A surgeon performs a diagnostic shoulder arthroscopy before repairing a patient’s rotator cuff. The surgeon knew ahead of time that he or she would be repairing the rotator cuff. Should a coder or biller append modifier -59 (distinct procedural service) to the CPT® code for the diagnostic shoulder arthroscopy to ensure reimbursement for both procedures?
Learn about documentation and principal diagnoses, coders and EHR implementation, clarifying IBS and IBD for accurate code assignment, and ICD-10 fracture codes.
What happens in Vegas might stay in Vegas, but when things go wrong in Atlantic City, people end up at Fix ‘Em Up Clinic. Today, we have several bachelor party victims who made the clinic their first...
Why hello there, Mr. Coyote. Long time, no see. Are you still chasing that roadrunner? You are? Well, you are certainly persistent, I’ll give you that. So what brings you into the Acme Clinic today?...
The American Osteopathic Association (AOA) House of Delegates has joined the American Medical Association’s (AMA) crusade to crush ICD-10 implementation. Back in November 2011, the AMA’s House of...
Cross-training coders has definitive short-term advantages, such as enhancing staff coverage during holidays and vacations and increasing the department's ability to handle periods of fluctuation in certain bill types. But coding managers might not realize that these benefits can also help hospitals with long-term preparation for ICD-10. Angie Comfort, RHIT, CCS, and Rose T. Dunn, MBA, RHIA, CPA, FACHE, explain the benefits of cross training coders as ICD-10 approaches.
The National Center for Health Statistics, the Centers for Disease Control and Prevention (CDC), and CMS have posted updated files for ICD-10-CM for 2013.
Many coders can quickly quote the code for diabetes mellitus in ICD-9-CM (code 250.00) when the physician only documents diabetes mellitus. But what will coders need in the documentation for diabetes mellitus in ICD-10-CM? Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, Jill Young, CPC, CEDC, CIMC, and Donna Smith, RHIT, dissect the differences in coding for diabetes mellitus in ICD-9-CM and ICD-10-CM.
Over the weekend, Matt decided to grill up dinner, which sounds at first like a good idea. He started with chicken, then added some vegetables, unfortunately including some cherry tomatoes. While he...
Epilepsy affects nearly 3 million Americans and 50 million people worldwide, so you may see some of these patients come through your facility or practice. In ICD-9-CM, you find many of the epilepsy...
The National Center for Health Statistics, the Centers for Disease Control and Prevention, and CMS have posted some updated files for ICD-10-CM for 2013. The following files are available for...
I grew up in Western Pennsylvania coal country, where coal mines at one time were prevalent and back in the day, you could smell the hydrogen sulphide (at least according to my mother). A lot of the...
The thought of learning ICD-10 is intimidating for many coders, but does it need to be? Robert S. Gold, MD, and Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, explain why coders may not need to fear the transition quite as much as they think.
The digestion process is complex and there’s a lot that can go wrong. Thankfully, Robert S. Gold, MD, unravels the topic of mechanical and paralytic ileuses in this week’s article.
New clinical guidelines for malnutrition could help alleviate compliance challenges associated with coding the condition, which has never had universally accepted clinical criteria. Jane White, James S. Kennedy, MD, CCS, CDIP, and Alice Zentner, RHIA, describe the new guidelines and what coders need to know about malnutrition coding.
QUESTION: A patient is admitted with pneumonia and atrial fibrillation and both are present on admission. The patient receives antibiotics for the pneumonia and a pacemaker during the stay, but undergoes no other procedures. Does the procedure automatically make ICD-9-CM code 427.31 for the atrial fibrillation the principal diagnosis?
In late May, CMS released nationwide a new short-term (ST) acute care Program for Evaluating Payment Patterns Electronic Report (PEPPER). The ST PEPPER provides short-term acute care hospital (STACH) statistical data for the most recent 12 federal fiscal quarters, ending with the first quarter of fiscal year 2012.
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...