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 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.
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.
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...
