Coders will find many more options for fractures in ICD-10-CM. Review the anatomy of the foot and the specificity providers will need to document to code accurately with the new code set.
Body mass index (BMI) reporting is becoming more important as a diagnostic tool for providers, and ICD-10-CM will expand the ability to accurately report it. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , looks at documentation concerns and coding concepts for BMI in both ICD-9-CM and ICD-10-CM.
ICD-10-CM expands the coding options for phobias, eating disorders, and pervasive developmental disorders. Betty Hovey, CPC, CPC-H, CPB, CPMA, CPC-I, CPCD , reviews these disorders and how to report them in ICD-10-CM.
Q: We are coding for pain management procedures and have been doing dual coding in ICD-9-CM and CPT ®. With a medial branch block ablation at two levels for L3-L4 and L4-L5 for a bilateral injection, we are coding: ICD-9-CM procedure code 04.2 (destruction of cranial and peripheral nerves) CPT codes 64635 (destruction by neurolytic agent, paravertebral facet joint nerve[s], with imaging guidance [fluoroscopy or CT]; lumbar or sacral, single facet joint) and 64636 (destruction by neurolytic agent, paravertebral facet joint nerve[s], with imaging guidance [fluoroscopy or CT]; lumbar or sacral, each additional facet joint [List separately in addition to code for primary procedure]), each with modifier -50 (bilateral procedure) appended. What would be your recommendation for the ICD-10-PCS code? Currently we are coding 015B3ZZ (destruction, lumbar nerve, percutaneous) twice. We are not sure if we should be picking this code up twice or only once.
The 2015 OPPS proposed rule , released July 3 by CMS, is relatively short at less than 700 pages, but contains refinements to the previously introduced Comprehensive APC policy and significant packaging of ancillary services.
Holly spent the weekend hanging out at the beach, enjoying the sun. The sand was so warm that she slipped off her shoes to stroll near the water. And disturbed a crab in the process. The crustacean,...
A lot of people are starting their Fourth of July celebrations early. At least it seems that way at the Fix ‘Em Up Clinic. Shannon took her dog Damian to the park to watch some fireworks last night...
Go to your local bookstore, pick up a copy of Gray’s Anatomy (the book, not the television show), and flip though the illustrations. Alternately, you can Google “Gray’s anatomy illustrations.” They...
Documentation and billing for observation stays has come under increased scrutiny from the OIG, though many hospitals have struggled with changing regulations and frequently updated guidance.
Physician documentation drives quality measures, but physicians often don't understand how the quality of their documenation relates to their quality of care.
Documentation and billing for observation stays has come under increased scrutiny from the OIG, though many hospitals have struggled with changing regulations and frequently updated guidance.
ICD-10-PCS will be a big change for inpatient coders. The best way to learn the new coding system is to practice, practice, practice. See how well you know ICD-10-PCS by assigning all applicable ICD-10-PCS codes for the following case.
Editor's note: With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in anatomy and physiology. To help coders prepare for the upcoming transition, we will provide an occasional article about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation. This month's column addresses the anatomy of the feet.
In this month's issue, we explain how to identify inpatient-only procedures, discuss ways to educate physicians about how quality of their documentation reflects the quality of their care, and provide an ICD-10-PCS case study to test your knowledge. Dr. Robert Gold reviews the various types of diverticula.
CMS' introduction of the 2-midnight rule in the 2014 IPPS final rule makes properly identifying inpatient-only procedures even more important for hospitals.
CMS and Obamacare have increasingly been moving healthcare toward a more value-based model. They want to pay physicians for how well they treat patients and not by the volume of services they provide...
More healthcare providers would have been ready for an October 1, 2014 ICD-10 implementation date than people may have realized, according to a survey by Edifecs, eHealth Initiative (eHI) and AHIMA...
Composers lead pretty safe lives, right? They compose music, conduct the symphony, and hang out at post-show parties. And we’re not talking rock star parties. Sometimes, though, that job isn’t so...
Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I , examines common orthotic procedures, including fracture reduction, total knee replacement, and total hip replacement, to determine how to choose the correct CPT ® code and key terms that should be documented.
Q: I work for general surgeons. Here is a common scenario: The surgeon is called in to see patient in the ED for trauma or consult. The patient is admitted, but our physician is not the admitting physician. I would tend to bill the ED code set, but do I have to use the subsequent hospital care codes instead?
Sarah L. Goodman, MBA, CHCAF, CPC-H, CCP, FCS , and Susan E. Garrison, CHCA, CHCAS, PCS, FCS, CPC, CPC-H, CCS-P, CHC, CPAR, examine a pair of case studies to determine whether the right codes were applied and whether it's appropriate to append a modifier.
The increased specificity required for ICD-10 coding requires a solid foundation in anatomy and physiology for coders. Review the anatomy of the kidney, as well as the essential coding concepts to properly report kidney conditions in ICD-10-CM.
Poor Finn is having a rough week. It started out well as he spent Sunday with his folks and older brother at an amusement park being as amused as a 6-month-old can be. Things started going downhill...
Jeff comes in to the Fix ‘Em Up Clinic complaining of shortness of breath, a persistent cough, tightness in his chest, and frequent respiratory infections. He tells Nurse Nosey that he smokes a pack...
CMS focused on quality measures in the 2015 IPPS proposed rule, released April 30. Kimberly A.H. Baker, JD, Cheryl Ericson, MS, RN, CCDS, CDIP, James S. Kennedy, MD, CCS, CDIP ,and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, highlight the most significant proposed changes.
Sequela, or late effect, is the remaining or lasting condition produced after the acute stage of a condition or injury has ended. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, reviews the correct way to code for sequelae in ICD-9-CM and ICD-10-CM.
For anyone who has not yet started ICD-10 training, CMS posted a transcript, audio file, and slide presentation from the June 4 More ICD-10 Basics MLN Provider call on its website.
Q: A few days into the patient’s stay, an order for a Foley catheter was placed for incontinence and around the same time the physician documented a urinary tract infection (UTI). Would it be appropriate to query the physician regarding the relationship of the UTI to the Foley? Our infection control department caught this but we did not. I am concerned about this for two reasons; first, I worry about writing a leading query and second, whether the UTI could be considered a hospital-acquired condition (HAC) if additional documentation isn’t provided.
Learning to code in ICD-10-PCS is in some respects like learning a language, you need a strong foundation in the rules. Sue Bowman, MJ, RHIA, CCS, FAHIMA , Gerri Walk, CCS-P , Nena Scott, MSEd, RHIA, CCS, CCS-P , and Jennifer Avery, CCS, CPC-H, CPC, CPC-I, discuss the guidelines related to root operations in ICD-10-PCS.
Dodge ball is not a game for wimps or the uncoordinated. Even master ball dodgers can end up in the Fix ‘Em Up Clinic. Steve engaged in a spirited game of dodge ball over the weekend, which resulted...
What do you get when you combine a full moon and Friday the 13th? Some really odd injuries at the Fix ‘Em Up Clinic. Fortunately, we here at the clinic suffer from neither paraskevidekatriaphobia (...
I recently spoke with Barbara Hinkle-Azzara, RHIA , vice president of HIM operations for HRS Coding in Baltimore about preparing for ICD-10 and, more specifically, about the anticipated MS-DRG...
On July 1, CMS will implement a variety of changes to current supervision requirements as recommended by the Hospital Outpatient Payment Panel. Debbie Mackaman, RHIA, CHCO , reviews the panel's recommendations, and which CMS plans to accept or reject.
Guidance for coding OB delivery lacerations sometimes differs between the CPT ® Manual and the American Congress of Obstetricians and Gynecologists. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , explains the difference in guidance and documentation necessary to report tears to the proper degree.
Q: If the clinical impression is physical assault, vomiting, blunt injury to abdomen, and head injury with loss of consciousness, can I code the history of hypertension, diabetes mellitus, headache, bipolar disorder, and depression?
A patient comes into the ED following an automobile accident. The physician documents that the patient has an open, displaced fracture of the lateral condyle of the right tibia. The physician also...
We all know that ICD-10 codes will require more complete documentation. We’ve been telling physicians that, but maybe we’re not explaining it well or correctly. What makes documentation better? It’s...
Both knee and shoulder replacement procedures include devices and fall under the ICD-10-PCS root operation Replacement (R). Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, CHTS-CP, and Nena Scott, MSEd, RHIA, CCS, CCS-P , review the definition of a device in ICD-10-PCS and review how to code for shoulder and knee replacements.
ICD-10-PCS root operations Occlusion, Restriction, and Dilation involve changing the diameter of a tubular body part. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Angie Comfort, RHIT, CDIP, CCS, review the definitions of these root operations and examine when they should be used.
Both knee and shoulder replacement procedures include devices and fall under the ICD-10-PCS root operation Replacement (R). Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, CHTS-CP, and Nena Scott, MSEd, RHIA, CCS, CCS-P , review the definition of a device in ICD-10-PCS and review how to code for shoulder and knee replacements.
