A patient undergoes a hysterectomy and experiences post-procedural bleeding. The surgeon cauterizes the bleed and evacuates a blood clot. In ICD-10-PCS, how do you code the cauterization? With the...
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.
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.
Coders may struggle to differentiate between ICD-10-PCS root operations Excision and Resection. Nena Scott, MSEd, RHIA, CCS, CCS-P, AHIMA-approved ICD-10-CM/PCS trainer, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, illustrate the details that will help coders arrive at the correct root operation.
Sometimes a surgeon must take drastic action and amputate a patient’s upper or lower extremity. For these cases, we would use ICD-10-PCS root operation Detachment (third character 6). ICD-10-PCS...
Map (third character K) is a very narrowly defined ICD-10-PCS root operation. By definition, Map procedures are used to locate the route of passage of electrical impulses and/or locate functional...
Coders may struggle to differentiate the ICD-10-PCS root operations excision and resection. Nena Scott, MSEd, RHIA, CCS, CCS-P, AHIMA-approved ICD-10-CM/PCS trainer, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, explain why excision is the root operation of choice for excisional debridement and sebaceous cyst removal.
Almost all of the ICD-10-PCS root operations describe very specific intent. Think about the difference between root operations excision and resection. Excision involves removing some of a body part...
ICD-10-CM root operations excision and resection are sometimes hard to differentiate. ICD-10-PCS defines excision (B) as cutting out or off, without replacement, a portion of a body part. Resection (T) is almost identical, but involves cutting out or off the entire body part.
CMS reversed course earlier this week and announced it will conduct end-to-end ICD-10 training with a sample of providers. Previously, CMS had stated it would not conduct any end-to-end testing...
ICD-10-PCS defines devices for coding purposes in a very specific way. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, CHTS-CP, explain how to assign the correct device character in ICD-10-PCS.
Inpatient coders will see an entirely new coding system October 1 when they begin officially using ICD-10-PCS. However, MS-DRGs are not changing. The only thing that is changing is what codes map to a particular MS-DRG.
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.
Odds are, most coders will never use ICD-10-PCS table 0W4. Why? Because root operation 4 is creation (making a new genital structure that does not physically take the place of a body part). Unless...
It’s the gift-giving season and HCPro is giving you free on-demand access to the audio conference, ICD-10-PCS: Coding, Structure and Format, when you sign up for the January 10 live webcast, ICD-10-...
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.
ICD-10-PCS implementation is less than a year away, so the pressure is on coders to learn the new system and maintain productivity. Gerri Walk, RHIA, CCS-P, AHIMA-approved ICD-10-CM/PCS trainer, discusses how to overcome some of the challenges inpatient coders will face in ICD-10-PCS.
In ICD-10-PCS, coders will need to find details they currently don’t use. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, AHIMA-approved ICD-10-CM/PCS trainer, offers tips for locating the necessary information in the body of the operative report.
ICD-10-PCS is a whole new ball game for inpatient coders. Everything will change. Coders have been hearing that almost constantly since CMS announced the first ICD-10 implementation date in 2009.
Initially, we thought that outpatient coders didn’t have to learn to code in ICD-10-PCS. They would still use CPT® codes to report physician services in the outpatient world. Now it looks like that...
Coders will use an ICD-10-PCS table to build a code for a hip or knee replacement. As with any procedure, coders must first determine the root operation. Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CPCD, COBGC, CCS-P, CDIP, and Wanda L. Cidor, guide you through coding for these procedures.
Approach is the fifth character in the ICD-10-PCS code. Laura Legg, RHIT, CCS, AHIMA-approved ICD-10 CM/PCS trainer , reviews the seven approaches used in ICD-10-PCS.
The ICD-10-PCS Official Guidelines for Coding and Reporting address four specific circumstances when coders will report multiple procedures. Jennifer Avery, CCS, CPC-H, CPC, CPC-I, and Mark N. Dominesey, MBA, RN, CCDS, CDIP, HIT Pro-CP, explain the guidelines and how they differ from the current ICD-9-CM guidelines.
We have just a little over a year remaining until ICD-10 implementation. How well do you know your ICD-10-PCS codes? ICD-10-CM shares a lot of similarities with ICD-9-CM. Sadly, ICD-9-CM procedure...
Unlike ICD-10-CM, ICD-10-PCS does not include unspecified codes. Thus, clinicians may see an increased number of queries on procedures post-implementation. Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, explains why facilities should review documentation for inpatient procedures now.
When it comes to ICD-10-CM/PCS, coders may be the hardest and most directly hit employees. Laura A. Shaffer, PhD, and Monica Lenahan, CCS, explain how hospitals may be lagging behind in terms of actually managing the change for these individuals.
When it comes to ICD-10-CM/PCS, coders may be the hardest and most directly hit employees. Yet some experts say that aside from technical training, hospitals may be lagging behind in terms of actually managing the change for these individuals.
Complete capture of procedure codes in ICD-9-CM helps to ensure accurate translation to ICD-10-PCS. Donna M. Smith and Patricia L. Belluomini, RHIA, reveal coding errors—including omission of procedure codes—that make the translation process more challenging.
The 2014 draft ICD-10-PCS guidelines include a code for the usage of a robotic-assist device in surgery, something coders can currently report in ICD-9-CM. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , compares documentation requirements for coding robotic-assisted surgery in both ICD-9-CM and ICD-10-PCS.
At first glance, codes for insertion, removal, and revision of pacemakers look quite different in ICD-10-PCS. Kimberly J. Carr, RHIT, CCS, CDIP, and Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, compare and contrast pacemaker procedure coding in ICD-9-CM and ICD-10-PCS.
BCCS recently spoke with advisory board member Gloryanne Bryant, RHIA, CCS, CDIP, CCDS, about the role of state HIM associations in ICD-10-CM/PCS coder education. The following is a summary of that conversation. Bryant serves as the president of the California Health Information Association (CHIA), which has approximately 5,000 members to date. For more information, visit http://californiahia.org .
Joint replacement surgery is nothing short of a miracle for those experiencing pain due to an arthritic or damaged joint. The surgery is performed not only on the hip and knee, but also on the ankle, foot, shoulder, elbow, or finger. Patients who have undergone this surgery often regain mobility and are able to live pain free.
In ICD-10-PCS, coders will need to select the root operation based on the objective of the procedure (not what the physician calls it). If the physician’s objective is to strip out by force all of a...
Upon quick glance, codes for insertion, removal, and revision of pacemakers look quite different in ICD-10-PCS. The good news is that much of the logic that coders use to assign these codes in ICD-9-CM won't change. The silver lining? The procedure itself doesn't change, nor does anatomy.
The ideal approach to ICD-10-CM/PCS preparation is capitalizing on the synergistic partnership between clinical documentation improvement and coding professionals. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS, discusses how organizations can use this dynamic to improve preparations for ICD-10.
Betsy comes in to Stitch ‘Em Up Hospital suffering from a cerebral aneurysm. Dr. Jannettta performs a vessel embolization procedure to treat Betsy. [caption id="attachment_3480" align="alignright"...
Any ICD-10-CM/PCS to-do list wouldn’t be complete without the task of reviewing and revising query templates. Cheryl Robbins, RHIT, CCS, Gloryanne Bryant, RHIA, CCS, CDIP, CCDS, and Sandra L. Macica, MS, RHIA, CCS, provide tips for updating queries for ICD-10.
In ICD-10-PCS, root operations precisely identify the purpose, intent, or objective of a procedure. Cynthia L. Stewart, CPC, CPC-H, CPMA, CPC-I, CCS-P, highlights the specific—and often subtle—differences in the definitions of ICD-10-PCS root operations.
ICD-10 implementation challenges will vary from organization to organization, depending on size, setting, and patient mix. Factor in physician buy-in and budget woes, and implementation seems overwhelming.
Sometimes our patients are very sick, very injured, or undergo multiple procedures during their stay. So how do you pick your principal procedure code in ICD-10-PCS? The ICD-10-PCS guidelines offer...
The ICD-10-PCS codes for 2014 are now available on the CMS website. CMS also posted the 2014 ICD-10-PCS guidelines and an ICD-10-PCS reference manual. You will find four new codes under new...
Everyone in healthcare—providers and payers alike—faces the same problems when preparing for ICD-10 implementation . Stephen Spain, MD, CPC, Michael Miscoe, Esq., CPC, CPCO, CASCC, CCPC, CUC, and Annie Boynton, BS, RHIT, CPC, CCS, CPC-H, CCS-P, CPC-P, CPC-I, offer the physician, compliance, and payer perspectives on the ICD-10 transition.
When coders begin using ICD-10-PCS the second and fourth character definitions seem simple enough: Second character-Body system Fourth character-Body part However, when coders start assigning codes,...
Change is consistently a part of HIM and coding. Rules, regulations, and codes change yearly and sometimes quarterly. Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, reveals why the switch to ICD-10 is different from the annual changes coders are used to and how coders and organizations can prepare.
Choosing the correct root operation may be one of the most challenging aspects of ICD-10-PCS. Sandra Macica, MS, RHIA, CCS, and Kristi Stanton, RHIT, CCS, CPC, define some of the root operations in the surgical section of ICD-10-PCS and explain when to report them.
We all know that procedure coding will change considerably on October 1, 2014 with the implementation of ICD-10-PCS. But what about change as an ICD-10-PCS root operation? In ICD-10-PCS, you will use...
Obstetric coding has always been challenging for coders and coding multiple births is particularly difficult. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA COBGC, reviews how coding for multiple births differs between ICD-9-CM and ICD-10-CM.
