Review key policy updates introduced in the 2023 IPPS final rule, including an increase in operating payments, changes to New Technology Add-on Payment designations, MS-DRG updates, and introduction of a birthing-friendly hospital designation. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A great deal of change has occurred over the past three years in healthcare, and every organization nationally is feeling the financial burden in the wake of COVID-19 and recent natural disasters.
Paraneoplastic syndrome is a rare condition that results from an immune system response to a neoplasm. In this article, Sarah Nehring, RHIA, CCS, CCDS , breaks down ICD-10-CM/PCS coding for paraneoplastic syndrome of the nervous system.
If a urinary tract infection is left untreated, it can spread to other organs and cause sepsis and septic shock. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down ICD-10-CM coding for this life-threatening diagnosis.
The 2023 CPT code update introduced an option for reporting nasal valve collapse repairs, as well as revisions to certain injection codes to include imaging guidance.
As of November 16, the CPT Editorial Panel has approved 56 Category I codes for severe acute respiratory syndrome coronavirus 2 vaccines and immunization administration. In this article, Kimberly Lee, M.Ed., RHIA, CCS-P, addresses some of the new COVID-19 product and administration codes.
CMS developed the National Correct Coding Initiative (NCCI) to control improper coding and potentially inappropriate payment of Part B services. Review NCCI basics to ensure compliance with the latest coding policies.
The CPT Editorial Panel recently announced that it approved new CPT codes for Pfizer’s bivalent COVID-19 vaccine booster and its administration for children six months to 4 years old after they have received administration of the first and second doses of the product.
The 2023 CPT code set takes effect on January 1, 2023. This article covers code changes for bariatric gastric balloon procedures, hernia repairs, and other updates within the digestive system chapter. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Peter Hollman, MD , breaks down 2023 CPT guidance in a new section of the manual for initial and subsequent E/M services, which will impact reporting of hospital inpatient and observation care services beginning January 1.
Q: What is the difference between “normal” and “abnormal” native connections in the descriptors for new 2023 CPT codes 33900-33903 describing percutaneous pulmonary artery revascularization by stent placement?
The average patient length of stay in hospitals has increased by 19.2% in 2022 compared to 2019 levels, the American Hospital Association said, citing data from Strata Decision Technology. For patients awaiting discharge to post-acute care settings, the increase is nearly 24%.
Healthcare professionals often struggle to define the role of CDI in their organization. Marlene Goodwin-Esola, MSN, RN-C, CV , clarifies the role of CDI specialists and professionals in related disciplines who contribute to documentation improvement efforts.
While laser interstitial thermal therapy (LITT) is not new, the expansion of its use for diagnoses beyond brain tumors can help a new patient population. Shelley C. Safian, PhD, RHIA, HCISPP, CCS-P, COC, CPC-I , describes how LITT is documented and reported in ICD-10-PCS.
The 2023 ICD-10-CM Official Guidelines for Coding and Reporting include new reporting guidance for neoplasms, care complications, social determinants of health, and more. Review significant updates to the guidelines, which took effect October 1. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The Office of Inspector General (OIG) recently released a report investigating instances of incorrect co-surgery and assistant-at-surgery modifier usage, which found that 69 of 100 sampled procedural services did not meet federal requirements.
The American Medical Association recently published CPT codes for 2023, including 103 code additions, 88 revisions, and 69 deletions. This article covers new codes and the single revision made to the cardiovascular system chapter. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Medicare finalized a care management service for chronic pain management (CPM). Effective January 1, CPM services can be reported by a wide range of providers, including primary care practitioners.
As of November 16, the CPT Editorial Panel has approved 56 Category I codes for severe acute respiratory syndrome coronavirus 2 vaccines and immunization administration. In this article, Kimberly Lee, M.Ed., RHIA, CCS-P, addresses some of the new COVID-19 product and administration codes.
The principal diagnosis is key to prioritizing subsequent reviews, identifying potential quality measure inclusion, and pinpointing query opportunities. Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , breaks down guidance for selecting the principal diagnosis.
Vaccinations are simple and effective ways of protecting individuals against harmful diseases. Review ICD-10-CM/PCS coding for vaccines administered during inpatient admission. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Clinical quality measures are tools used by healthcare professionals to measure or quantify processes and outcomes. Audrey Howard, RHIA, and Susan Belley, RHIA, CPHQ, describe documentation elements that affect quality metrics and how to incorporate them into an audit workflow.
Coded housing instability is linked to higher hospital admission rates for mental disorders, longer inpatient stays, and substantial healthcare costs, according to a study recently published in JAMA Network Open .
Vaccinations are simple and effective ways of protecting individuals against harmful diseases. Review ICD-10-CM/PCS coding for vaccines administered during inpatient admission.
While laser interstitial thermal therapy (LITT) is not new, the expansion of its use for diagnoses beyond brain tumors can help a new patient population. Shelley C. Safian, PhD, RHIA, HCISPP, CCS-P, COC, CPC-I , describes how LITT is documented and reported in ICD-10-PCS.
Acute hospital care at home is reimbursed the same as if the patient was physically an inpatient in a hospital, with the same documentation requirements, quality measures, and medical necessity guidelines. Learn how strengthening CDI's role in these programs can help support their success.
CMS confirmed in the 2023 Medicare Physician Fee Schedule final rule that it will adopt the framework of the revised AMA E/M guidelines, including payment based on medical decision-making (MDM) or time, effective January 1, 2023. Laura Evans, CPC, explains how the agency will diverge from the AMA on some points, however.
Coding and billing professionals must ensure that medical record information is accurate, up to date, and compliant. In this article, Holly Cassano, CPC, CRC , defines late entries, corrections, and addendums, and explains the proper methods used to alter health records while maintaining Medicare compliance.
Medicare finalized a care management service for chronic pain management (CPM). Effective January 1, CPM services can be reported by a wide range of providers, including primary care practitioners.
Cardiorenal syndrome refers to acute or chronic dysfunction of the heart or kidneys that causes dysfunction in the other organ. Review ICD-CM coding for heart and kidney failure and the physiological impact that dysfunction in one system has on the rest of the body. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The terms “admission” and “observation” are often confused. Dawn Valdez, RN, LNC, CCDS, CDIP , distinguishes between these terms and evaluates ICD-10-CM coding for patients who begin in observation and are later admitted to the hospital for more intensive care.
Quality metrics are complex, and it takes deep knowledge to understand their intricacies. Audrey Howard, RHIA, and Susan Belley, RHIA, CPHQ , describe commonly overlooked documentation elements that can affect quality metrics and outline how to incorporate these elements into an audit workflow.
The severity and length of post-COVID-19 symptoms has been a topic of study almost ever since the pandemic began. In a new study involving patients with significant respiratory disability following hospitalizations for COVID-19, daily supervised pulmonary rehabilitation was associated with significant improvement in exercise tolerance and quality of life.
CMS confirmed in the 2023 Medicare Physician Fee Schedule final rule that it will adopt the framework of the revised AMA E/M guidelines, including payment based on medical decision-making (MDM) or time, effective January 1, 2023. Laura Evans, CPC, explains how the agency will diverge from the AMA on some points, however.
CMS released its 2023 OPPS final rule on November 1. The document finalizes most proposed policies, including a new provider type for rural emergency hospitals (REH), continued coverage of telehealth services, and implementation of new skin substitute HCPCS codes, among other changes, which largely take effect January 1, 2023.
Diabetes mellitus is a chronic disease that causes elevated levels of glucose in the blood. It invades the body in many different ways. Shelley Safian PhD, RHIA, CCS-P, COC, CPC-I describes the types, manifestations, and treatment methods for diabetes mellitus and how to report them accurately in ICD-10-CM.
The 2023 ICD-10-CM update brought many new codes to report injuries sustained from collisions between motorcycles or electric-assisted bicycles and other vehicles, entities, or objects. This article reviews external cause codes and examines the new additions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
As the shift to outpatient care has accelerated, likely due to COVID-19, inpatient volumes continue to remain below pre-pandemic levels for hospitals and health systems this year, according to Kaufman Hall’s 2022 State of Healthcare Performance Improvement report.
ICD-10-CM coding for respiratory illnesses requires a solid understanding of clinical indicators and coding guidelines. Review documentation and guidance for reporting acute respiratory distress syndrome, asthma, and pediatric multisystem inflammatory syndrome. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
