Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, defines abnormal pregnancies and explains how to determine the appropriateCPT ® , ICD-9-CM, and ICD-10-CM codes.
Providers have one last chance to volunteer for ICD-10 end-to-end testing, with CMS extending the deadline to sign up for the July testing period through May 22.
Coding Clinic won't be updating its ICD-9-CM guidance for ICD-10-CM, but that doesn't mean none of the previous answers will be applicable in the new code set. Nelly Leon-Chisen, RHIA, Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I, and Anita Rapier, RHIT, CCS, review various tricky coding situations that can be resolved now, ahead of implementation.
Coding and guideline changes in ICD-10-CM for neurological conditions may require coders to learn new terms and look for additional information in documentation. Caren J. Swartz, CPC, CPMA, CPC-I, CIC, and Jennifer E. Avery, CCS, CPC-H, CPC, CPC-I, explain the changes for hemiplegia, hydrocephalus, and meningitis and how to find the proper code.
Our friends at the Association of Clinical Documentation Improvement Specialists are putting the final touches on their conference preparations. They have sent off the final shipment to San Antonio (...
We love surveys, especially about ICD-10. Seriously, how many ICD-10 surveys have you been asked to fill out in the past year alone? It’s very easy to look at survey results and think things look...
An automated Recovery Auditor review of discharge status codes identified improper payments, according to the Medicare Quarterly Compliance Newsletter . However, CMS did not report the prevalence of the errors.
PSI 7 evaluates the hospital’s risk-adjusted rate of central venous catheter-related bloodstream infections. Shannon Newell, RHIA, CCS, Steve Weichhand , and Sean Johnson explain inclusions, exclusions, and risk adjustment factors for this measure.
As coders have prepared for ICD-10-CM, they have raised questions about how to select the correct seventh character. Nelly Leon-Chisen, RHIA, and Jennifer E. Avery, CCS, CPC-H, CPC, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer, offer tips for determining the correct seventh character.
Coders and clinical documentation improvement specialists need to pay attention to what conditions are considered CCs and MCCs, as well as sequencing rules which could affect MS-DRGs. Laurie L. Prescott, MSN, RN, CCDS, CDIP, AHIMA-approved ICD-10-CM/PCS trainer, and William E. Haik, MD, FCCP, CDIP, AHIMA-approved ICD-10-CM/PCS trainer, discuss some common CCs and MCCs.
If nothing else, Rep. Ted Poe, R-Texas, is consistent. He again introduced legislation to kill ICD-10. (The bill is H.R.2126 if you are interested.) Poe has tried this trick before. He introduced an...
In case getting allergic rhinitis from your dog wasn’t bad enough, a Colorado man contracted the plague from his pit bul l. And then he may have passed it on to another person. Person-to-person...
And the flowers bring pollen. Achoo! Allergies are a fact of life for millions of Americans—approximately 30% of adults and 40% of children suffer from allergies, according to the American College of...
CMS released updated I/OCE specifications in January with several changes that could require providers to examine claims submitted early in 2015 that include comprehensive APCs (C-APC) to ensure proper payment.
CMS released updated I/OCE specifications in January with several changes that could require providers to examine claims submitted early in 2015 that include comprehensive APCs (C-APC) to ensure proper payment.
The policies that CMS publishes each year in the OPPS proposed rule don't always come as a surprise. Sometimes, CMS will announce its future intent in a previous rule in order to notify providers about data it is looking at or requesting comments on.
Many coders rely on the AHA's Coding Clinic advice to resolve sticky situations with ICD-9-CM coding. However, AHA will not be transitioning its current guidance to ICD-10-CM. Instead, in January 2014, AHA began focusing solely on ICD-10-CM questions to help clear up confusion prior to implementation.
PSI 15 measures the hospital's risk-adjusted rate of accidental punctures and lacerations. PSI 15 has the highest weight in the PSI 90 composite under both the Hospital-Acquired Condition Program and the Hospital Value Based Purchasing Program. Coders and CDI specialists can improve performance for PSI 15 by ensuring complete documentation and correct ICD-9-CM code assignment for PSI 15?pertinent inclusions, exclusions, and risk adjustment variables.
When CMS introduced the -X{EPSU} modifiers in August 2014 to be used in specific instances to replace modifier -59 (distinct procedural service), the agency encouraged "rapid migration" to the new modifiers.
This month’s issue features the second article in a series of PSI 90, PSI 15. In addition, we highlight similarities and differences in coding poisonings and adverse events in ICD-9-CM and ICD-10-CM. Sharme Brodie highlights some of the top questions about ICD-10 answered by Coding Clinic and Robert S. Gold, MD, reviews how to identify conflicting documentation.
Our friends at the Association of Clinical Documentation Improvement Specialists hold their annual conference next month in San Antonio , Texas. And like everything in Texas, it’s going to be BIG ...
You learn something new every day. Today’s new fact: you can be a professional video game player. I’m not sure why that surprises me. After all, video games have come a long way from the Atari and...
Dave Fee, MBA, identifies updates to CMS' programming logic for comprehensive APCs and provides a step-by-step approach to determine whether a complexity adjustment will be applied.
Primary care providers see patients for a wide variety of conditions, meaning coders in those settings may have to learn many of the new concepts and terms in ICD-10-CM. Annie Boynton, BS, RHIT, CPCO, CCS, CPC, CCS-P, COC, CPC-P, CPC-I, and Rhonda Buckholtz, CPC, CPC-I, CPMA, CRC, CHPSE, CGSC, CENTC, COBGC, CPEDC, discuss three common conditions seen in these settings and what information coders will need to look for in documentation to code them in ICD-10-CM.
A Recovery Auditor automated review of claims for cardiovascular nuclear medicine procedures found potential incorrect billing due to lack of medical necessity, according to the latest Medicare Quarterly Compliance Newsletter.
Q: We are trying to verify whether we should bill for two units of the CPT® code when the provider performs a service with and without magnetic resonance angiography (MRA), such as an MRA of the abdomen, with or without contrast material (code 74185). The description of the MRA CPT codes say "with or without," not with and without for billing all non-Medicare payers. We realize for Medicare we are to use HCPCS codes C8900-C8902.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, reviewsCPT® coding for interrupted pregnancies, while also highlighting changes coders can expect for related diagnoses in ICD-10-CM.
You may recall that Steve’s super streak at the Vegas craps table ended with a torn right ulnar collateral ligament. On the recommendation of his primary care physician, Steve consulted an orthopedic...
You know us and the staff at the Acme ED, Fix ‘Em Up Clinic, and the Stitch ‘EM Up Hospital. Now, we want to get to know a little bit about you, our readers. Please complete this short survey to tell...
When providers use different definitions for the same disease, confusion and chaos result. Trey La Charité, MD , discusses how coding and clinical documentation improvement specialists can clear up the situation.
Heart failure is the intrinsic inability of the heart to supply target organs with sufficient nutrient flow to function normally. Robert S. Gold, MD, and Gloryanne Bryant, RHIA, RHIT, CCS, CDIP, CCDS, review the clinical and coding guidelines for heart failure.
Q: A patient came to the ED with shortness of breath (SOB). The admitting diagnosis was possible acute coronary syndrome (ACS) due to SOB and elevated troponin levels. The ACS was ruled out. Elevated troponin levels were assumed to be due to chronic renal failure (CRF), and no reason was given for SOB. Before discharge, the patient was noted with an elevated temperature and found to have a urinary tract infection (UTI). All treatment was directed at the UTI, and the doctor noted the discharge diagnosis as the UTI. What would be the principal diagnosis in this case?
PSI 15 measures the hospital’s risk-adjusted rate of accidental punctures and lacerations. Shannon Newell, RHIA, CCS, Steve Weichhand , and Sean Johnson explain inclusions, exclusions, and risk adjustment factors for this measure.
I spent the weekend reading the 2016 Inpatient Prospective Payment System (IPPS) proposed rule. Not the most thrilling reading ever (government-ese should be classified as a foreign language). I did...
Last week, Steve spent some serious time at the craps table in Las Vegas. He was on a real roll with those dice, racking up a 14-hour winning streak. However, on that last throw, something went very...
The endless last-minute patches for the Sustainable Growth Rate (SGR) are almost history. Late last night, the Senate overwhelmingly passed H.R. 2, which repeals the SGR. The House overwhelmingly...
A Comprehensive Error Rate Testing (CERT) study of transcatheter aortic valve replacement/implantation (TAVR/TAVI) services found that approximately one third of the claims received improper payments, mostly due to insufficient documentation, according to the latest Medicare Quarterly Compliance Newsletter.
Peggy Blue, MPH, CPC, CCS-P, CEMC, and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, review code changes in the 2015 CPT® Manual's Medicine section, including newly available products and services.
Reporting procedures for the skin can require a variety of documented details, such as location, severity, and size. John David Rosdeutscher, MD, and Gloria Miller, CPC, CPMA, CPPM, explainwhich details coder should look forto accurately report excisions, closures, and other wound care services.
Q: If a patient is given Reglan ® intravenously at 12:20, 13:00, and 13:20, would this be considered an IV push because the clinician did not document a stop time?
CMS is asking for some social media help in support of ICD-10. The agency is planning a social media rally to encourage the healthcare community to get ready for the ICD-10 transition. You can sign...
