CMS updated its E/M Services Guide in August, reflecting changes for E/M services that went into effect January 1. The guide includes plain-language explanations of policy changes, but some do not align perfectly with AMA guidance.
CMS recently proposed to pay for certain currently bundled caregiver training service CPT codes and three new CPT codes that, if finalized, will be established January 1. Review the criteria of defining a caregiver and which caregiver training services apply.
Our experts answer questions about 2024 ICD-10-CM coding for HIV-related encounters, ICD-10-PCS reporting for Impella insertions and removals, and more.
Providers and coders alike can find NCCI policies challenging to follow and apply. Denise Williams, COC, CHRI , explains the basics of NCCI by defining the initiative, edits, modifiers, and clinical procedure examples.
Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , summarizes the highlights from the newest installment of Coding Clinic, which includes guidance on reporting pancytopenia, inherent conditions, ORIF, and neurally adjusted ventilatory assist devices.
Coders should take note of hundreds of updates to the tabular addenda that serves as an instruction guide to the 2024 ICD-10-CM code set. Both take effect October 1.
Cardiopulmonary resuscitation (CPR) is a lifesaving treatment used when the heart or lungs cease to function. Whether CPR is conducted alone or with other services, Nancy Reading, RN, CPC, CPC-P , covers the various ways that CPR can be reported and how to do so.
There is one tell-tale sign that fall is here: the October implementation of the ICD-10 coding updates. Courtney Crozier, MA, RHIA, CCS, CDIP , explains the highlights of the update for fiscal year 2024, including 395 new codes, 25 deletions, 22 revisions, and 131 new headers.
The heart is a restless organ whose constant rhythm is integral to normal bodily functions. Unfortunately, there are many maladies that can occur, as Linda Martien, CPC, CPC-I, COC, CPMA, CRC, explains through her review of normal cardiac pathophysiology and how to report common rhythm abnormalities in ICD-10-CM.
The Centers for Disease Control and Prevention (CDC) announced the launch of its Hospital Sepsis Program Core Elements initiative on August 24. The program offers resources for hospitals to improve identification and management of sepsis.
The fiscal year (FY) 2024 IPPS final rule, released in August, provides updates on inpatient hospital reimbursement, ICD-10-CM/PCS coding and DRG changes, quality and reporting programs, and more.
Diabetes mellitus is a common condition that occurs when a patient’s blood sugar (blood glucose) is consistently too high. Sarah Gould, CPC , delves into the disorder and covers how to report some of its many complications in ICD-10-CM. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
As coders witness annually, the ICD continues to evolve over its decades of use. This article covers the history of disease classification, current coding techniques, and possible future technologies of the industry. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS recently released a national coverage determination update to the Medicare Claims Processing Manual . This update covers new requirements for CPT coding associated with acupuncture and dry needling services.
Q: Our coding department has a longstanding issue with physicians not presenting enough information to properly report CPT debridement services for ulcers, resulting in queries and denials. What do you recommend?
In this article, the author takes a closer look at CMS’ 2024 Medicare Physician Fee Schedule (MPFS) proposed rule—specifically a proposal to allow new providers to perform and bill behavioral health codes, offer providers new service categories, and give a code-valuation adjustment.
Cardiopulmonary resuscitation (CPR) is a lifesaving treatment used when the heart or lungs cease to function. Whether CPR is conducted alone or with other services, Nancy Reading, RN, CPC, CPC-P , covers the various ways that CPR can be reported and how to do so.
While taking time to relax is important, professionals must seize all opportunities to prepare for updates. Connie White, CPC, CPAR , reviews the process her team at Northside Hospital in Atlanta, Georgia takes to prepare for annual CPT code changes.
CMS recently published a summary of its second quarter 2023 HCPCS Level II code update application decisions, accepting 16 of 24 submissions. Many of the changes addressed in the announcement have an effective date of October 1, but one code revision and one code discontinuation will take effect before then.
As the summer temperatures continue to soar worldwide, so does the number of patients with heat-related illnesses (HRI). This article defines common HRIs and includes guidance on how to report them correctly in ICD-10-CM. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Terry Tropin, MSHAI, RHIA, CCS-P , reviews the biggest changes to the 2024 ICD-10-CM guidelines and tabular list set to take effect October 1, including deletions of certain COVID-19 screening guidelines, and additional direction for new resistant hypertension and myocardial infarction codes.
With certain medical conditions, encountering differing opinions and discrepancies in provider documentation is inevitable. Deanne Wilk, MPS, RN, CCDS, CCDS-O, CDIP, CCS , reviews 10 diagnoses whose documentation commonly features discrepancies.
Q: Is there a hierarchy of social determinants of health codes? Is there an order of importance for us to sequence first, since only a certain number will fit on a Medicare claim?
Hemodialysis involves diverting blood into an external machine, where it is filtered and returned to the body. Sarah Gould, CPC , describes the vascular surgical options for hemodialysis (fistulas and grafts), their various types, and how to report them in ICD-10-PCS. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Parkinson's disease is a chronic and progressive neurodegenerative disorder that affects the central nervous system. Debbie Jones, CPC, CCA , explains the symptoms, treatment, and how 2024 ICD-10-CM coding changes will affect reporting for this disease.
A July JAMA Network study found that cannabis use disorder slightly increased patient morbidity and in-hospital mortality. The study included 12,422 hospitalizations following major elective inpatient surgeries.
The fiscal year 2024 IPPS final rule, released in August, provides updates on inpatient hospital reimbursement, ICD-10-CM/PCS coding and DRG changes, quality and reporting programs, and more.
Our experts answer questions about documentation requirements for CPT debridement codes, sequencing social determinants of health ICD-10-CM codes, and more.
With certain medical conditions, encountering differing opinions and discrepancies in provider documentation is inevitable. Deanne Wilk, MPS, RN, CCDS, CCDS-O, CDIP, CCS , reviews 10 diagnoses whose documentation commonly features discrepancies.
Terry Tropin, MSHAI, RHIA, CCS-P, reviews the biggest changes to the 2024 ICD-10-CM guidelines and tabular list set to take effect October 1, including deletions of certain COVID-19 screening guidelines, and additional direction for new resistant hypertension and myocardial infarction codes.
Surgeons are often the toughest contingent of any medical staff with which a CDI program must make headway. Understanding a little surgeon psychology is the key to making positive inroads. Surgeons see themselves as “doers” or “fixers,” while they consider most other medical specialties as “thinkers” who are not “doers.”
CMS’ 2024 OPPS proposed rule, released in July, details major changes to price transparency requirements and proposes numerous changes to behavioral health reimbursement, coverage of dental services, and more.
CMS’ 2024 OPPS proposed rule, released July 13, details major changes to price transparency requirements and proposes numerous changes to behavioral health reimbursement, coverage of dental services, and more.
Chronic ulcers are a prolific, costly problem in hospitals. This article examines the most common types of chronic ulcers—diabetic, venous, and pressure ulcers—and the ICD-10-CM guidance coders should know to properly report them. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS published the 2024 Medicare Physician Fee Schedule (MPFS) proposed rule on July 13 with new potential policies and codes affecting physician reporting, including new HCPCS codes for E/M services and behavioral health.
Q: CMS recommends greater than 38°C as the upper limit temperature threshold for sepsis in the Sepsis-1 bundle, but our consulting group recommends greater than 38.3°C. What would you recommend using as the temperature threshold for diagnosing sepsis?
A recent study from Epic Research showed that the average length of provider notes increased, but note-taking time decreased since 2020. The study explains the reason for this change and the effect it has on providers.
Shelley Safian, PhD, RHIA, CCS-P, COC, CPC-I, defines hand-assisted laparoscopic surgery (HALS) procedures and how to report them according to new guidance in the 2024 ICD-10-PCS guidelines. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Kate Siemens, RN, CMSRN, CCDS , offers her nursing and coding experience to explain postoperative ileus, a common complication after gastrointestinal surgery, and associated ICD-10-CM coding.
Coders should take note of hundreds of updates to the tabular addenda that serves as an instruction guide to the 2024 ICD-10-CM code set. Both take effect October 1.
CMS released the fiscal year 2024 ICD-10-CM Official Guidelines for Coding and Reporting on July 5. The release included updated language and examples for reporting COVID-19 preoperative testing, sepsis, the coma scale, and other conditions.
