On the eighth day of Christmas my true love gave to me eight maids a-milking. Why, exactly, has a herd of cows taken up residence in my backyard, True Love? What are we going to do with them and more...
Q: If the physician writes septic shock instead of sepsis, do I need to query for sepsis? Is this an integral part of the diagnosis and sepsis would be the principal diagnosis, with septic shock a secondary diagnosis, making it an MCC?
The anatomical definition of a body part may not be the same as the ICD-10-PCS identification of a body part. Jennifer Avery, CCS, CPC-H, CPC, CPC-I, Nena Scott, MSEd, RHIA, CCS, CCS-P, and Gretchen Young-Charles, RHIA, explain the guidelines for selecting the appropriate body part and how body parts can affect root operation selection.
In the first part of a two-part series, Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer, discusses the use of Z codes in ICD-10-CM.
CMS Transmittal 547 changes the audit timeframe for complex reviews from 60 to 30 days for some MAC and Recovery Auditor reviews. The change could significantly affect the volume and timeliness of complex reviews for providers. The transmittal becomes effective February 24, 2015.
On the seventh day of Christmas my true love gave to me seven swans a-swimming. To be completely accurate, he took a group of us on a road trip to a pond where the swans swam in blissful ignorance of...
On the sixth day of Christmas my true love gave to me six geese a-laying. My favorite Uncle Ted was so excited about this gift that he rushed right over to relieve those geese of their eggs. Bad idea...
On the fifth day of Christmas my true love gave to me five golden rings. Hey wait, there are only four rings here. Where did the other one go? Oh no, little Andrew shoved it up his nose. Time to...
On the fourth day of Christmas my true love gave to me four calling birds. I’m starting to think he raided a pet shop. Or maybe he captured these in the park. He says they’re calling birds. They look...
On the third day of Christmas my true love gave to me, three French hens. Awesome, more birds. My house is starting to look like an aviary. I’m also not sure why my true love thought it necessary to...
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about how to reduce queries by highlighting the information providers need to document for the most common OB ultrasound procedures.
Recovery Auditors have identified improper payments for claims involving end-stage renal disease (ESRD) services when more than one monthly service was billed per month and per-day codes exceeded the limit, according to the latest Medicare Quarterly Provider Compliance Newsletter .
Q: I have a question regarding CPT ® code 99184 (initiation of selective head or total body hypothermia in critically ill neonate, includes appropriate patient selection by review of clinical, imaging, and laboratory data, confirmation of esophageal temperature probe location, evaluation of amplitude EEG, supervision of controlled hypothermia, and assessment of patient tolerance of cooling) in the 2015 CPT Manual . What if the neonate is in the hospital for several weeks? The total body hypothermia is performed, the baby improves, but remains in the hospital and then needs the procedure performed a second time. Can we report it a second time if several weeks have elapsed?
The added detail found in ICD-10-CM may require coders to brush up on their anatomy and physiology training to select the most appropriate codes. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , reviews the anatomy of the male reproductive system and how coding for it will change in ICD-10-CM.
On the second day of Christmas my true love gave to me, two turtle doves. Hmm, you think he would have learned his lesson with the partridge. Apparently not. And apparently Mr. Whiskers isn’t hungry...
On the first day of Christmas, my true love gave to me, a partridge in a pear tree. How…nice. Fortunately, the tree is way too big for the living room (it also clashes with my real Christmas tree)...
Usually in this blog, I talk about ICD-10 implementation and coding from the coder or HIM point of view. But I wanted to share some suggestions from James S. Kennedy, MD, CCS, CDIP, president of...
Poor Finn. He’s heading for his first birthday, but he may not be in a partying mood. After Finn developed his fifth ear infection in six months, mom Melissa decided it was time to put tubes in his...
I’m almost afraid to read my email these days. It seems like every day brings a new group trying to delay ICD-10 or another piece of legislation that ICD-10 opponents might slip delay language into...
ICD-10-CM introduces new requirements for coding skull fractures and brain injuries. Kim Carr, RHIT, CCS, CDIP, CCDS , and Kristi Stanton, RHIT, CCS, CPC, CIRCC, explore how coding for these conditions changes in ICD-10-CM.
The advantages offered by ICD-10-CM can directly affect providers, patients, and third-parties alike. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer, discusses this history of ICD-10-CM and the improvements the new system offers.
Q: We’ve heard that ICD-10-CM does not include a diagnosis code to show that a laparoscopic procedure was converted to an open procedure. How will we report this in ICD-10?
ICD-10-PCS will change the way coders count sites for coronary artery bypass graft (CABG) procedures. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Nena Scott, MS, RHIA, CCS, CCS-P, explain how coders will report CABG in ICD-10-PCS.
In this issue, we explain how to code CABG in ICD-10-PCS, review sepsis clinical criteria and ICD-9 coding guidelines, and review the changes to physician certification finalized in the OPPS final rule. Robert S. Gold, MD, highlights areas of concern for respiratory conditions in ICD-10-CM.
The endocrine system, which consists of many glands located throughout the body, is responsible for producing hormones and releasing chemicals into the bloodstream. These glands help maintain many important bodily functions, including metabolism, growth, and reproductive functions.
The ICD-10 implementation delay mandated by Congress this spring granted providers an extra year to prepare their coders and clinicians on the requirements of the new code set, but a recent survey has found some organizations heading in the wrong direction.
With quarterly code updates and other regulatory changes from CMS throughout the year, the chargemaster coordinator has to constantly monitor the healthcare landscape, but the final few months of the year remain the most challenging.
Beginning January 1, 2015, physicians will no longer need to provide certification for an inpatient admission unless the admission is expected to last for at least 20 days or the case is an outlier.
The ICD-10 implementation delay mandated by Congress this spring granted providers an extra year to prepare their coders and clinicians on the requirements of the new code set, but a recent survey has found some organizations heading in the wrong direction.
We’ve survived the holiday feast and decided to skip the doorbusting to head out and visit the cute and fluffy animals at the Anytown Zoo. Of course, no outing would be complete without some injuries...
Tom Turkey has come in to the Stitch ‘Em Up Hospital for a little work before Thanksgiving. Dr. Carver is going to first take out Tom’s guts, then replace them with stuffing. How would we code Tom’s...
Q: We have a patient diagnosed with neuropathy due to poorly controlled insulin-dependent Type 1 diabetes mellitus. What should we report in ICD-10-CM?
AHIMA is calling for coders, billers, and providers to contact Congress to ask for no additional delays to ICD-10 after physician groups have recently started to advocate for members to petition Congress to introduce a new, two-year implementation delay to push the compliance date to October 1, 2017.
With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in anatomy and physiology. Review the anatomy of the endocrine system and how to code for conditions affecting it.
The majority of providers either stopped or slowed their ICD-10 preparations as a result of the latest implementation delay, but now providers have less than a year to become ready. CMS' Denesecia Green and Stacey Shagena offer advice on how providers can create an action plan to be ready by October 1, 2015—even if they haven't started yet.
In its November issue, the Journal of AHIMA published an article citing significantly lower costs for physician practices to transition to ICD-10 than the numbers supplied by Nachimson Advisors in a...
Oh, that Jose Canseco. Such a kidder. Turns out, his claim that his finger fell off during a poker game was a joke. He did actually shoot part of it off “cleaning” his gun and did indeed have it...
Providers gauge the severity of an acute brain injury using the Glasgow Coma Scale, and in ICD-10-CM, coders will be able to code this score. Kim Carr, RHIT, CCS, CDIP, CCDS , and Gretchen Young-Charles, RHIA, explain how to code the coma scale in ICD-10-CM.
Malnutrition is at its most basic level any nutritional imbalance and it is often underdiagnosed. James S. Kennedy, MD, CCS, William E. Haik, MD, FCCP, CDIP, and Mindy Hamilton, RD, LD , explain the clinical indicators and coding basics for malnutrition.
Coders often talk about guidelines and coding conventions, but what about ethics? Robert S. Gold, MD , discusses the value of following ethical coding standards.
Q: We have a problem getting our physicians to understand what we are querying for chronic respiratory failure when a patient is on home oxygen continuously with documented supplementary oxygen of less than 90%, or arterial blood gas with hypoxemia. The physicians tell us chronic obstructive pulmonary disease (COPD) is chronic respiratory failure by definition. Can you help us clarify this situation or give us some tips on how to educate our physicians?
Baseball fans may remember Jose Canseco as part of the Oakland A’s slugging duo, the Bash Brothers. He made a lot of money hitting the ball very, very far. I hope he saved some for his medical bills...
As healthcare professionals, we’re all familiar to some degree with HIPAA. You know, the law that makes it illegal to release protected health information, among other things. Hospital employees have...
One of the biggest stumbling blocks for ICD-10 implementation by small physician practices was the estimated cost of the transition. Those costs may not be as high as originally estimated, according...
