Clinical validation reviews and queries ensure that the documented diagnoses and clinical indicators hold up to inspection. This article gives an overview on processes and templates, top queried diagnoses, and physician engagement to help CDI teams perfect their clinical validation efforts.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, details MS-DRG updates found in the fiscal year (FY) 2021 IPPS proposed rule, including the proposed creation of MS-DRG 521 (Hip Replacement with Principal Diagnosis of Hip Fracture with MCC) and MS-DRG 522 (Hip Replacement with Principal Diagnosis of Hip Fracture without MCC). Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The following questions were answered by Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, HCS-D, director of HIM and coding for HCPro in Middleton, Massachusetts, and Yvette DeVay, MHA, CPC, CPMA, CIC, CPC-I, lead instructor for HCPro’s Medicare Boot Camp®—Physician Services Version.
Diagnosis codes for neurologic disorders are widespread throughout the ICD-10-CM manual. In this article, Joel Moorhead, MD, PhD, CPC , breaks down ICD-10-CM code selection for cerebrovascular diseases, transient cerebral ischemic attacks, and peripheral neuropathies.
Even experienced coders have difficulty adhering to CPT reporting guidelines for wound care procedures. Review Medicare’s medical necessity requirements for debridement procedures and CPT coding for wound care services delivered via interactive audio and video. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS issued the proposed lists of new, revised, and invalidated ICD-10-CM codes May 11 in conjunction with the fiscal year (FY) 2021 Inpatient Prospective Payment System proposed rule. The update will be significantly larger than the FY 2020 ICD-10-CM update if all the proposed changes are finalized.
All queries, regardless of their origin, are bound to follow the “ Guidelines for Achieving a Compliant Query Practice .” In order to ensure queries stand up to outside scrutiny and are effective, many CDI and inpatient coding leaders have put query audit practices in place for their departments as they bring on new team members.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, writes that attention must be paid to coding guidelines and instructional notes for blindness, low vision, and laterality when reporting diseases of the eye and adnexa in Chapter 7 of the ICD-10-CM manual. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah Nehring, CCS, CCDS, says that strokes are complicated, which is why it is important for inpatient coders to be familiar with the brain’s anatomy and the clinical concepts of a stroke in order to report the most accurate ICD-10-CM codes.
Pulmonary hypertension is a complex, progressive disease that affects both children and adults, and leads to significant morbidity and mortality. In this article, Amy Sanderson, MD , reviews this disease to help ensure proper inpatient reporting and more precise queries.
Sepsis is a major challenge for patients, hospitals, and coders in America. Three articles first published online by the journal Critical Care Medicine give an update on trends in sepsis in the U.S. through Medicare beneficiary data collected between 2012 and 2018.
To assign CPT codes for spinal procedures, coders need a solid understanding of spinal anatomy and procedural terminology. They must also be up to date on guidance from CMS and the American Medical Association for facility reporting of spinal surgeries. Note : To access this free article, make sure you first register here if you do not have a paid subscription.