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 skull.
A writer paints a picture with words. The English language alone offers somewhere in the neighborhood of a quarter of a million words. But really how many does the average person use? According to...
Summer semi-officially arrived this week with Memorial Day and that means plenty of sun and sand related illnesses at the Fix ‘Em Up Clinic. Our first patient is Todd, who was trying to grill up the...
Our Town Zoo hosted its annual black tie fundraiser and things got a little, well, wild as the patients at the Fix ‘Em Up Clinic prove. Tiffany made a fashion statement with a bright blue shimmering...
In ICD-10-CM, coders must report two codes to fully describe certain conditions. They will find “Use additional code” notes in the Tabular List at codes when they need to report a secondary code to...
So we’ve survived the zombie apocalypse, but we’re not out of the undead woods yet. It seems a group of vampires is trying to one-up the zombies. But, never fear, vampires can actually be regular...
Gregory House, MD, is hanging up his stethoscope before the transition to ICD-10-CM. I loved House MD when Fox first starting airing it in 2005, but the last few seasons, not so much. Let’s ask Dr...
QUESTION: We are a small anesthesia group and we are concerned about the specificity for ICD-10-CM. If we submit a claim with an unspecified code and the surgeon submits a claim with more specificity, will we still get paid?
Coders will need very specific information in order to code for fractures in ICD-10-CM, including the type of fracture, specific bone fractured, and whether the patient is seen for an initial or subsequent visit. Robert S. Gold, MD, Sandy Nicholson, MA, RHIA, and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, detail the information physicians must document for accurate fracture code assignment.
Coders often report signs and symptoms when physicians document them in the patient’s medical record. However, coders should not always report additional codes for signs and symptoms. How can coders...
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. ICD-10-CM coding conventions for such conditions require coders to report...
Home repair and improvement can be hazardous to your health. Just ask the residents of Calamity Condos who are visiting the Fix ‘Em Up Clinic. Tom and Wendy decided to repaint the living room of...
Braaaaains! Braaaaains! Don’t look now, but the Centers for Disease Control and Prevention was right about the zombie apocalypse . It’s here! Run for your lives! Okay, we’re not about to be overrun...
...and the documentation coach will turn into a pumpkin if you're not on time. As a CDI specialist, what has been your approach to ICD-10? Are you hoping it will go away? Are you waiting for 2014?...
Coders will need more information in order to code for fractures in ICD-10-CM. For instance, the physician must document which specific bone is fractured, including which side of the body. They will also need to document whether the patient is seen for an initial or subsequent visit.
Spinal conditions can be congenital, pathologic, or traumatic, and they can affect the vertebrae, spinal cord, muscles, nerves, discs, or a combination of the parts of the spine.
Happy Monday! I hope you had a great weekend because it’s time to dive into coding for today’s visitors to the Fix ‘Em Up Clinic. Our first patient, nine-year-old Chris, arrived with a really nasty...
A surgeon performs an open reduction of right tibia fracture for an inpatient. Which ICD-10-PCS root operation should be reported? In this case, it’s fairly easy: reposition. In a reposition...
ICD-10-CM and ICD-10-PCS contain a significant number of new codes, which shouldn’t be news to anyone at this point. Most of the codes are longer than the current ICD-9-CM codes, which could increase...
The additions and revisions to the ICD-10-CM Official Guidelines for Coding and Reporting in 2012 include some new information that coders should be aware of in preparation for ICD-10-CM/PCS implementation. Sandy Nicholson, MA, RHIA, and Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I, CHA, explore some of the biggest guideline changes.
[caption id="attachment_2698" align="alignright" width="150" caption="Hey, look, it's a friend of Wile E.!"] [/caption] Wile E. Coyote is back in the Acme ED, this time with a broken arm, leg, pelvis...
A one-year delay in ICD-10-CM/PCS isn’t a slam dunk. “We’re recommending it, but it’s not [guaranteed],” said Denise Buenning, group director CMS Office of E-Health Standards and Services. Buenning...
After HHS proposed year-long delay of ICD-10, questions emerged regarding the current ICD-9-CM code freeze. CMS confirmed that the code freeze will hold until ICD-10-CM/PCS is implemented regardless...
Don’t trust the squirrels in the park. They may look cute and friendly, but they are really covert operatives on a mission to steal your food. [caption id="attachment_2676" align="alignright" width="...
Do you suffer from triskaidekaphobia, paraskevidekatriaphobia or friggatriskaidekaphobia? In other words are you afraid of the number 13 or Friday the 13 th ? More importantly, can you code for those...
And the new proposed ICD-10-CM/PCS implementation date is (drum roll, please)…October 1, 2014. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the new date as part...
My feet are killing me. I wonder what the problem is. Let’s see what it could be and how we would code it in ICD-10-CM. I got a new pair of shoes, so maybe the problem is a blister. That should be...
Several years ago, a pharmaceutical company came under fire because its sales reps were pushing the company’s drugs using Tigger and Eeyore, two popular characters from the "Winnie the Pooh" series...
The transition to ICD-10-CM is coming. The only question is when. Despite the delay, coders and other HIM professionals must continue to prepare for the transition.
Spring is in the air and Anytown just held its combined Spring Festival and Easter egg hunt. I’m sad to say things did not go smoothly, judging by the number of patients in the Fix ‘Em Up outpatient...
"What's in a name? That which we call a rose by any other name would smell as sweet." [caption id="attachment_2635" align="alignright" width="150" caption="It's Pandemonium!"] [/caption] Ah, dear...
Poor Wile E. Coyote ® . He just came into the Acme ED with a skull fracture caused by a falling boulder. It seems the Roadrunner ® got away again. Dr. Frankenbean documents a closed fracture of the...
The Department of Health & Human Services (HHS) may do more harm than good by delaying ICD-10-CM/PCS implementation, according to survey, Industry Reaction to Potential Delay of ICD-10 ,...
The transition to ICD-10-CM is coming. The only question is when. Despite the possible delay, coders and other HIM professionals must continue to prepare for the transition. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, Sandy Nicholson, MA, RHIA, Robert S. Gold, MD, Jennifer Avery, CCS, CPC-H, CPC, CPC-I, and Kim Felix, RHIA, CCS, provide information on how ICD-10-CM will—and will not—differ from ICD-9-CM.
Knowing spinal anatomy provides the foundation necessary to assign codes both before and after the switch to ICD-10-CM. Shelley C. Safian, Kim Pollock, RN, MBA, CPC, and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, guide coders through the anatomy and common coding situations in ICD-9-CM and ICD-10-CM.
The American Health Information Management Association (AHIMA) has urged CMS not to delay ICD-10-CM/PCS implementation in its February 23 letter to HHS Secretary Kathleen Sebelius . Meanwhile, the...
Who knew St. Patrick’s Day was such a dangerous holiday? Take a look around the Fix ‘Em Up Clinic and see for yourself. First, we have Bobby, who was looking for a four-leaf clover. Unfortunately, he...
The Office of E-Health Standards and Services (OESS) announced a second delay in the enforcement of HIPAA 5010, CMS announced March 15 . OESS announced the first enforcement delay November 17, 2011...
ICD-10-CM is full of oddly specific codes for causes of injuries. Some of them are funny (I’m talking to you, W61.43, pecked by turkey) and others are so strange that most coders will probably never...
Coders use ICD-9-CM E codes to describe the accident, circumstance, event, or specific agent that caused a patient’s injury. In ICD-10-CM, these codes will not be prefaced with the letter ‘E,’ and...
In honor of Dr. Seuss' birthday, we present: Oh, the ICD-10-CM codes you’ll find Hit by a truck? Bit by a duck? There’s an ICD-10-CM code for that. Liver contused? Wrong substance infused? There’s an...
I love the National Public Radio (NPR) program, "Wait, Wait, Don't Tell me" (WWDTM), a fun look a the news. The program features a panel of amusing well-knowns who answer questions and try to win a...
Cross-training coders has definitive short-term advantages, such as enhancing staff coverage during holidays and vacations and increasing the department's ability to handle periods of fluctuation in certain bill types, but these aren't the only benefits.
The respiratory system, responsible for inspiration (carrying oxygen into the body) and expiration (the expulsion of carbon dioxide), is composed of two tracts: the upper respiratory tract and the lower respiratory tract.
ICD-10 will allow coders to report nonspecific, unspecified, or not otherwise specified (NOS) codes, but experts say doing so will be counterproductive because of the specificity inherent in the new system.
Don’t let rumor steer you away from the goal of being ready for ICD-10-CM/PCS implementation. By now, everyone has heard that CMS plans to issue a proposed rule with a new ICD-10-CM/PCS...
Even though this kink (the possible implementation delay) has been presented to everyone, I think we need to remember that the likelihood of continuing status quo for a lengthy amount of time using...
So CMS may or may not change the October 1, 2013 implementation date for ICD-10-CM/PCS. We’re still waiting to hear more from CMS and the Department of Health and Human Services. While we’re waiting...
Physician queries are considered communications between coding (or coding-related) professionals and physicians to clarify or increase specificity in the documentation to ensure good clinical...
The transition to ICD-10-CM/PCS has not been cancelled, just delayed. And we’re not even sure for how long. Some industry experts offer their thoughts on what organizations should do while we wait...
It’s no longer a mere possibility; HHS has confirmed its intent to delay the ICD-10 compliance deadline, according to its latest press release . “We have heard from many in the provider community who...
After years of repeatedly saying the implementation date for ICD-10-CM/PCS wasn’t changing, the Department of Health and Human Services (HHS) and CMS are rethinking their stance. HHS Secretary...
A patient comes in with displaced fracture of base of second metacarpal bone of his right hand. The physician treats the patient and sends him home. The coder would report ICD-10-CM code S62.310A for...
CMS is looking at the timeline for ICD-10 implementation, acting administrator Marilyn Tavenner told attendees at the American Medical Association (AMA) National Advocacy Conference in Washington, DC...
A great storyteller understands that it’s all in the details. Perhaps it’s the back-story about a particular character or maybe it’s the little facts peppered throughout the tale, but it’s the details that convey the essence of the story. Likewise, some ICD-10-CM injury codes tell only part of a patient’s story. Lolita M. Jones, RHIA, CCS, and Donna M. Smith, RHIA, discuss how to report associated injuries and complications and also talk about why it’s so important to have a firm grasp on anatomy and physiology to ensure accurate coding.
Big news regarding the ICD-10-CM/PCS implementation timeline came out this morning during the American Medical Association (AMA) National Advocacy Conference in Washington, DC. Per CMS acting...
What’s in a name? That which we call a rose by any other name would smell as sweet. At least Shakespeare says so. And that has what to do with coding in ICD-10-PCS you might ask. Well, you won’t find...
Outpatient coders are getting very familiar with combination codes when it comes to procedure coding, thanks to the AMA. Coders have been seeing more and more combined procedures in recent years in...
When the American Medical Association (AMA) made it clear back in November that it wanted to delay the transition to ICD-10-CM/PCS, the first thing that came to mind was ... are you kidding me?...
Here are the top 10 reasons you should attend the JustCoding Virtual Summit: ICD-10-CM and ICD-10-PCS February 29-March2. 10. October 1, 2013 is getting closer all the time Remember when CMS...
The only thing we have to fear is fear itself, according to Franklin D. Roosevelt. We certainly shouldn’t fear the transition to ICD-10-CM/PCS. Unfortunately, however, it seems to be a common...
Coders will need more information to correctly assign fracture codes in ICD-10-CM, but don’t fear. Most of that information is already in the medical record. Robert S. Gold, MD, Sandy Nicholson, MA, RHIA, and Shannon McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, walk through what you need to know to code fractures in ICD-10-CM
We hear about physician engagement across and throughout all healthcare settings almost daily, so it’s nothing new. But it's important for the upcoming transition to ICD-10-CM/PCS. Gloryanne Bryant, RHIA, RHIT, CCS, CCDS, offers suggestions for how to get your physicians engaged in the change.
Have you heard that not all payers will be ready for the ICD-10-CM/PCS coding system on October 1, 2013? What a headache, huh? All payers were required to be ANSI X12 Version 5010 compliant by...
The 2012 ICD-10-CM updates include significant narrative changes for primary malignant neoplasms overlapping site boundaries and malignant neoplasm of ectopic tissue, as well as smaller narrative...
The Medicare Code Editor (MCE) is software that detects and reports errors in the coding on claims that are submitted for payment. All Part A inpatient discharges and transfers pass through the MCE...
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...
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...
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...
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...
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...
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...
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...
