Sarah Nehring, RHIT, CCS, CCDS , reviews documentation and ICD-10-CM guidance for reporting for toxic effects, adverse drug reactions, and underdosing of prescribed medications.
A spinal fusion, or surgery to permanently connect two or more vertebrae in the spine, is sometimes necessary to correct spinal deformities and instability. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down ICD-10-CM and ICD-10-PCS coding for fusion procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The evolution of the role of clinical documentation integrity (CDI) specialists and their impact on coders has changed the landscape of inpatient coding departments. Learn about how to effectively collaborate with CDI professionals when conducting physician queries.
The American Medical Association (AMA) recently updated the CPT code set to include immunization and administration codes for a COVID-19 vaccine under development by Novavax Inc.
The monetary value of outpatient clinical documentation integrity (CDI) programs is increasing dramatically year after year. Read about steps your facility can take to create and maintain a successful outpatient CDI program.
The Centers for Disease Control and Prevention reports that approximately 15 million people in the U.S. report experiencing acute joint pain due to arthritis. Shelley C. Safian, Ph.D., RHIA, CCS-P, reviews ICD-10-CM and CPT coding for lower extremity arthritis and procedures used to treat it.
The perinatal period begins before birth and ends 28 days after delivery. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down ICD-10-CM coding for fetal and newborn conditions originating in the perinatal period. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Before assessing a coder’s work performance, a facility must set goals that define that success. Review quality improvement standards that facilities use to define coding success.
CMS released the fiscal year (FY) 2022 IPPS proposed rule on April 27, with proposals for the annual ICD-10-CM/PCS code update, the creation of new MS-DRGs, and increases to hospital payment rates.
Spinal fusion procedures are reported using two different ICD-10-PCS tables, depending on the location of the vertebrae fused. Sarah Nehring, RHIT, CCS, CCDS , breaks down ICD-10-PCS coding for spinal fusions based on details in the operative note.
Susan Belley, RHIA, CPHQ , and Audrey Howard, RHIA , analyze the frequently changing ICD-10-CM guidelines for reporting COVID-19 and related respiratory complications. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: A patient receives Apligraf® (44 sq. cm) after subcutaneous wound debridement. Ten sq. cm is applied to a diabetic foot ulcer on the patient’s left heel and 20 sq. cm to an ulcer on the patient’s right ankle. What CPT codes would the facility use to report these services?
Laura Evans, CPC , and Julia Kyles, CPC , break down potentially confusing updates to the 2021 E/M guidelines, including new definitions for technical terms and revised guidance for reporting diagnostic laboratory testing with interpretation.
Facility E/M coding reflects the volume and intensity of resources utilized by the facility during patient encounters. Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , describes how facilities can create internal guidelines and point systems for determining E/M level section. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS’ recently released fiscal year (FY) 2022 IPPS proposed rule includes 153 proposed ICD-10-CM code additions, mainly affecting reporting for immune effector cell-associated neurotoxicity syndrome, gastric intestinal metaplasia, and poisonings by cannabis and synthetic cannabinoids.
Facility E/M coding reflects the volume and intensity of resources utilized by the facility during patient encounters. Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , describes how facilities can create internal guidelines and point systems for determining E/M level section.
Monica Tyiska, MBA-PM, RHIA, CCS, CPC, CPMA, CHA, OHCC, CCP-P, offers advice for how organizations can improve hiring practices to ensure candidates from diverse backgrounds that represents the community are brought in.
Hierarchical Condition Categories (HCC) are used to represent risk scores for patients on Medicare Advantage plans. Learn why it’s important for organizations to understand how HCCs are used across settings.
Effective management of claim edits and denials is a cornerstone of a sound revenue cycle. See how your organization compares to others and what you can do to improve.
It’s always been easy to show financial return on investment for inpatient CDI endeavors, but the monetary value of outpatient programs is increasing dramatically year after year, making outpatient CDI reviews more attractive to many healthcare organizations.
A Humana health plan in Florida collected nearly $200 million in Medicare overpayments in 2015 by improperly coding for high-severity Hierarchical Condition Category conditions, according to a recent audit from the Office of Inspector General (OIG).
Q: I’m having trouble determining how to report an acute myocardial infarction (MI) for subsequent admissions occurring within four weeks of the initial MI in ICD-10-CM. Can you walk me through the process?
Vaginal cuff dehiscence is a severe complication of a total hysterectomy. In this article, Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about ICD-10-CM coding for vaginal cuff dehiscence and ICD-10-PCS coding for dehiscence repairs. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Encephalopathy is a general term used to describe any disease of the brain that alters its function or structure. Alba Kuqi, MD, CICA, CCS, CDIP, CCDS, CRCR, CSMC, MSHIM, RHIA , analyzes ICD-10-CM coding for toxic, metabolic, and hepatic encephalopathies.
Review quality reporting metrics such as length of stay and mortality indexes that you can use to assess patient outcomes and improve revenue cycle processes.
Q: A patient is diagnosed with Type 2 diabetes mellitus and arteriosclerotic peripheral artery disease (PAD). Can we report ICD-10-CM code E11.51 with a code from subcategory I70.2- to describe affected vessels?
CMS recently added 24 audiology and speech-language pathology services to its list of telehealth services covered under Medicare during the COVID-19 public health emergency (PHE). These services include speech, hearing, and swallowing assessments, and cognitive interventions.
Effective management of claim edits and denials is a cornerstone of a sound revenue cycle. See how your organization compares to others and what you can do to improve.
Viral hemorrhagic fevers (VHF) are infectious diseases that pose a great public health risk due to their epidemic potential. Debbie Jones, CPC, CCA , breaks down ICD-10-CM coding for four VHFs: Crimean-Congo hemorrhagic fever, Ebola virus disease, Lassa fever, and Marburg virus disease. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Essential newborn care includes services provided at the time of birth and over the first hours of life. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about E/M coding for these routine obstetric services.
About 1% of children in the U.S. suffer from chronic malnutrition, according to John Hopkin’s Medicine. In this article, Alba Kuqi, MD, CICA, CCS, CDIP, CCDS, CRCR, CSMC, MSHIM, RHIA, breaks down ICD-10-CM coding and documentation requirements for malnutrition.
Allen Frady, RN, BSN, CCS, CRC, CCDS, describes steps that coding and clinical documentation integrity managers can take to improve quality metrics and hold staff accountable for reporting errors.
Billing for high-level inpatient stays increased over a six-year period sparking concerns by the government about upcoding, according to a recent report from the Office of Inspector General (OIG).
Cheryl Manchenton, RN, BSN, Beth Wolf, MD, CCDS, CPC, and Audrey Howard, RHIA, review ICD-10-CM coding for cytokine release syndrome, sepsis, and multisystem inflammatory syndrome. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: What CPT codes and modifiers would be used to report excisional debridement for removal of a 2x4-cm ulcer on a patient’s right buttocks with vacuum-assisted closure (VAC)?
Medicare auditors have identified failure to document time as a key flaw in claims for advance care planning (ACP), and the Office of Inspector General plans to conduct an audit of these services. Read up on documentation requirements and CPT coding for ACP to prevent claim denials.
Physician and non-physician practitioners may benefit from reviewing documentation requirements and HCPCS Level II codes for knee orthoses, according to a recent Medicare Quarterly Compliance Newsletter .
Approximately 34.2 million Americans, or 10.5% of the U.S. population, were diagnosed with diabetes in 2018, according to the Centers for Disease Control and Prevention. Review signs and symptoms of diabetes mellitus types 1 and 2 and ICD-10-CM coding for these conditions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Corneal dystrophies are a group of genetic, often progressive, eye disorders that alter functioning of the cornea. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , breaks down ICD-10-CM coding for corneal dystrophies and CPT coding for procedures used to treat them.
Regular monitoring and internal auditing are critical to ensure compliance throughout the revenue cycle and protect revenue integrity. Consider the different strategies that can be applied to documentation and chart audits, coding audits, and more.
