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.
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...
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?
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.
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.
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.
Hospital outpatient therapeutic services, such as ED or clinic visits, that are paid under the OPPS or to critical access hospitals (CAH) on a cost basis must be furnished "incident to" a physician's service to be covered.
CMS made relatively few changes in the April quarterly I/OCE update, introducing four new APCs, deleting one, and reclassifying several skin substitute codes.
April 1 was supposed to mark the final six months providers, payers, and CMS had to prepare for ICD-10's implementation on October 1, 2014. Instead, it brought another delay for the code set, with providers still waiting for CMS to announce a new deadline as of presstime.
The April 1 confirmation of the delay in implementing the ICD-10 code set until at least October 1, 2015, certainly took the wind out of many healthcare organizations' sails.
In this month’s issue, we review the changes CMS proposed in the 2015 IPPS proposed rule. Shannon E. McCall explains why you should view the latest ICD-10 implementation delay with optimism instead of skepticism. Dr. Robert Gold discusses wound care coding in ICD-10.
CMS' 2015 IPPS proposed rule, released April 30, focuses on quality measures, such as HAC reduction, readmissions reduction, and hospital value-based purchasing (VBP) programs.
If you’ve glanced through the ICD-10-CM Manual, you likely noticed all of the codes for fractures, strains, and dislocations. We’re going to have a lot more choices in ICD-10-CM, which means we’re...
As the role of radiologists has expanded to new procedures, so have the codes to report their work in the CPT ® Manual . Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, writes about key terms for coders to look for in documentation to correctly report these procedures.
The April quarterly I/OCE update brought relatively few changes, though CMS has continued to refine skin substitute reporting. Dave Fee, MBA, reviews the updated skin substitute categories, as well as updates to laboratory billing.
Recovery Auditors have found that modifier misuse is resulting in underpayments to providers, according to the most recent Medicare Quarterly Provider Compliance Newsletter .
Q: I read that CPT ® code 20680 (removal of implant; deep, e.g., buried wire, pin, screw, metal band, nail, rod, or plate) is commonly used for deep hardware removal. What would be the proper code for removal on one screw that has already made its way out, is not under any muscle, and is easy to visualize?
Betty Hovey, CPC, CPC-H, CPB, CPMA, CPC-I, CPCD , looks at common dermatology conditions, including non-pressure chronic ulcers and psoriasis, as well as new concepts coders will need to look for to report these conditions in ICD-10-CM.
Ah, Memorial Day, the unofficial start of summer. And the day after Memorial Day is the unofficial start of summer injury season at Fix ’Em Up Clinic. Jackee took advantage of the long weekend by...
We won’t need to learn any new ICD-10-PCS codes or guidelines for 2015. CMS released the draft codes and guidelines and they include not much of anything. That’s not really a surprise since the code...
Some conditions, such as gangrene due to diabetes, require two codes to correctly report in ICD-9-CM. In ICD-10-CM, coders will only need one code. Jennifer Avery, CCS, CPC-H, CPC, CPC-I, and William E. Haik, MD, FCCP, CDIP, explain how these combination codes act as their own CC or MCC in ICD-10-CM.
Q: We had a question regarding documentation in a record of SIRS due to acute peritonitis without sepsis. Our critical care physician on that case called it severe sepsis as well. What would you do in a situation like that?
Reporting codes for use, abuse, and dependence isn’t completely new for ICD-10-CM. Coders can report them in ICD-9-CM. Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I , AHIMA-approved ICD-10-CM/PCS trainer, reviews the meaning of use, abuse, and dependence and how to code these conditions.
Coders can only use the documentation they have to code in ICD-9-CM and ICD-10-CM. Adelaide La Rosa, RN, BSN, CCDS, and Deborah Lantz, RHIA, discuss the importance of good documentation when coding for fractures and congestive heart failure in both systems.
Recently I have seen many articles casting a negative outlook on ICD-10. They scare everyone into believing that added specificity to the codes will create more work for everyone, especially the...
I’m going to pick on our friends from the Association of Clinical Documentation Improvement Specialists for one more day because I’ve heard some really good stories about the doings in Las Vegas last...
Our friends from the Association of Clinical Documentation Improvement Specialists came back from the desert with some minor maladies. Apparently everything that happens in Vegas doesn’t stay in...
CMS' Comprehensive Error Rate Testing (CERT) program found "many" improper payments in a review of Part B psychiatry and psychotherapy services claims, according to the most recent Medicare Quarterly Provider Compliance Newsletter .
Q: My office often has denials of evaluation and management (E/M) visits with our OB patients when using HCPCS modifier -GB (claim being resubmitted for payment because it is no longer covered under a global payment demonstration). Would coding with V22.2 (pregnant state, incidental) as a secondary diagnosis possibly alleviate this issue?
Some facilities plan to use both CPT ® and ICD-10-PCS to code procedures after implementation. Kristi Stanton, RHIT, CCS, CPC, CIRCC, and Angie Comfort, RHIT, CDIP, CCS, discuss the advantages and challenges of this strategy, and how to implement it.
Coders are very familiar with the diagnosis codes they use frequently, but the look of those codes will change in ICD-10-CM. Betty Hovey, CPC, CPC-H, CPB, CPMA, CPC-I, CPCD , reviews common dermatology conditions and how they will be reported with the new code set.
We’re still waiting for CMS to release the interim final rule on the new ICD-10 implementation date, but we did get some news on the ICD-10 front this week. The Office of Budget and Management...
Today I will focus on the chronological transition to ICD-10 readiness. My intent is to dispel myths and compare real-world experience in the ICD-10 planning space with the commonly disseminated...
Pneumonia is an inflammatory process that affects the lung tissue. Robert S. Gold, MD , and Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CHA, explain the clinical and documentation pieces of pneumonia coding.
Q: I’m in a little debate: Does documentation of the patient’s body mass index (BMI) need to come from an ancillary clinician, like the dietitian or nurse? I thought that we could use such ancillary documentation for clinical indicators supporting our physician query, but the treating physician needed to document the BMI. Can you help clarify this for me?
Our good friends at the Association of Clinical Documentation Improvement Specialists (ACDIS) have descended on Sin City for the seventh annual ACDIS conference. And while what happens in Vegas might...
