Terry Tropin, MSHAI, RHIA, CCS-P , outlines changes to the ICD-10-PCS for fiscal year 2026, which were made primarily in the codes for the cardiovascular system, joints and bones, and nervous system. Some of these changes were in the Medical and Surgical section but others were in the New Technology and Extracorporeal or Systemic Assistance and Performance sections.
CMS released the fiscal year 2026 Inpatient Prospective Payment System final rule on July 31, which will provide a 2.6% payment increase for hospitals instead of the original 2.4% considered in the proposed rule. Among other provisions, the rule will continue the mandatory Transforming Episode Accountability Model and modify various quality reporting programs.
As the healthcare landscape evolves with new diseases, technologies, and treatment methodologies, so too must the guidelines that support the ICD-10-CM coding system. Review updates to the ICD-10-CM Official Guidelines for Coding and Reporting for fiscal year 2026 that will become effective October 1. Note : To access this free article, make sure you first register if you do not have a paid subscription.
Q: Are there solutions for having better coding and CDI collaboration? How might this help teams with escalation processes and implementation of AI programs?
Joanne Chopak-Foss, PhD , and Alba Kuqi, MD, MSHIM, CDIP, CCS, CCDS, CRCR, CICA, CSMC, RHIA, CCM , look to prove how CDI professionals and coders can fully realize the value of SDOH documentation and coding in maternal and child health and shift the narrative toward equitable care for new and expecting mothers.
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A recent Springer Nature study found an increase in Acinetobacter baumannii infections between 2018 and 2021 and carbapenem-resistant A. baumannii (CRAB) infections between 2018 and 2022. The presence of the bacteria was identified in 1% of hospitalized U.S. patients, and over one third of A. baumannii cases were CRAB, designated by the WHO as a critical pathogen in need of new antibiotics.
Temperatures in the upper 90s and spikes into the low 100s can bring an increased risk of hospitalization for heat-related illnesses, especially in those areas which do not traditionally experience these outside intensities. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , provides guidance for reporting both diagnosis and procedure codes for sun poisoning and heatstroke admissions.
With the fiscal year (FY) 2026 ICD-10-CM update adding 487 new diagnosis codes, inpatient coders will have the opportunity to report conditions with more specificity in areas such as wound care, ophthalmology, neurology, nephrology, pathology, and chronic disease coding. Note : To access this free article, make sure you first register if you do not have a paid subscription.
While many bone fractures are often treated in emergency rooms or orthopedic clinics, certain fractures—especially severe, complex, or high-risk ones—tend to require inpatient admission. Nancy Reading, BS, CPC, CPC-P, CPC-I , shows how recognizing severity of fractures that may warrant hospitalization helps coders capture the full scope of the patient’s condition.
Reporting aneurysm repairs can appear almost as complex as the procedure itself. However, Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , shows how taking it one character at a time and using the helpful guidelines and descriptors provided within ICD-10-PCS will allow coders to master this accurately and quickly.
CMS recently published the fiscal year 2026 ICD-10-PCS code set and official guidelines. Although CMS made no significant changes to the guidelines, the ICD-10-PCS code set includes 156 new codes, 27 deleted codes, and four new tables.
Terry Tropin, MSHAI, RHIA, CCS-P , clarifies the featured terms and interventions of Coding Clinic ’s ICD-10-PCS second quarter update so that coders can comprehend and accurately apply procedure codes in specific scenarios.
Excluding skin cancer, breast cancer and prostate cancer are the most frequently diagnosed cancers among women and men, respectively. While both diseases originate in gender-specific organs and can range from slow-growing to aggressive forms, their clinical presentation and diagnostic complexity differ—differences that are reflected in how they are medically coded. Note : To access this free article, make sure you first register if you do not have a paid subscription.
Alba Kuqi, MD, MSHIM, CDIP, CCS, CCDS, CRCR, CICA, CSMC, RHIA, CCM , walks through the evolution of sepsis definitions that reflect the growing sophistication in our understanding of how the body responds to infection. Understanding the history not only helps contextualize definition variations in provider documentation but also has important implications for coding and reimbursement.
Our experts answer questions on organizing clinical validation queries, the difficulty of diagnosing skin failures, and establishing an organizational definition of sepsis.
With its enhanced specificity and comprehensive structure, ICD-11 offers a more detailed and accurate framework for documenting cancer diagnoses. Karla VonEschen, MS, CCDS-O, CPC, CPMA , explores how precise documentation and the coder’s ability to capture all the diagnosis codes to fully describe the condition will be crucial for healthcare organizations.
Reporting aneurysm repairs can appear almost as complex as the procedure itself. However, Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , shows how taking it one character at a time and using the helpful guidelines and descriptors provided within ICD-10-PCS will allow coders to master this accurately and quickly.
