Q: Per Coding Clinic, Second Quarter 2017, when a spinal fusion is performed without bone grafting it cannot be coded to the root operation Fusion in ICD-10-PCS. Is this advice still accurate?
Judith L. Kares, JD, reviews potential updates found in the fiscal year (FY) 2022 IPPS proposed rule that pertain to quality programs for inpatient hospitals and changes to address existing inequities in the delivery of these services.
Pediatric record reviews require a different skill set than those in the traditional adult acute care space. Often, those reviewing these specialized charts are islands within their overall CDI or coding department, acting as the sole pediatric chart reviewer. This article sheds light on how some have perfected these reviews within their department.
The Centers for Disease Control and Prevention recently released the fiscal year (FY) 2022 ICD-10-CM code set which includes 159 new, 20 revised, and 32 deleted ICD-10-CM codes. CMS also released the finalized ICD-10-PCS codes for FY 2022, which includes 191 new, 62 revised, and 107 deleted ICD-10-PCS codes. The code changes take effect October 1, 2021.
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.
Medicare Recovery Auditors will review claims submitted by inpatient psychiatric facilities to ensure that billed services are medically reasonable and necessary, according to a recent Medicare Quarterly Provider Compliance Newsletter.
Howard Rodenberg, MD, MPH, CCDS , describes how internal reviews can be used to identify repeated coding errors and prevent payment penalties due to Patient Safety Indicators (PSI) and hospital-acquired conditions (HAC).
Approximately 1.5% of the general population sees a primary care physician each year for treatment of chest pain symptoms, according to Family Practice . In this article, Sarah Nehring, RHIT, CCS, CCDS , breaks down potentially confusing ICD-10-CM coding guidelines for chest pain and angina. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Joe Rivet, Esq, CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , summarizes findings from recent Office of Inspector General audits that highlight improper billing of high-level inpatient stays. He also outlines steps hospitals can take to prevent billing errors due to upcoding.
CMS offers hospitals some breathing room to recover from the effects of the COVID-19 pandemic in the 2022 IPPS proposed rule. Review proposed updates to complication/comorbidity (CC) and major CC classifications, and a proposed new MS-DRG rate-setting method aimed at alleviating hospital burden.
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.
A recent Office of Inspector General audit estimates that Medicare improperly paid inpatient hospitals $267 million over a two-year period for transfer services incorrectly billed as discharges. Judith Kares, JD , analyzes documentation and billing rules for acute and post-acute transfers.
The Office of Inspector General (OIG) recently performed a compliance audit of specific diagnosis codes billed by Anthem Community Insurance Company Inc. to CMS and found that the company submitted unsupported diagnosis codes for 123 of the 203 enrollee-years.
The Office of Inspector General (OIG) performed a provider compliance audit of the Virtua Our Lady of Lourdes Hospital and found that the hospital received overpayments of approximately $4.8 million between January 1, 2016 and December 31, 2017.
The evolution of the role of clinical documentation integrity (CDI) specialists and their impact on coders has changed the landscape of inpatient coding departments. Learn about how to effectively collaborate with CDI professionals when conducting physician queries.
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.
Sarah Nehring, RHIT, CCS, CCDS , reviews documentation and ICD-10-CM guidance for reporting for toxic effects, adverse drug reactions, and underdosing of prescribed medications.
