Cardiopulmonary resuscitation (CPR) is a lifesaving treatment used when the heart or lungs cease to function. Whether CPR is conducted alone or with other services, Nancy Reading, RN, CPC, CPC-P , covers the various ways that CPR can be reported and how to do so.
Coders should take note of hundreds of updates to the tabular addenda that serves as an instruction guide to the 2024 ICD-10-CM code set. Both take effect October 1.
Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , summarizes the highlights from the newest installment of Coding Clinic, which includes guidance on reporting pancytopenia, inherent conditions, ORIF, and neurally adjusted ventilatory assist devices.
Our experts answer questions about 2024 ICD-10-CM coding for HIV-related encounters, ICD-10-PCS reporting for Impella insertions and removals, and more.
There is one tell-tale sign that fall is here: the October implementation of the ICD-10 coding updates. Courtney Crozier, MA, RHIA, CCS, CDIP , explains the highlights of the update for fiscal year 2024, including 395 new codes, 25 deletions, 22 revisions, and 131 new headers.
The fiscal year (FY) 2024 IPPS final rule, released in August, provides updates on inpatient hospital reimbursement, ICD-10-CM/PCS coding and DRG changes, quality and reporting programs, and more.
Diabetes mellitus is a common condition that occurs when a patient’s blood sugar (blood glucose) is consistently too high. Sarah Gould, CPC , delves into the disorder and covers how to report some of its many complications in ICD-10-CM. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The heart is a restless organ whose constant rhythm is integral to normal bodily functions. Unfortunately, there are many maladies that can occur, as Linda Martien, CPC, CPC-I, COC, CPMA, CRC, explains through her review of normal cardiac pathophysiology and how to report common rhythm abnormalities in ICD-10-CM.
The Centers for Disease Control and Prevention (CDC) announced the launch of its Hospital Sepsis Program Core Elements initiative on August 24. The program offers resources for hospitals to improve identification and management of sepsis.
Cardiopulmonary resuscitation (CPR) is a lifesaving treatment used when the heart or lungs cease to function. Whether CPR is conducted alone or with other services, Nancy Reading, RN, CPC, CPC-P , covers the various ways that CPR can be reported and how to do so.
In this article, the author takes a closer look at CMS’ 2024 Medicare Physician Fee Schedule (MPFS) proposed rule—specifically a proposal to allow new providers to perform and bill behavioral health codes, offer providers new service categories, and give a code-valuation adjustment.
CMS recently released a national coverage determination update to the Medicare Claims Processing Manual . This update covers new requirements for CPT coding associated with acupuncture and dry needling services.
Q: Our coding department has a longstanding issue with physicians not presenting enough information to properly report CPT debridement services for ulcers, resulting in queries and denials. What do you recommend?
As coders witness annually, the ICD continues to evolve over its decades of use. This article covers the history of disease classification, current coding techniques, and possible future technologies of the industry. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Terry Tropin, MSHAI, RHIA, CCS-P , reviews the biggest changes to the 2024 ICD-10-CM guidelines and tabular list set to take effect October 1, including deletions of certain COVID-19 screening guidelines, and additional direction for new resistant hypertension and myocardial infarction codes.
CMS recently published a summary of its second quarter 2023 HCPCS Level II code update application decisions, accepting 16 of 24 submissions. Many of the changes addressed in the announcement have an effective date of October 1, but one code revision and one code discontinuation will take effect before then.
While taking time to relax is important, professionals must seize all opportunities to prepare for updates. Connie White, CPC, CPAR , reviews the process her team at Northside Hospital in Atlanta, Georgia takes to prepare for annual CPT code changes.
As the summer temperatures continue to soar worldwide, so does the number of patients with heat-related illnesses (HRI). This article defines common HRIs and includes guidance on how to report them correctly in ICD-10-CM. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
With certain medical conditions, encountering differing opinions and discrepancies in provider documentation is inevitable. Deanne Wilk, MPS, RN, CCDS, CCDS-O, CDIP, CCS , reviews 10 diagnoses whose documentation commonly features discrepancies.
Q: Is there a hierarchy of social determinants of health codes? Is there an order of importance for us to sequence first, since only a certain number will fit on a Medicare claim?
A July JAMA Network study found that cannabis use disorder slightly increased patient morbidity and in-hospital mortality. The study included 12,422 hospitalizations following major elective inpatient surgeries.
Hemodialysis involves diverting blood into an external machine, where it is filtered and returned to the body. Sarah Gould, CPC , describes the vascular surgical options for hemodialysis (fistulas and grafts), their various types, and how to report them in ICD-10-PCS. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Parkinson's disease is a chronic and progressive neurodegenerative disorder that affects the central nervous system. Debbie Jones, CPC, CCA , explains the symptoms, treatment, and how 2024 ICD-10-CM coding changes will affect reporting for this disease.
With certain medical conditions, encountering differing opinions and discrepancies in provider documentation is inevitable. Deanne Wilk, MPS, RN, CCDS, CCDS-O, CDIP, CCS , reviews 10 diagnoses whose documentation commonly features discrepancies.
CMS’ 2024 OPPS proposed rule, released in July, details major changes to price transparency requirements and proposes numerous changes to behavioral health reimbursement, coverage of dental services, and more.
Our experts answer questions about documentation requirements for CPT debridement codes, sequencing social determinants of health ICD-10-CM codes, and more.
The fiscal year 2024 IPPS final rule, released in August, provides updates on inpatient hospital reimbursement, ICD-10-CM/PCS coding and DRG changes, quality and reporting programs, and more.
Terry Tropin, MSHAI, RHIA, CCS-P, reviews the biggest changes to the 2024 ICD-10-CM guidelines and tabular list set to take effect October 1, including deletions of certain COVID-19 screening guidelines, and additional direction for new resistant hypertension and myocardial infarction codes.
Surgeons are often the toughest contingent of any medical staff with which a CDI program must make headway. Understanding a little surgeon psychology is the key to making positive inroads. Surgeons see themselves as “doers” or “fixers,” while they consider most other medical specialties as “thinkers” who are not “doers.”
CMS published the 2024 Medicare Physician Fee Schedule (MPFS) proposed rule on July 13 with new potential policies and codes affecting physician reporting, including new HCPCS codes for E/M services and behavioral health.
Chronic ulcers are a prolific, costly problem in hospitals. This article examines the most common types of chronic ulcers—diabetic, venous, and pressure ulcers—and the ICD-10-CM guidance coders should know to properly report them. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS’ 2024 OPPS proposed rule, released July 13, details major changes to price transparency requirements and proposes numerous changes to behavioral health reimbursement, coverage of dental services, and more.
Coders should take note of hundreds of updates to the tabular addenda that serves as an instruction guide to the 2024 ICD-10-CM code set. Both take effect October 1.
Q: CMS recommends greater than 38°C as the upper limit temperature threshold for sepsis in the Sepsis-1 bundle, but our consulting group recommends greater than 38.3°C. What would you recommend using as the temperature threshold for diagnosing sepsis?
Kate Siemens, RN, CMSRN, CCDS , offers her nursing and coding experience to explain postoperative ileus, a common complication after gastrointestinal surgery, and associated ICD-10-CM coding.
A recent study from Epic Research showed that the average length of provider notes increased, but note-taking time decreased since 2020. The study explains the reason for this change and the effect it has on providers.
Shelley Safian, PhD, RHIA, CCS-P, COC, CPC-I, defines hand-assisted laparoscopic surgery (HALS) procedures and how to report them according to new guidance in the 2024 ICD-10-PCS guidelines. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS released the fiscal year 2024 ICD-10-CM Official Guidelines for Coding and Reporting on July 5. The release included updated language and examples for reporting COVID-19 preoperative testing, sepsis, the coma scale, and other conditions.
Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , covers the highlights from the Coding Clinic’s latest installment. It includes sequencing for cancer, COVID-19 screening updates, and analysis of “with” guidelines in ICD-10-CM.
Fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths in the U.S. Tonya Chandler, RHIT , examines ICD-10-CM reporting for fentanyl use, overdose, symptoms, and dependence through several coding scenarios.
Sickle cell disease is a group of inherited disorders that causes red blood cell deformation. This article discusses the disease and covers new guidance for it and its manifestations according to FY 2024 ICD-10-CM guidelines and codes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: What are some tips for organizations that are just starting out capturing the type of information to report social determinant of health (SDOH) diagnoses in ICD-10-CM?
ICD-10-PCS provides many codes related to respiratory assistance, ECMO, and ultrasound for procedures for newborns/neonates. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , reviews these procedures and offers clinical coding scenarios to clear up confusion. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A June study in The Journal of the American Medical Association concluded that data collection and reporting efforts to comply with CMS inpatient hospital quality programs cost more than $5 million and took more than 100,000 personnel hours for a large hospital.
Kate Siemens, RN, CMSRN, CCDS , conducts an interview with Majed Gharfeh, MD, to offer a physician’s perspective on queries and tips on how coders can receive the best results from querying their providers.
The rise in remote work has enabled many healthcare systems to transition to a systemwide model. This change has left some CDI departments struggling to create a unified team. Learn from other facilities on how to overcome these challenges.
As the COVID-19 public health emergency has ended, audits are likely to pick up steam. To prepare for this increase in audit activity, it’s essential for providers and coders to examine both current and upcoming trends.
Shelley Safian, PhD, RHIA, CCS-P, COC, CPC-I, defines hand-assisted laparoscopic surgery (HALS) procedures and how to report them according to new guidance in the 2024 ICD-10-PCS guidelines.
Surgical osseointegrated bone prostheses have emerged as a popular alternative to hearing aids. Debbie Jones, CPC, CCA, defines how these devices work and how to report implantation, removal, and replacement of these devices in CPT.
Coders saw extensive code changes and expansion for ICD-10-CM category O35.- in 2023. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG, reviews what coders need to know when reporting fetal conditions affecting the management of the mother.
Fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths in the U.S. Tonya Chandler, RHIT, examines ICD-10-CM reporting for fentanyl use, overdose, symptoms, and dependence through several coding scenarios.
Kate Siemens, RN, CMSRN, CCDS, conducts an interview with Majed Gharfeh, MD, to offer a physician’s perspective on queries and tips on how coders can receive the best results from querying their providers.
Julie Kyles, CPC, explains that CMS issued a modest set of hospital and practitioner procedure-to-procedure and medically unlikely edits in the latest quarterly update to the National Correct Coding Initiative (NCCI) edits, effective July 1
Surgical osseointegrated bone prostheses have emerged as a popular alternative to hearing aids. Debbie Jones, CPC, CCA, defines how these devices work and how to report implantation, removal, and replacement of these devices in CPT.
The Office of Inspector General (OIG) recently released the results of an audit of Medicare billing requirements for psychotherapy services submitted from March 2020 through February 2021 as providers adapted to changes introduced as a result of the COVID-19 public health emergency.
The aim of every hernia repair procedure is to manipulate the herniated organ back into its proper position. This article reviews procedures and 2023 CPT coding guidance for hiatal, inguinal, femoral, abdominal, and parastomal hernia repairs. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The term “stroke” or cerebrovascular accident (CVA) indicates an interruption in blood flow to the brain. Nancy Reading, RN, CPC, CPC-P , reviews strokes and explains how coders should report them and their treatment in ICD-10-CM and ICD-10-PCS. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Amanda Vincent , Javier Ortiz , and Teresa Brown, RN, CCDS, CDIP, CCS , identify various CMS quality programs, discuss common conditions these programs assess, and highlight their impact on patient safety through examples and coding case studies.
CMS’ FY 2024 ICD-10-PCS codes, guidelines, and conversion table were published June 6. The release featured minor guideline changes, 78 new codes, 14 revisions, and five deletions.
As the COVID-19 public health emergency has ended, audits are likely to pick up steam. To prepare for this increase in audit activity, it’s essential for providers and coders to examine both current and upcoming trends.
CMS released Transmittal 12053 in May, outlining CMS’ intended changes in the July 2023 OPPS update. The new HCPCS codes will be used to report gastric procedures, insulin pump equipment, echocardiography processing, and more.
Coders saw extensive code changes and expansion for ICD-10-CM category O35.- in 2023. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG, reviews codes in Chapter 15, section E: Fetal conditions affecting the management of the mother.
Q: A physician performs a lithotripsy on a stone in the ureter or removes a stone from the ureter through a transurethral approach, then performs a percutaneous nephrostomy and treats a stone in the kidney. Would both procedures be reported?
Julia Kyles, CPC, offers insights into the risk category of the medical decision-making (MDM) table with three scenarios presented by Peter Hollmann, MD, and Barbara Levy, MD, co-chairs of the CPT/RUC Workgroup on E/M.
This article defines types of hernias coders may encounter, including inguinal, femoral, congenital hiatus, congenital diaphragmatic, diaphragmatic hiatal, and what details coder will need to look for to accurately report them, per 2023 ICD-10-CM guidelines. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS recently published an MLN Fact Sheet that explains how providers can check Medicare claim status information. This quick reference guide also offers pointers on establishing an NPI, monitoring claims, when to check claims’ payment statuses, and more.
Antibiotic resistance occurs when bacteria become resistant to drugs designed to kill them. Deanne Wilk, MPS, BSN, RN, CCDS, CCDS-O, CDIP, CCS, offers guidance on querying physicians for antibiotic resistance organisms.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, explains the significance of reporting social determinants of health (SDoH) with examples related to health literacy, environmental factors, and living conditions.
Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS, describes how coding reviews provide an opportunity to conduct a thorough compliance review that not only addresses components of the coding process, but also the integrity of the patient’s record. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Encephalopathy refers to any disease of the brain that alters its function or structure. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG, breaks down documentation requirements and ICD-10-CM coding for toxic, acute, and chronic encephalopathy.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, explains the significance of reporting social determinants of health (SDoH) with examples related to health literacy, environmental factors, and living conditions.
The term “stroke” or cerebrovascular accident (CVA) indicates an interruption in blood flow to the brain. Nancy Reading, RN, CPC, CPC-P , reviews strokes and explains how coders should report them and their treatment in ICD-10-CM and ICD-10-PCS.
Learn about the challenges faced and collaborative opportunities encountered by one organization when it began the process of improving its observed-over-expected mortality ratio.
Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS, describes how coding reviews provide an opportunity to conduct a thorough compliance review that not only addresses components of the coding process, but also the integrity of the patient’s record.
This article reviews the most common types of external diagnostic cardiology tests, examines relevant CPT coding guidelines, and offers reporting advice from an expert.
Revenue cycle leaders reported denials management as their most time-consuming revenue cycle task, followed by prior authorizations, according to a new survey by AKASA.
Key performance indicators are used by organizations to monitor the progress of CDI initiatives. Waldo Herrera, MD, MBA, MSc, FACP, SFHM, CHCQM-PHYADV , describes performance metrics that professionals at his facility use to track revenue cycle performance and opportunities for improvement.
Physicians have found ways to treat many congenital defects in utero, enabling the neonate to be born without defects. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, details ICD-10-CM coding for common birth defects, and ICD-10-PCS and HCPCS Level II coding for their treatment.
Spinal fusions can effectively eliminate pain and restore stability to the spine. Learn how to apply ICD-10-PCS codes and guidelines for spinal fusions and related procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
This article reviews the most common types of external diagnostic cardiology tests, examines relevant CPT coding guidelines, and offers reporting advice from an expert. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Laura Evans, CPC , takes a deep dive into four CPT Category III codes that were released in the 2023 CPT Manual . Those codes are used to report cutting-edge regenerative musculoskeletal procedures, the use of animal implants, and facet joint replacements.
Modifier -25 is used to report a significant, separately identifiable E/M service by the same physician. Courtney Crozier, MA, RHIA, CCS, CDIP , reviews the American Medical Association’s guidance on correct reporting of modifier -25, and outlines when and how to report it.
CMS published its first quarter 2023 HCPCS Application Summaries and Coding Recommendations April 27, which summarizes the final decisions on HCPCS Level II code assignments. CMS created 58 new HCPCS codes, deleted seven codes, and revised one code. Most changes will be implemented July 1.
