Our coding experts answer your questions about determining ED visit level, coding open reduction and internal fixation of a radius fracture, and coding image-guided minimally invasive lumbar decompression.
In this month's issue, you will find in-depth anaylsis of the OPPS Final Rule and a discussion on how to properly set charges to avoid payment reductions. In addition, we continue our occassional series of ICD-10 anatomy refreshers with the eye and our experts answer your coding questions.
Fortunately for providers, CMS decided not to cap outpatient payment rates for cardiac resynchronization therapy defibrillator (CRT-D) procedures at the standardized inpatient rate. The agency announced its decision as part of the CY 2012 OPPS final rule released November 1, 2011.
Removal sounds like it should be an easy root operation in ICD-10-PCS. Removal means taking something out, right? Physicians remove things all the time—your appendix, a cyst, the toy your son stuck...
When a physician frees a body part from an abnormal physical constraint by cutting or by use of force, coders will use the root operation release (N) in ICD-10-PCS. Keep in mind, though, that you...
The Medicare Code Editor (MCE) is software that detects and reports errors in the coding on claims that are submitted for payment. All Part A inpatient discharges and transfers pass through the MCE...
In ICD-10-PCS, coders assign the root operation bypass (third character 1) when the surgeon’s objective in the procedure is to reroute the contents of a tubular body part. Bypass procedures includes...
In the medical and surgical section of ICD-10-PCS, character 5 refers to the approach or method used to reach or expose a body part during a procedure. As a result, coders will need to look for...
CMS recently posted a file that identified duplicate codes within the ICD-9-CM and ICD-10-CM systems. The list isn’t terribly extensive, but in this atmosphere of transitioning from one system to the...
Looking for the 2012 ICD-10-CM code updates? Want to see what's included in the final regular update before implementation? Check the CMS’ ICD-10-CM and GEMS website. CMS posted the 2012 ICD-10-CM:...
Get ready to say goodbye to Coding Clinic for ICD-9 , and hello to Coding Clinic for ICD-10 . The AHA will cease publication of its ICD-9 guidance, but is already planning for an ICD-10-CM/PCS...
For those who work in environments where codes from category V57 (care involving use of rehabilitation procedures) are a staple, you be surprised to learn that when it comes to ICD-10-CM, all V57...
Late effects are considered to be the residual effects after the acute phase of an illness, disease, or injury. Typically, late effects are considered chronic conditions and can result from the...
CMS’ Office of E-Health Standards and Services (OESS) won’t enforce compliance with the HIPAA 5010 transaction set until March 31, 2012, the agency announced November 17 . The 90-day delay will not...
The American Medical Association (AMA) House of Delegates voted to “work vigorously to stop implementation of ICD-10” during the closing session of its semi-annual policy-making meeting November 15...
Coders are sharpening their knowledge of anatomy and physiology and honing their ICD-10-CM/PCS skills. The HIM department is getting ready for the transition, but did you remember to explain it to...
I had the opportunity to attend the American Health Information Management Association convention this year in Salt Lake City, and I helped work in HCPro's exhibitor booth. As a former HIM director...
Will the new ICD-10-CM concept of using seventh character code extensions to identify initial encounters vs. subsequent encounters cause additional confusion in relation to professional services, for...
Representatives from the American Hospital Association (AHA), the American Health Information Management Association, and the Centers for Disease Control and Prevention will discuss ICD-10...
As I continue to learn more and work with ICD-10-PCS codes, I find myself questioning the ancillary service codes in ICD-10-PCS. In my experience as an inpatient facility coder, I know that there are...
Coders will use the root operation division when the physician plans to cut into, transect, or otherwise separate all or a portion of a body part. Do not use division if the physician plans to cut or...
2013 is right around the corner. Learn how to kick start your hospital-wide ICD-10 educational plans. During this live 90–minute audio conference, our expert speakers will walk you through two...
As an AHIMA ICD-10 certified trainer, I have been doing a lot of work on various ICD-10 projects. When it comes to working with the new coding system, I find myself wondering whether the first ICD-10...
Coders should focus on chest pain, among other areas, as part of a larger review of ICD-9-CM codes and in preparing for ICD-10-CM. Coding chest pain in ICD-9-CM requires the physician to document the...
5010. That’s the cool way of saying Version 5010 of the Accredited Standards Committee (ASC) X12. It is the next version of the HIPAA electronic transaction standards that providers and all HIPAA...
Coders will find they need more information to select the appropriate code in chapter 13 (Diseases of the Musculoskeletal System and Connective Tissue [M00–M99]) of the ICD-10-CM Manual. Most of the...
Over the summer, I was in the process of going through the American Health Information Management Association Academy for ICD-10-CM for trainers. I had completed the online, self-paced part of the...
Another new term coders will need to know for ICD-10-PCS root operations is fragmentation. Fragmentation is breaking solid matter in the body into pieces. Note that in a fragmentation procedure, the...
When should a coder report multiple procedures performed during a single operative session in ICD-10-PCS? Look to the official guidelines for information. According to the guidelines, coders should...
These days it seems like a new ICD-10 tool is waiting for you around every corner. Be sure to periodically check different organization's websites, as many of them are constantly updating information...
Do you remember the Y2K scare? Vendors and information technology staff were entranced with making upgrades to computers and information systems months in advance to make sure that the internal...
Some of the removal root operations can easily be confused with other root operations that involve taking out solids, fluids, or gases from a body part (e.g., drainage, extirpation, and fragmentation...
The CDC updated the terminology used to describe asthma in ICD-10-CM to reflect the current clinical classification of asthma. In ICD-9-CM, asthma is described as extrinsic or intrinsic. In ICD-10-CM...
Given the many differences between the ICD-9-CM and ICD-10-CM/PCS system and the thousands of new codes that will be used, all skilled-nursing facility (SNF) and homecare agency staff members...
A step-by-step approach to code assignment is helpful when trying to understand the complexity of ICD-10-PCS. Step one: Determine the first character, which denotes the general category of the...
When I hear "YouTube," I think of video clips of babbling babies, stupid pet tricks, and “don’t try this at home” stunts. But did you know that CMS is now on YouTube? Who’d a thunk it! They even have...
I’m not really crazy about the title of this blog post, but that’s how the adage goes. Once you get used to something, like ICD-9-CM for example, change is met with resistance. I don’t want to think...
When we think of all of the steps we have to take to get ready for ICD-10 implementation, missing one step in the planning process could cause chaos in your facility. Don’t forget about 5010! Your...
If an excision involves cutting out a portion of a body part, and a resection involves cutting out all of a body part, what then is an extraction? According to the ICD-10-PCS guidelines, an...
Will physician documentation be specific enough so coders can select the most appropriate code in ICD-10-CM/PCS or will coders be defaulting to unspecified codes? For starters, don't dwell on details...
With ICD-10-PCS, coders will have 31 root operations to choose from and not all of them are clear cut. Start learning the root operations now to prepare you for the switch to ICD-10-PCS. The ICD-10-...
One of the things that has concerned me about ICD-10-CM is the lack of guidance regarding sequencing. Since the American Hospital Association announced that it would not be converting Coding Clinic...
If you haven’t already done so, now is a good time to look at your system capabilities and see what you need to update or upgrade before the transitions to HIPAA Version 5010 and ICD-10-CM/PCS. Start...
As a kid, do you remember playing the game where you sat round in a circle and one person whispered a phrase in the ear of the person sitting next to them, and that person passed it along until...
CMS created the following four podcasts based on the January 12 national provider call, “Preparing for ICD-10 Implementation in 2011:” Welcome and ICD-10 Overview Implementation Strategies for 2011...
So the transition to ICD-10-CM/PCS is still more than two years away, and it’s too early to start learning actual codes. But you can start reviewing some of the major concepts of ICD-10-CM/PCS with...
