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.
ICD-10-PCS includes specific guidelines for coding spinal fusion procedures, including guidelines for selecting the body part value. The body part for a spinal vertebral joint(s) rendered immobile by...
ICD-10-PCS differs significantly from ICD-9-CM procedure coding, but fortunately, the Cooperating Parties are providing plenty of guidelines. Laura Legg, RHIT, CCS, discusses some of the key ICD-10-PCS guidelines and why coders should learn them.
So far, we’ve covered three different ICD-10-PCS guidelines for multiple procedures. We’ve looked at how to report multiple procedures involving: Same root operation, different body parts as defined...
Providers and coders seem to speak two different languages-clinical and coding. Providers already have issues parsing ICD-9-CM "coder speak," so how can you get them to understand ICD-10?
Nervous or worried about the upcoming transition to ICD-10-PCS? Don’t be. Charlotte Lane, RHIA, CCS, and Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, offer up tips to reduce your anxiety about the new coding system.
In order to assign the correct ICD-10-PCS code, coders will need to determine the correct root operation. Christina Benjamin, MA, RHIA, CCS, CCS-P, discusses the various root operations found in the medical and surgical section of ICD-10-PCS.
We’ve already discussed one of the multiple procedure guidelines in ICD-10-PCS, but we still have three more to go. And that’s not counting the guidelines that are not included in the multiple...
The multiple procedure guidelines in ICD-10-PCS present possibilities for coder confusion. Several guidelines relate to the coding of multiple procedures, some under the heading of multiple...
Penny arrived at the Stitch ‘Em Up Hospital with a benign growth on her thyroid gland (ICD-10-CM code D35). The growth isn’t causing any functional problems, so we don’t need to report any additional...
Maternal fetal medicine procedures highlight the differences between ICD-9-CM procedure codes and ICD-10-PCS codes and can serve as a foundation for understanding ICD-10-PCS. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, demonstrates how coding for fetal thoracentesis will change after the switch to ICD-10.
You need enthusiasm and a desire to keeping learning to tackle the monumental task of learning ICD-10-PCS. In authoring an ICD-10 CM/PCS education program 10 hours per work I learn something new...
Thinking about exiting the coding profession before the transition to ICD-10? Laura Legg, RHIT, CCS, enjoys coding too much to give it up and offers some tips for how to prepare for the transition.
The manager of clinical documentation integrity program/HIMS at a 300-bed academic medical center and pediatric specialty hospital has high hopes for computer-assisted coding (CAC). In particular, she anticipates that it will increase productivity and ease the transition from ICD-9-CM to ICD-10-CM/PCS.
Assess. Educate/train. Practice. Gloryanne Bryant, RHIA, CCS, CDIP, CCDS, and Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CPCD, COBGC, CCS-P CDIP, reveal how following those three steps can prepare you for ICD-10 implementation.
In ICD-9-CM, coders report specific codes to indicate a surgeon used robotic assistance. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, explains how that will change in ICD-10-PCS.
Outpatient coders currently report procedures using CPT codes. That won’t change after the switch to ICD-10. However, some facilities currently require outpatient coders to also report procedures...
We all know coder productivity will go down after the transition to ICD-10 and it may never rebound to current levels. The question is, how much will productivity decline? It could drop more than you...
Dr. Cap I. Larry is back at work on some blood vessels at Stitch ‘Em Up Hospital. Let’s see what she’s up to today. For all of Dr. Larry’s procedures, we’re going to be coding from the Medical and...
Today we are taking a peek into OR 3 at the Stitch ‘Em Up Hospital to watch Dr. Cap I. Larry work on some blood vessels. Then we’re going to code her procedure. Dr. Larry is harvesting part of the...
By now, you probably know that ICD-10-PCS codes contain seven alpha-numeric characters. Each character represents a specific piece of information and those meanings can vary by section. In the...
If you have looked at the ICD-10-PCS Manual, you know that the codes are arranged in tables based on the first three characters of the code. The table contains all of the possible choices for...
Welcome to Stitch ‘Em Hospital, where we’re preparing for ICD-10-PCS by actually coding some of our procedures using the new system. We want to make sure we’re ready to go on October 1, 2014, and...
When a physician places a device that takes the place of all or some of a body part, assign a code from ICD-10-PCS root operation replacement (third character R). Think of a total knee replacement or...
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 coding managers might not realize that these benefits can also help hospitals with long-term preparation for ICD-10. Angie Comfort, RHIT, CCS, and Rose T. Dunn, MBA, RHIA, CPA, FACHE, explain the benefits of cross training coders as ICD-10 approaches.
In ICD-10-PCS, coders will only report a device when the device remains in the patient after the procedure. If it’s removed, it’s not a device and your sixth character will be Z. For many procedures...
As expected, not much has changed for 2013 with ICD-10-PCS codes. The updated code set is now available on the the CMS website . CMS confirmed in April that the code freeze will hold until ICD-10-CM/...
When a physician performs a procedure designed to put in a device without doing anything else to a body part, coders will report ICD-10-PCS root operation insertion (third character H in the medical...
A lot of learning is ahead for coders and others who will need to learn how to code in ICD-10. There are changes all around, and OB coding is no exception. Lori-Lynne A, Webb, COBGC, CPC, CCS-P, CCP, CHDA, explains coding for OB ultrasounds, amniocentesis, MRIs, and other procedures in CPT ® , ICD-9, and ICD-10
Some ICD-10-PCS root operations encompass a wide range of procedures. Think biopsy, excision, and extraction. Others cover a much smaller range of possible procedures, including fusion. Coders will...
A patient comes in for a face lift or another cosmetic procedure. What root operation should you code the procedure to in ICD-10-PCS? The answer: alteration (third character 0). The goal of an...
When a physician performs a procedure intended to narrow the diameter of a tubular body part or orifice, coders will select the root operation restriction in ICD-10-PCS. Restriction includes both...
When a physician performs a procedure to enlarge the diameter of a tubular body part or orifice, coders will report root operation dilation with 7 as the third character in the medical and surgical...
Unfortunately, ICD-10-PCS is not very comparable to the current ICD-9-CM volume 3 codes inpatient coders currently use. But coders shouldn’t despair, according to Sandy Nicholson, MA, RHIA, Jennifer Avery, CCS, CPC-H, CPC, CPC-I and Robert S. Gold, MD —ICD-10-PC coding may even be fun once coders get the hang of it.
Not all of the ICD-10-PCS root operations are complicated or confusing. Take reattachment for example. The root operation is pretty much what you would expect. The official definition of reattachment...
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...
When a physician moves a body part to a new place without disrupting its vascular and nervous supply, coders will code to root operation Transfer in ICD-10-PCS. The root operation is indicated by the...
When a physician completely closes the orifice or lumen of a tubular body part, coders will look to the root operation occlusion in ICD-10-PCS. The orifice can be a natural orifice or an artificially...
The ICD-10-PCS defines root operations excision and resection in a very similar way. Excision is cutting out or off, without replacement, a portion of a body part. Coders should report the qualifier...