CMS implemented the FY 2025 IPPS final rule on October 1, which introduced several updates to New Technology Add-on Payment designations, directly affecting how inpatient services are coded and reimbursed. Follow Judith Kares, JD , as she reviews NTAP eligibility criteria and payment strategies, alternative pathways for approval, final new technologies, and application process changes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: Video colonoscope was advanced through a patient’s rectum to the cecum where there was normal-looking mucosa throughout. The patient had scattered diverticula in the sigmoid colon and a 6-mm sessile polyp in the proximal rectum that was removed completely by hot biopsy technique. Surgeon documented to await pathology report. How would this operative note be reported in ICD-10-CM and ICD-10-PCS?
Our experts answer questions about coding for controlled puerperium diabetes and endoscopic procedures as well as provide suggestions for referring to prior encounter information in queries.
The new ICD-10-PCS code set for fiscal year 2025, which includes 371 new codes, will be effective October 1, 2024. With highlights from Terry Tropin, MSHAI, RHIA, CCS-P , inpatient coders can make sense of each new term before they go into effect.
The new ICD-10-PCS code set for fiscal year 2025, which includes 371 new codes, will be effective October 1, 2024. With highlights from Terry Tropin, MSHAI, RHIA, CCS-P , inpatient coders can make sense of each new term before they go into effect.
CMS recently published the fiscal year 2025 ICD-10-PCS code set and guidelines. Although CMS made no changes to the guidelines, the update includes 371 new codes, 61 deleted codes, and three new tables.
Sarah McDonald, CPC , reviews ICD-10-CM and ICD-10-PCS coding guidelines for the U.S.’ most common orthopedic surgeries: hip and knee replacements. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Educating clinical staff on proper documentation of mechanical ventilation can avoid compliance issues and support accurate reimbursement. This article clarifies the complications of reporting mechanical ventilation in ICD-10-PCS.
Sarah McDonald, CPC , examines the ICD-10-CM/PCS coding conventions for symptoms, stages, and treatment of gastroesophageal reflux disease—a commonly diagnosed digestive disorder in the U.S. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah McDonald, CPC , explains the spinal fusion process and overviews the process of constructing ICD-10-PCS procedure codes character by character. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Educating clinical staff on proper documentation of mechanical ventilation can avoid compliance issues and support accurate reimbursement. This article clarifies the complications of reporting mechanical ventilation in ICD-10-PCS.
Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , summarizes guidance from the 2024 first quarterly release of Coding Clinic , including reporting for postoperative complications, non-traumatic kidney injuries, and vertebral artery dissection.
Terry Tropin, MSHAI, RHIA, CCS-P , continues her exploration of ICD-10-PCS April updates with added options for intracranial brachytherapy, electroporation, sinus dilation, pedicled omentoplasty, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS will be holding its next ICD-10 Coordination and Maintenance Committee meeting March 19-20. The committee will deliberate applications for new ICD-10-PCS and ICD-10-CM code assignments. If approved, the codes will become effective October 1, 2024.
Shannon Oitker, MSN, RN , reviews the nine MS-DRGs for ventilator use, explains how DRGs are designed, and assesses whether hospitals are receiving adequate reimbursement for ventilation services.
Shannon Oitker, MSN, RN , reviews the nine MS-DRGs for ventilator use, explains how DRGs are designed, and assesses whether hospitals are receiving adequate reimbursement for ventilation services.
Terry Tropin, MSHAI, RHIA, CCS-P , explores the 2024 ICD-10-PCS updates that will become effective April 1. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A patient who presents with complaints of progressive neck and bilateral arm symptoms is diagnosed with cervical spondylosis—worse at joints C5-C6 and C6-C7. Which ICD-10-CM codes would be reported?
Spinal surgery for hospital coders can be very challenging if they do not know the rules for assigning the correct ICD-10-PCS codes. Nancy Reading, RN, CPC, CPC-P , reviews spinal anatomy and surgical approaches, and offers tips on how to select the most appropriate characters in ICD-10-PCS.
Colder weather is approaching, which brings an increase in respiratory infections. Shelley C. Safian, PhD, RHIA, CCS-P, COC, COC-I, clarifies the pathogenic causes of pneumonia, specifically those with recent additions to ICD-10-CM, and those with antibiotic resistance. She also reviews how to report treatment methods in ICD-10-PCS.
Q: How would a coder report a coronary artery bypass graft complicated by ineffective external cardiac device insertion, subsequent removal, and intra-aortic balloon pump placement?
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reviews the clinical definition and types of postpartum hemorrhage, the intrauterine treatment devices used to treat it, and relevant ICD-10-PCS coding. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reviews the clinical definition and types of postpartum hemorrhage, the intrauterine treatment devices used to treat it, and relevant ICD-10-PCS coding.
Gastroparesis is a condition that affects stomach motility. Sarah Gould, CPC , explains how to report the condition and its complications in ICD-10-CM, in addition to treatment methods in ICD-10-PCS. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A patient’s previously implanted Impella, a small, catheter-based ventricular assist device, was removed and replaced due to an emergency. How would we report this in ICD-10-PCS and which DRG would it lead to?
Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , summarizes the highlights from the newest installment of Coding Clinic, which includes guidance on reporting pancytopenia, inherent conditions, ORIF, and neurally adjusted ventilatory assist devices.
Building ICD-10-PCS codes for cardiovascular surgery can be tricky given the number of root operations that may apply. Sarah Gould, CPC , reviews cardiac anatomy and ICD-10-PCS guidelines for reporting cardiac insertion and bypass procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The fiscal year (FY) 2024 IPPS final rule, released in August, provides updates on inpatient hospital reimbursement, ICD-10-CM/PCS coding and DRG changes, quality and reporting programs, and more.
Shelley Safian, PhD, RHIA, CCS-P, COC, CPC-I, defines hand-assisted laparoscopic surgery (HALS) procedures and how to report them according to new guidance in the 2024 ICD-10-PCS guidelines. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
ICD-10-PCS provides many codes related to respiratory assistance, ECMO, and ultrasound for procedures for newborns/neonates. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , reviews these procedures and offers clinical coding scenarios to clear up confusion. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
As the COVID-19 public health emergency has ended, audits are likely to pick up steam. To prepare for this increase in audit activity, it’s essential for providers and coders to examine both current and upcoming trends.
Shelley Safian, PhD, RHIA, CCS-P, COC, CPC-I, defines hand-assisted laparoscopic surgery (HALS) procedures and how to report them according to new guidance in the 2024 ICD-10-PCS guidelines.
The term “stroke” or cerebrovascular accident (CVA) indicates an interruption in blood flow to the brain. Nancy Reading, RN, CPC, CPC-P , reviews strokes and explains how coders should report them and their treatment in ICD-10-CM and ICD-10-PCS. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The term “stroke” or cerebrovascular accident (CVA) indicates an interruption in blood flow to the brain. Nancy Reading, RN, CPC, CPC-P , reviews strokes and explains how coders should report them and their treatment in ICD-10-CM and ICD-10-PCS.
Physicians have found ways to treat many congenital defects in utero, enabling the neonate to be born without defects. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, details ICD-10-CM coding for common birth defects, and ICD-10-PCS and HCPCS Level II coding for their treatment.
Spinal fusions can effectively eliminate pain and restore stability to the spine. Learn how to apply ICD-10-PCS codes and guidelines for spinal fusions and related procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Kerri Swart, RN, CCRN, CCDS, writes about how a previously 100%on-site CDI program shifted to remote work and maintained productivity and education standards.
Spinal fusions can effectively eliminate pain and restore stability to the spine. Learn how to apply ICD-10-PCS codes and guidelines for spinal fusions and related procedures.
Functional and structural disorders, infections, and irritations of the large intestine can cause debilitating digestive complications that require surgical intervention. Review ICD-10-PCS coding for colectomy and ostomy procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Functional and structural disorders, infections, and irritations of the large intestine can cause debilitating digestive complications that require surgical intervention. Review ICD-10-PCS coding for colectomy and ostomy procedures.
Cerebrovascular accidents (CVA) are the fifth-leading cause of death and a leading cause of disability in the U.S., according to the Centers for Disease Control and Prevention. Review ICD-10-CM coding for CVA and ICD-10-PCS coding for surgical interventions used to open blocked arteries. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Adhere to ICD-10-PCS guidance for reporting multiple procedures and procedural components when coding for wound debridement and skin grafting. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Robotic and computer-assisted surgical procedures are still considered new technology despite having been used in the U.S. for many years. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG , unpacks ICD-10-PCS coding for surgeries performed using specialized software and robotic technology.
Obesity has grown into a global epidemic with significant social and economic consequences. Review ICD-10-CM coding for obesity and other weight-related conditions, and ICD-10-PCS coding for surgical interventions used to maintain a healthy weight.
Robotic and computer-assisted surgical procedures are still considered new technology despite having been used in the U.S. for many years. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG , unpacks ICD-10-PCS coding for surgeries performed using specialized software and robotic technology.
Obesity has grown into a global epidemic with significant social and economic consequences. Review ICD-10-CM coding for obesity and other weight-related conditions, and ICD-10-PCS coding for surgical interventions used to maintain a healthy weight. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Pneumonia is a common infection of the lungs that can be life-threatening. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , breaks down ICD-10-CM/PCS coding for this infectious disease and its treatment.
Paraneoplastic syndrome is a rare condition that results from an immune system response to a neoplasm. In this article, Sarah Nehring, RHIA, CCS, CCDS , breaks down ICD-10-CM/PCS coding for paraneoplastic syndrome of the nervous system.
While laser interstitial thermal therapy (LITT) is not new, the expansion of its use for diagnoses beyond brain tumors can help a new patient population. Shelley C. Safian, PhD, RHIA, HCISPP, CCS-P, COC, CPC-I , describes how LITT is documented and reported in ICD-10-PCS.
Vaccinations are simple and effective ways of protecting individuals against harmful diseases. Review ICD-10-CM/PCS coding for vaccines administered during inpatient admission. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
While laser interstitial thermal therapy (LITT) is not new, the expansion of its use for diagnoses beyond brain tumors can help a new patient population. Shelley C. Safian, PhD, RHIA, HCISPP, CCS-P, COC, CPC-I , describes how LITT is documented and reported in ICD-10-PCS.
Vaccinations are simple and effective ways of protecting individuals against harmful diseases. Review ICD-10-CM/PCS coding for vaccines administered during inpatient admission.
The 2023 ICD-10-PCS code update includes 331 new codes and 64 code deletions that take effect this week. This article takes a close look at new ICD-10-PCS codes and guidelines for amputations, laser ablation, and aortic valve replacements. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Coders must be familiar with updates to the ICD-10-CM/PCS code sets for fiscal year 2023 . Audrey Howard, RHIA , reviews new codes and reporting guidelines for dementia, care complications, and vascular procedures as well as updates to MS-DRGs.
Endometriosis is a common gynecological condition that occurs when the tissue that lines the inside of the uterus grows outside of the uterus. Brush up on ICD-10-CM coding for the condition and ICD-10-PCS coding for surgical procedures used to treat it. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Debridement is used to treat serious or chronic wounds that do not heal with standard treatment. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG , describes five types of debridement and how to report these procedures in ICD-10-PCS.
Bronchus, lung, and lymph node biopsies are often performed via a bronchoscopic technique. Sarah Nehring, BS, RHIT, CCS, CCDS , breaks down ICD-10-PCS coding for brush, transbronchial fine needle aspiration, and transbronchial forceps biopsies.
A spinal fusion is used to permanently connect two or more vertebrae, eliminating motion between them. Read up on ICD-10-PCS guidance for reporting spinal fusions based on key details in the operative note. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Bronchoscopy is often performed in conjunction with other therapeutic procedures for the treatment of lung problems. Sarah Nehring, BS, RHIT, CCS, CCDS , breaks down ICD-10-PCS coding for bronchoscopy with bronchoalveolar lavage and suction of a mucus plug.
A spinal fusion is used to permanently connect two or more vertebrae, eliminating motion between them. Read up on ICD-10-PCS guidance for reporting spinal fusions based on key details in the operative note.
Determining the most specific ICD-10-PCS code for a procedural service can be tricky given that there are 34 character values and over 78,000 ICD-10-PCS codes for 2022. This article breaks down potentially confusing ICD-10-PCS guidelines for obstetric and cardiovascular procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A handful of new ICD-10-CM/PCS codes took effect April 1. Read up on the updates and CMS’ process for implementing code changes biannually. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Cranial diagnoses present with varied symptoms and require an individualized approach to treatment. Brush up on documentation and ICD-10-CM/PCS coding for neuroendoscopy, posterior fossa decompression, and embolectomy/thrombectomy procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Inpatient coding for brain surgery can be challenging as many approaches, techniques, and devices may be used to treat cranial abnormalities. Read up on reporting requirements and ICD-10-CM/PCS coding for craniotomies and deep brain stimulation (DBS). Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A cesarean section is typically performed when complications from pregnancy make a traditional vaginal birth difficult. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , breaks down ICD-10-CM coding for common labor and delivery complications, and ICD-10-PCS coding for cesarean deliveries.
Mechanical ventilation is a life-saving intervention used for acutely ill patients who cannot breathe on their own. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , evaluates medical terminology used to describe mechanical ventilation and breaks down ICD-10-PCS coding for this procedure.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes that it’s not unusual for an outpatient coder to advance their career by diving into inpatient coding. When deciding to learn about ICD-10-PCS, it’s important to first understand the basics and compare and contrast ICD-10-PCS and CPT. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
In part two of this two-part series, Audrey Howard, RHIA, covers fiscal year (FY) 2022 updates to ICD-10-PCS reporting for spinal procedures, specificity updates to the ICD-10-CM official coding guidelines, and modified MS-DRG logic for type 2 myocardial infarctions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah Nehring, RHIT, CCS, CCDS, writes that ICD-10-CM/PCS reporting for the cardiac system is complex and requires frequent review in order to report the most accurate codes. In this article, Nehring covers ICD-10-CM/PCS coding and clinical indicators for cardiogenic shock, intra-aortic balloon pumps, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Shelley C. Safian, PhD, RHIA, CCS-P, writes that inpatient Removals of a device from a lower bone may be performed less frequently than other procedures, which creates a need for more education on reporting ICD-10-PCS codes from table 0QP. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Approximately 185,000 amputations occur in the U.S. each year, according to the Amputee Coalition. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down documentation and ICD-10-PCS coding for amputations of the upper and lower extremities. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah Nehring, RHIT, CCS, CCDS, examines inpatient procedural coding for pacemaker procedures, as well as taking a look at how coding accuracy for these procedures can impact MS-DRG assignment.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, writes about the spinal conditions that may result in a patient’s need for spinal fusion surgery and outlines how to find the correct ICD-10-PCS code for the procedure.
The agency is proposing methods to alleviate burden on hospitals that have been under strain for the past year, while also asking for feedback that may shape future data reporting and rate-setting.
A spinal fusion, or surgery to permanently connect two or more vertebrae in the spine, is sometimes necessary to correct spinal deformities and instability. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down ICD-10-CM and ICD-10-PCS coding for fusion procedures. 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 (FY) 2022 IPPS proposed rule on April 27, with proposals for the annual ICD-10-CM/PCS code update, the creation of new MS-DRGs, and increases to hospital payment rates.
Spinal fusion procedures are reported using two different ICD-10-PCS tables, depending on the location of the vertebrae fused. Sarah Nehring, RHIT, CCS, CCDS , breaks down ICD-10-PCS coding for spinal fusions based on details in the operative note.
It’s important for inpatient coders to frequently review hospital-acquired conditions (HAC) and the rules governing their assignment in order to ensure proper reimbursement. Part two of this two-part series will review HACs in particular as part one focused on present on admission indicators.
Sarah Nehring, RHIT, CCS, CCDS, writes that the ICD-10-PCS code set update for fiscal year 2021 included the creation of five new Fragmentation tables. For this article, Nehring will take a look at two vascular Fragmentation procedures: ultrasound-assisted thrombolysis (EKOS) and intravascular shockwave lithotripsy (IVL). Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah Nehring, RHIT, CCS, CCDS, reviews several new COVID-19-related ICD-10-CM and ICD-10-PCS codes recently released by CMS that will become effective January 1. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The final 2021 CPT, ICD-10-CM, and ICD-10-PCS code sets were released in September, introducing new, revised, and deleted codes for diagnostic and procedural services and accompanying guideline changes.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP , details important ICD-10-PCS code updates and MS-DRG designation changes found in the fiscal year (FY) 2021 IPPS final rule. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The final 2021 CPT, ICD-10-CM, and ICD-10-PCS code sets were released last week, introducing new, revised, and deleted codes for diagnostic and procedural services and accompanying guideline changes. Read up on the changes, which will impact payment for hospital services in 2021.
Sarah Nehring, CCS, CCDS, RHIT , writes that the increased complexity and cost of implantable cardiac defibrillator devices is reflected in the higher relative weight and longer length of stay for these MS-DRGs compared to pacemaker MS-DRGs. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sharme Brodie, RN, CCDS, CCDS-O , writes that the cost of new technologies can lead to an overwhelming financial burden to hospitals and patients, which is why accurate reporting of ICD-10-PCS codes in the new technology section of the ICD-10-PCS manual is more important than ever.
Sarah Nehring, CCS, CCDS , says to ensure ICD-10-PCS coding accuracy and appropriate MS-DRG assignment, inpatient coders must understand the device being inserted and how to apply the coding conventions and guidelines for pacemaker-related procedure coding. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Dawn Valdez RN, LNC, CCDS, reviews MS-DRG and code assignment for COVID-19-related pediatric multi-system inflammatory syndrome (PIMS), as well as common findings and treatments for the condition.
Laurie L. Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , reviews Coding Clinic , First Quarter 2020, guidance, which includes topics such as reporting vaping-related disorders, malnutrition, and bariatric procedures.
Sarah A. Nehring, CCS, CCDS, details ICD-10-PCS reporting for extracorporeal membranous oxygenation (ECMO) procedures and says basic knowledge of what an ECMO procedure is, how it is established in a patient, and why it is used can have a large impact on proper reporting and hospital reimbursement.
Sarah Nehring, CCS, CCDS, reviews ICD-10-CM reporting for the novel coronavirus (COVID-19) as well as ICD-10-PCS reporting for procedures such as mechanical ventilations, tracheostomies, and extracorporeal membrane oxygenations. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
