Each year, more than 2,000 Americans are diagnosed with mesothelioma— an aggressive and deadly type of cancer that develops in the lining of the lungs, abdomen, or heart. Debbie Jones CPC, CCA , writes about different types of mesothelioma and how they should be reported in ICD-10-CM.
In advance of ICD-10-CM/PCS, many institutions implemented computer-assisted coding (CAC) hoping to mitigate anticipated productivity losses. Erica E. Remer, MD, FACEP, CCDS, highlights some of the pitfalls of CAC and provides techniques to improve accuracy. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
In order to accurately code for complex diseases and procedures of the brain, spinal cord, and sense organs, coders need a basic understanding of nervous system functionality. This article provides detailed information on nervous system anatomy and terminology, common brain and nervous system disorders, and recently introduced 2018 ICD-10-CM codes related to nervous system conditions.
Ovarian cysts may develop at any point in a woman's life and frequently occur with other medical diseases. In this article, Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, details best practices when assigning ICD-10-CM/CPT codes for ovarian cyst diagnoses and procedures.
In July, Utah pain doctor Jahan Imani, MD, and Intermountain Medical Management, P.C., entered into a nearly $400,000 settlement with the OIG to resolve allegations that Imani’s practice submitted false or fraudulent claims due to improper modifier use for payment by improperly using modifier -59 with HCPCS code G0431.
James S. Kennedy, MD, CCS, CDIP, CCDS, writes that now that the fiscal year 2018 IPPS final rule and the 2018 ICD-10-CM Official Guidelines for Coding and Reporting have been released, it’s important to review MS-DRG dynamics that warrant consideration in documentation and coding compliance.
The new ICD-10-CM codes for FY 2018, effective October 1, represent significant changes in some hospital documentation and coding practices. James S. Kennedy, MD, CCS, CDIP, CCDS , reviews some of the most significant revisions to the ICD-10-CM guidelines for 2018.
Documentation is crucial for the development of data reflecting the healthcare needs of domestic violence victims. Yvette DeVay, MHA, CPMA, CPC, CIC, CPC-I , explains how to properly screen for and code incidents of domestic violence.
James S. Kennedy, MD, CCS, CCDS, CDIP , deciphers the new information given for functional quadriplegia, marasmus, kwashiorkor, and palliative care found in the various fiscal year 2018 ICD-10-CM guidance updates.
In 2017, an estimated 252,710 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S. In this article, Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS , details best practices when assigning ICD-10-CM/PCS codes for breast cancer diagnoses and procedures. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
The best time to determine code edits is when the account is coded, meaning coding professionals play a key role in establishing overarching principles and best practices for edit management.
The 2018 update to the ICD-10-CM code set introduced a number of new gynecological codes, and Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC , writes about the significance and distinguishing details of the new codes.
The 2018 update to the ICD-10-CM code set went into effect October 1, 2017, and features 728 total code changes, including 360 new, 142 deleted, and 226 revised codes.
Atrial fibrillation is the most common type of heart arrhythmia in the U.S. Peggy Blue, MPH, CCS, CCS-P, CPC, CEMC, writes about common symptoms and treatments as well as proper ICD-10-CM coding for the condition.
Changes to the ICD-10-CM guidelines go into effect October 1, and coders will need to master knowledge of alterations to the general coding guidelines as well as new additions to guidelines on reporting diabetes, substance abuse, and myocardial infarctions. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Outpatient coding’s impact on reimbursement is evolving as healthcare continues its march toward value-based care. Kim Miller, CPC, CHC , and Kerri Wing, RN, MS , detail how coders play a central role in this shift.
With weeks remaining before the 2018 ICD-10-CM codes are implemented, it is important to review new codes—including myocardial infarction and ophthalmology codes--as well as changes to the coding guidelines and documentation requirements. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
James S. Kennedy, MD, CCS, CCDS, CDIP, details how Coding Clinic , Second Quarter 2017, did not disappoint in addressing clinical issues affecting those in coding compliance and instructing how to properly use the ICD-10-CM Index and Table .
The new ICD-10-CM codes for FY 2018, effective October 1, represent significant changes in our documentation and coding practices. Let’s discuss some of these new codes and their potential impact upon your diagnostic decision-making and documentation.
The words “endometriosis” and “endometrioma” look similar, but as Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, writes, these conditions vary greatly in terms of physiology and coding.
The 2018 OPPS proposed rule is one of the shortest—and latest—in recent memory, being released July 13 at only 663 pages, but it contains major proposed policy changes for the 340B drug discount program, incorporates new modifiers, and expands packaging to drug administration for the first time.
The urinary system might not be one of the body systems people are most eager to discuss, but learning the anatomy of the urinary system is key in coding certain procedures, especially in the surgical and interventional radiology specialties. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Peggy S. Blue, MPH, CPC, CCS-P, CEMC , reviews coding guidelines, signs, and symptoms of gastroparesis and helps coders avoid tricky guidance that can lead to reporting errors. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
James S. Kennedy, MD, CCS, CDIP , discusses the new ICD-10-CM codes for FY 2018 and describes some of the changes that could be made to documentation and billing habits for these conditions.
Coding and billing for the transgender patient can be difficult even when society in general has become more aware of people who are transgender. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, covers some of the challenges coders may face when filing claims for transgender patients.
In the outpatient world, physicians are accustomed to seeing services as the key to reimbursement, but diagnoses and outcomes will increasingly factor into reimbursement as healthcare shifts toward value-based care. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Starting October 1, the new and revised ICD-10-CM and ICD-10-PCS codes go into effect along with proposed DRG changes. Coders will benefit from digging deeper into the meanings of the new cardiovascular code descriptions to be able to fully understand and use them.
With the increased focus on clinical documentation improvement in the outpatient arena, Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, shares her tips for proving medical necessity on claims.
July is National Juvenile Arthritis Awareness Month. Yvette DeVay, MHA, CPC, CIC, CPC-I, explains the differences between the many different types of juvenile arthritis in order to help coders report the disease correctly.
The Quality Payment Program proposed rule seems to bring relief to providers anticipating escalation of Medicare Access and CHIP Reauthorization Act (MACRA) requirements, but there are a plethora of reasons for coding professionals to start adapting their workflow for MACRA now. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
In ICD-10-CM, defining, diagnosing, and documenting the various forms of altered mental status and their underlying causes remains an ongoing challenge for physicians and their facilities, according to James S. Kennedy, MD, CCS, CDIP .
The American College of Obstetricians and Gynecologists is encouraging providers to decrease the number of cesarean section deliveries. According to Lori-Lynne A. Webb, CPC, CCS-P, CCP, COBGC, CHDA, this means coders should brush up on their knowledge of how to code fetal intervention procedures for babies who are in a breech position.
In late June, CMS released a major proposed rule that hospitals will need to pay attention to—and no, I don’t mean to say that CMS released the CY 2018 OPPS proposed rule early, though we’ve thought that might happen since it’s been at the Office of Management and Budget (OMB) for several months.
As CMS and third-party payers have looked for ways to treat patients in the outpatient setting and reduce inpatient volumes, CMS has used the 2-midnight rule, in addition to other methods, to treat patients as outpatients or in observation whenever possible.
Laura Legg, RHIT, CCS, CDIP, writes that coders will benefit from digging deeper into the meanings of the new fiscal year 2018 ICD-10-PCS cardiovascular code descriptions to be able to fully comprehend and use them.
Sharme Brodie, RN, CCDS, reviews 2017 First and Second Quarter Coding Clinic advice, which includes sequencing chronic obstructive pulmonary disease with other respiratory diagnoses and body mass index reporting instructions.
May was a busy month for telehealth in the political world on both the federal and state levels. This action serves as a reminder that expanded access will mean an increase in telehealth coding, but navigating eligibility requirements and coding regulations can be a challenge. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Podiatry coding can become complicated quickly, as a number of procedures can be performed on the same site or region of the foot. This means codes could easily run into NCCI edits or denials. One way to ensure physicians are reimbursed properly for provided services is to review NCCI edits pertaining to podiatry.
Traditionally, the OPPS rulemaking cycle has been the main vehicle for changes to outpatient coding and billing regulations and policy that hospitals need to pay attention to. But Jugna Shah, MPH , writes that, increasingly, CMS has been introducing or discussing changes relevant to outpatient hospitals beyond the scope of the OPPS rules.
Alcohol and Other Drug-Related Birth Defects Awareness Week began on Mother’s Day and aimed to raise awareness of the dangers of substance abuse during pregnancy. In honor of this awareness week, Yvette DeVay, MHA, CPC, CIC, CPC-I , discusses fetal alcohol syndrome disorders and ICD-10-CM coding for the condition.
Coding plays a large role in claims and therefore is a key factor in reimbursement compliance. As such, coders have a responsibility to be as accurate and up-to-date on coding practices as possible. Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS , explores some of the organizations and regulatory bodies available to assist coders.
As physicians and society debate the rising incidence and devastating effects of opioid dependency, neonatal abstinence syndrome, and the use and abuse of other mood-altering chemicals, James Kennedy, MD, CCS, CDIP , explains how providers must partner together to define, diagnose, document, and report drug-related events so that ICD-10-CM-dependent administrative data can accurately measure its epidemiology, responses to treatment, and consequences.
Wound care can be messy, but reimbursement and billing for wound care does not need to be as troublesome if coding and documentation are done correctly. One of the bedrocks in billing for wound care is ensuring medical necessity, and there are a few tricks and standards to learn about medical necessity in order to stay compliant. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
CMS released the fiscal year 2018 IPPS proposed rule in April, and with it came a bevy of new potential ICD-10-CM codes. The update includes a total of 406 proposed new, revised, and deleted codes to be implemented October 1, 2017.
CMS released the fiscal year 2018 IPPS proposed rule April 14, and with it came a bevy of new potential ICD-10-CM codes. Explore the new additions to the ophthalmologic, non-pressure chronic ulcer, maternity and external cause codes ahead of implementation October 1.
April marks sexually transmitted infections month, and Peggy S. Blue, MPH, CPC, CCS-P, CEMC , gets in the spirit by breaking down the staging, diagnosis, and treatment of syphilis before examining how to code the disease in ICD-10-CM. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
A benefit of the switch to ICD-10-CM is the ability to be as specific as possible about a patient’s condition, but the downside of this is that it can make coding fractures time-consuming and confusing. Knowledge of bone anatomy and how fracture codes work is therefore an invaluable asset in fracture coding.
Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS, discusses the use of unspecified codes after the ICD-10-CM grace period and advises providers on how to decrease the use of those codes.
