The Medicare Outpatient Observation Notice (MOON) finally went into effect after a bumpy start. The MOON was originally set to go into effect August 2016, but the draft version was only released for comment at the beginning of that month.
Now that the fiscal year 2018 ICD-10-CM/PCS codes have been released , let’s consider some of the compliance pitfalls, booby traps, and opportunities that await coders when these new codes are implemented on October 1.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, writes that coding for skin cancers requires understanding the guidelines as well as knowledge of how the conditions are classified in 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.
James S. Kennedy, MD, CCS, CDIP , explains how ICD-10-CM addresses kidney illness and advises on how to ensure documentation and coding integrity through certain challenges including risk-adjustment methodologies and functional versus anatomic diagnoses.
According to a study published in Annals of Emergency Medicine, researchers studying emergency department (ED) visits found that electronic sepsis alert implementation increased ED sepsis detection from 83% to 96%.
Starting October 1, the new and revised ICD-10-CM and ICD-10-PCS codes go into effect along with proposed DRG changes. Coders will benefit from digging deeper into the meanings of the new cardiovascular code descriptions to be able to fully understand and use them.
Q: Is CPT code 96416 (chemotherapy administration requiring use of portable pump) the same as HCPCS code G0498 (initiation of infusion of chemotherapy in office using portable pump)? Our facility is trying to determine if it would be appropriate to set up G0498 as a Medicare override for 96416.
E/M services are some of the most frequently used CPT codes, and they are also some of the most frequent examples of incorrect coding. One of the problem areas in selecting the proper E/M code is distinguishing between new and established patients. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
The 2018 OPPS and Medicare Physician Fee Schedule proposed rules usually make their debuts around the Fourth of July, but despite a later release this year, there were plenty of fireworks within each rule that should generate provider feedback during the comment periods.
With the increased focus on clinical documentation improvement in the outpatient arena, Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, shares her tips for proving medical necessity on claims.
July is National Juvenile Arthritis Awareness Month. Yvette DeVay, MHA, CPC, CIC, CPC-I, explains the differences between the many different types of juvenile arthritis in order to help coders report the disease correctly.
Coding Clinic , Second Quarter 2017, which became effective May 17, did not disappoint in addressing clinical issues affecting us in coding compliance and instructing us in how to properly use the ICD-10-CM Index and Table. Let’s review several of Coding Clinic’s changes.
Daniel E. Catalano, MD, FACOG, says that from the CDI perspective, the ability to communicate pediatric severity of illness is complicated by the fact that pediatricians have a lexicon that is not well captured in ICD-10-CM. This, he writes, is especially true for pediatric cardiology.
Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS , explains that as a coding manager, whether your inpatient team is on-site, off-site, or remote, creating the appropriate environment and selecting proper locations are key to any successful team. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
In June, CMS released the 2018 ICD-10-PCS Official Guidelines for Coding and Reporting which include various revisions from the 2017 guidelines. These changes come on the heels of the 2018 IPPS proposed rule and recently released ICD-10-PCS codes.
James S. Kennedy, MD, CCS, CDIP, writes that while you might have thought you’ve finally mastered coding compliance with DRGs and quality measures, now it is time to learn the compliance risks and opportunities with a new risk-adjustment method: Hierarchical Condition Categories.
Q: At my institution, all of our congestive heart failure exacerbations get at least one chest x-ray. Is that enough “diagnostic testing” to code the secondary condition in accordance to Coding Clinic ?
Many national organizations, such as the Centers for Disease Control, the American Liver Foundation, the Department of Health and Human Services, and the Food and Drug Administration have information and resources available to provide education and promote testing for viral hepatitis.
