We’re having a heat wave, a tropical heat wave, here at Anytown, which means the Fix ‘Em Up Clinic is seeing plenty of heat-related illnesses. Meredith, our first patient, comes in complaining of a...
In ICD-10-PCS, coders will only report a device when the device remains in the patient after the procedure. If it’s removed, it’s not a device and your sixth character will be Z. For many procedures...
Does even the mere thought of coding in ICD-10-CM give you a pounding headache? Well, you’re in luck. ICD-10-CM has plenty of codes for reporting that headache. In order to code for a headache, we...
CMS is proposing two major changes as part of the 2013 Outpatient Prospective Payment System (OPPS) proposed rule , released July 6. One has to do with how CMS proposes to calculate APC relative weights and the other with the reimbursement level for separately payable drugs and biologicals without pass-through status.
Coders can run into two types of edits that may require them to append modifier -59 (distinct procedural service) to override: National Correct Coding Initiative (NCCI) edits and medically unlikely edits (MUE). Sarah L. Goodman, MBA, CHCAF, CPC-H, CCP, FCS, and Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, explain the differences between the edits and how to correctly determine when to override the edit.
QUESTION: Our laboratory medical director sent out a notification to our medical staff, patient care departments, and order entry personnel that a physician order that read “CBC” or “CBC with differential” would be completed as a CBC with automated or manual differential and coded using CPT ® code 85025 (blood count; complete [CBC], automated [Hgb, Hct, RBC, WBC, and platelet count] and automated differential WBC count). Should we code 85025 when the order just reads CBC and when we do a manual differential with the CBC?
Pain is an expected component of injuries, illnesses, and surgical procedures. In some instances, however, the patient's pain is unexpected or is worse than predicted. Sometimes, the pain can last well beyond the time it should have resolved. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, and Susan E. Garrison, CHCA, CHCAS, CHC, PCS, FCS, CCS-P, CPAR, CPC, CPC-H, provide tips and guidance to help coders accurately report pain management diagnoses and procedures.
An anesthesia provider faces plenty of challenges: cancelled anesthesia, failed medical direction, monitored anesthesia care, time issues, invasive line placement rules, and start/stop times. Judy A. Wilson, CPC, CPC-H, CPCO, CPC-P, CANPC, CPC-I, CMRS, reviews some of the common challenges coders face when reporting anesthesia services.
One advantage to using ICD-10-PCS is increased specificity. Coders will find increased specificity for the procedure, approach, device, and even anatomical region or body system. In the Medical and...
The eyes are the windows to the soul, but even the best windows can get cloudy or scratched or suffer some other type of trauma. Suppose a patient comes in with cloudy vision. The patient could be...
Pain is an expected component of injuries, illnesses, and surgical procedures. Let's face it, breaking your leg hurts. In some instances, however, the patient's pain is unexpected or is worse than predicted. Sometimes, the pain can last well beyond the time it should have resolved.
Our coding experts answer your questions about correct use of modifier –PD, coding infusions to correct low potassium levels, payment for HCPCS code J2354, appropriate reporting of IV push followed by infusion of the same drug, and the difference between modifiers –AS and -80.
ICD-10-CM coronary artery disease and myocardial infarction codes will undoubtedly differ from their ICD-9-CM counterparts in some ways, but some aspects will remain the same.
A physician can debride a wound to remove dead, damaged, or infected tissue so the remaining healthy tissue can better heal. Coders need to look for specific information in the documentation of wound debridement.
In this month's issue, we examine pain management diagnosis and procedure coding, reveal how to differentiate between types of wounds when coding, explain how to read an operative report, and address your coding questions.
To correctly assign codes for any surgical procedure, coders need to have an operative (OP) report. But simply having the OP report isn't enough. Coders also must be able to read the report and pick out the important information.
Learn about ICD-10-CM coronary artery disease and myocardial infarction codes, three-day payment rule audits, malnutrition clinical guidelines, the causes of mechanical and paralytical ileuses, and the importance of documenting the history of present illness.
New clinical guidelines for malnutrition could help alleviate compliance challenges associated with coding the condition, which has never had universally accepted clinical criteria.
