoses than ICD-9-CM. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, explains how this could actually result in less work for coders.
Some of the most significant changes in cardiovascular coding in ICD-10-CM involve coding for myocardial infarctions (MI). Laura Legg, RHIT, CCS , and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, review new guidelines and specificity involved in ICD-10-CM MI coding.
Even though ICD-10-CM respiratory changes are relatively minor, coders will still have to learn the new guidelines and review anatomy and physiology in order to report them accurately. Tara L. Bell, RN, MSN, CCM, AHIMA-approved ICD-10-CM/PCS trainer, and Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I, CHA, AHIMA-approved ICD-10-CM/PCS trainer, highlight the changes and new guidelines.
The codes for complications of pregnancy, childbirth, and the puerperium appear in Chapter 11 in ICD-9-CM. They move to Chapter 15 in ICD-10-CM. But you will find some more significant changes than...
Holidays are always interesting times here at the Fix ‘Em Up Clinic. We get to see some of the most interesting cases. First up for St. Patrick’s Day is Sean, who at 8 years old thought it would be...
Is this a dagger I see before me? Why, yes, Caesar, that is a dagger aimed at your heart. And your head and just about everywhere else. Servilius Casca got in the first shot, hitting Caesar in the...
In ICD-9-CM, we have one base code for gestational diabetes: 648.8x (abnormal glucose tolerance). We need a fifth digit to specify the episode of care: 0, unspecified as to episode of care or not...
James S. Kennedy, MD, CCS, discusses the increased clinical specificity required for coders to report strokes and transient ischemic attacks in ICD-10.
Not surprisingly, coders will have many more options to report how a patient was injured in ICD-10-CM. Betty Hovey, CPC, CPC-H, CPB, CPMA, CPC-I, CPCD , and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS , explain how the codes differ from ICD-9-CM E codes, when to report them, and why coders should not be too worried about the transition.
The auditory system has its own code category in ICD-10-CM because of the number of new codes and specificity available. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , reviews ear anatomy and how to report newly introduced diseases and conditions.
Inpatient coders are used to being able to code conditions documented as possible, probable, suspected, or rule out, as if they were in fact confirmed. Outpatient coders can’t do that. They need a...
Coders are aware that ICD-10-CM will allow much more specificity than ICD-9-CM, and that is very evident in the section covering injuries to the wrist, hand, and fingers (S60–S69).
You all know that I have been unhappy with some code definitions in ICD-9 and have ucceeded in getting some changes made in ICD-9 and ICD-10-CM code sets.
Brush up on your knowledge of cardiovascular system anatomy as you learn how to code cardiovascular diseases in ICD-10-CM during the live, 90-minute webcast Reduce the Fear of ICD-10-CM...
I really want the t-shirt that says, “I only do what the voices in my head tell me” and its companion shirt, “The voices in my head don’t like you.” Sadly too many people I know might believe it...
One of the things that drives me crazy about how media, Congress, and the AMA discuss ICD-10 codes is their focus on the External Causes codes. Granted some of those codes are silly or strange or...
Maybe the AMA’s letter did the trick. Or maybe CMS just thought better of its decision not to conduct end-to-end testing prior to ICD-10 implementation. According to MLN Matters® SE1409 , CMS will...
The added specificity of ICD-10 may require coders to learn more about disease processes and terminology in order to code accurately. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reviews some medical terms coders should know and steps to take to improve communication between providers and coders.
What did you get for Valentine’s Day? Flowers? Chocolate? Mono? It is the kissing disease after all. ICD-9-CM includes only one code for infectious mononucleosis: 075. That code includes glandular...
Poor Paul, he just wanted to take his black Labrador Molly to the vet for her checkup. Instead he ended up needing a doctor. Paul put down a sheet in his truck so Molly wouldn’t have to sit on the...
/*--> */ In its continuing quest to halt ICD-10 implementation, the AMA is touting a new study by Nachimson Advisors that shows much higher costs to physician practices than initially estimated in...
Is this love that I’m feeling? Or do I have some deadly disease? What are my symptoms? Well, I feel lightheaded and dizzy. It could be the signs of new love or it could be acute mountain sickness...
There before me was a pale horse and its rider was named Reimbursement. Meet the final horseman of the ICD-10 Apocalypse and probably the one that keeps your C-suite up at night: Reimbursement. The...
In part two of a series, Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, explains how to identify various types of viral skin infections and how reporting for them will change in ICD-10-CM.
It turns out that Punxsutawney Phil seeing his shadow, and thereby forecasting six more weeks of winter, wasn’t the most painful part of Groundhog Day. Phil picked a bad moment to suffer from stage...
Shoveling snow can be great exercise. You can burn a lot of calories (depending on how much snow you’re shoveling and how much effort you’re putting into it). However, shoveling snow can also be...
These sample queries were adapted from The CDI Specialist’s Guide to ICD-10, created and donated by Cheryl Ericson, MS, RN, CCDS, CDIP, AHIMA-Approved ICD-10-CM/PCS Trainer, CDI education director at HCPro in Danvers, Mass.
Decreased productivity isn’t the only looming concern with the transition to ICD-10. Scot Nemchik, CCS , and Rachel Chebeleu, MBA, RHIA , reveal why accuracy will be just as important as productivity.
Baby, it’s cold outside. Really, really cold. And unlike polar bears and snow leopards, I am not a cold weather animal. So to offset the cold this morning (and motivate myself to crawl out from under...
You can stop holding your breath. Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I, CHA , AHIMA-approved ICD-10-CM/PCS trainer, and Tara L. Bell, RN, MSN, CCM, AHIMA-approved ICD-10-CM/PCS...
Our beloved (and much used) ICD-9-CM code 250.00 (unspecified diabetes) is going away soon. In fact, the whole idea of controlled or uncontrolled diabetes won’t matter either for coding purposes in...
The added specificity available in ICD-10-CM allows for more details to be included when reporting bacterial skin infections, such as the location of the infection. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, explains how to identify various types of infection and which codes to use to report them.
The transition to ICD-10-CM may require coders to brush up on their anatomy and physiology in order to report the most accurate codes. We take a look at the anatomy of the knee and how coding for knee injuries will change in ICD-10-CM.
What can we revise today at Stitch ‘Em Up Hospital? First, we need to know what falls under root operation revision in ICD-10-PCS. Is it a procedure where the physician alters a body part, such as a...
259 days. That’s the time remaining until we start using ICD-10. How far along are you? You’ve completed your coding assessments, right? Hopefully, you’ve already started your coder training. At the...
Without the right details in the documentation, coders can’t assign the correct code and that becomes more apparent in ICD-10. Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, Paul Weygandt, MD, JD, MPH, MBA, CCS , Kathy DeVault, RHIA, CCS, CCS-P, and Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC, highlight some areas coders and clinical documentation improvement specialists should focus on to prepare for ICD-10.
You’ve heard about temperatures so hot you can fry an egg on the sidewalk, right? (I don’t recommend eating the egg afterwards.) It turns out the polar vortex was so cold you could freeze boiling...
We’re on to the third horseman of our ICD-10 Apocalypse: productivity. More specifically, the anticipated upcoming decline in coder productivity. You’ve probably heard the horror stories about the 50...
Ann came in to Stitch ‘Em Up Hospital for a breast biopsy to confirm a diagnosis of breast cancer. Dr. Richards performed the biopsy and based on the results, decided to perform a partial mastectomy...
Fix ‘Em Up Clinic is open for 2014 and we’ve already seen some interesting post-New Year injuries. Rebecca is complaining of pain in her right ankle. Dr. Frost reviews her past medical history and...
Different studies using different methodologies all point to the same conclusion: Coder productivity will decrease after the switch to ICD-10. However, no one knows what will happen to coding accuracy.
Recently, Dr. Seuss saw the Grinch for a variety of health concerns. Today, he’s seeing some others who are not in the holiday spirit. First is Mr. Scrooge, who complains he is being harassed by...
Christmas decorating can be a drag, especially when you get tangled in the string of lights and they literally drag you off the roof. Just ask poor Clark. First, he tripped over a root in the forest...
With the added specificity available in ICD-10-CM, coders have many more options for reporting malignancies of the skin. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , compares ICD-9-CM codes with their ICD-10-CM counterparts and notes where more documentation may be needed to select the proper code.
Today’s rehearsal for the children’s Christmas play at Anytown Middle School was unforgettable for all of the wrong reasons. Just look at the waiting room at the Fix ‘Em Up Clinic. First in to see Dr...
Information that is not important for ICD-9-CM will take on new significance in ICD-10-CM. Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC, and Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, review areas when specificity comes into play in ICD-10-CM.
Good King Wenceslas looked out on the feast of Stephen And what a festive occasion it was! Participants are suffering from: Functional dyspepsia (K30) Nausea (R11.0) Projectile vomiting (R11.12)...
Dashing through the snow, in a one-horse open sleigh … oh, wait, maybe that’s not such a good idea. Little Bobby came down with chilblains, while Suzie developed frostbite. ICD-10-CM only gives us...
Worried that your vendors won't be ready for ICD-10? CMS has a tip sheet for talking with your vendors on its website. In addition, CMS recently added five new resources: Introduction to ICD-10...
Why in the world is Mr. Grinch so mean? Maybe the problem is his health. Let’s see if we can diagnose the Grinch’s health woes. First, he is as cuddly as a cactus. What does that mean? He’s covered...
Everybody likes a shortcut. We want to get things done faster, arrive home sooner, finish tasks more quickly. Generally shortcuts are good. Unless you’re talking about physician documentation. Then...
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 an occasional article about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation.
Physicians are never going to like receiving queries from coders and CDI specialists. They really won't like all the queries they will receive after the transition to ICD-10.
Ah, Black Friday, when shoppers go doorbusting for deals and then head to the Fix ‘Em Up Clinic for repairs. Today’s first wounded bargain hunter, Stephanie, comes in complaining of pain in her left...
Farmer Brown came in today to see Dr. Gobbler for some injuries sustained when he tried to prepare his Thanksgiving main course. It seems Farmer Brown’s turkey wasn’t interested in joining him as...
ICD-10-CM codes may look unfamiliar, but many concepts are the same as those in ICD-9-CM, with a few notable changes. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC , look at some of the new conventions and guidelines for ICD-10-CM.
Coding for acute and chronic pain will not change greatly in ICD-10-CM, though coders will have some new options at their disposal. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , discusses some common pain diagnoses and how they will translate from ICD-9-CM.
You may remember that the American Medical Association (AMA) has been pushing for an end to ICD-10 since 2012. During its recent House of Delegates meeting, the AMA reinforced its position that ICD-...
Conquest, War, Famine, and Death have nothing on the Four Horsemen of the ICD-10 Apocalypse: Accuracy Documentation Productivity Reimbursement How do you tame these terrors? With planning and...
A feral flock of wild turkeys has invaded New York City. Seriously. And with them, they bring all sorts ofcode-ready diseases and mishaps. First, turkeys can transmit fun infections such as...
CMS created a mini tempest in June when announced it would not conduct end-to-end testing for ICD-10. CMS has not reversed that decision, but will require MAC to conduct front-end testing in March...
