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Articles
    JustCoding Outpatient Archives
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    JustCoding Outpatient

    Unlocking health insights: The power of ICD-11 and big data

    January 22, 2025
    Although ICD-11 has not yet been adopted in the United States, various countries have implemented it to enhance their health data analysis, improve public health strategies, and foster international comparability. This article covers how other countries that have adopted ICD-11 are using their data.
    JustCoding Outpatient

    Get ready for ICD-10-CM changes for FY 2025

    August 21, 2024
    The ICD-10-CM changes for fiscal year 2025 are coming October 1, 2024. Learn about some of the changes to guidelines, notes, wording in current categories, and expansion of code categories.
    JustCoding Outpatient

    Healthcare News: CMS releases FY2025 ICD-10-CM code update and guidelines

    July 10, 2024
    CMS released the FY2025 ICD-10-CM codes and guidelines. See a sneak peak of some of the new codes that will be effective October 1.
    JustCoding Outpatient

    Uncertain diagnosis? Outpatient coding is different

    March 6, 2024
    Shelley Safian , PhD, RHIA, CCS-P, COC, CPC-I , defines the differences between reporting uncertain diagnoses in outpatient and inpatient settings.
    JustCoding Outpatient

    Looking ahead to ICD-11 implementation

    February 21, 2024
    Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, and Karla VonEschen, MS, CPC, CPMA, CCDS-O, take a look back at the progression of diagnosis and mortality coding before looking ahead to ICD-11 and how coding departments can prepare for it.
    JustCoding Outpatient

    Decipher documentation and ICD-10-CM coding for heart failure

    February 21, 2024
    Heart failure affects more than 6 million adults in the U.S. and costs the nation more than $30 billion. Review ICD-10-CM guidance and documentation details required for accurately reporting the condition. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
    JustCoding Outpatient

    AI proliferates: Coding and chat remain fertile ground, but watch decision-making

    February 21, 2024
    Artificial intelligence (AI) has burst on the scene with numerous clinical and coding applications for providers. This article looks at how the technology can be used and where human oversight is still required.
    JustCoding Outpatient

    Healthcare News: CMS proposes more than 400 ICD-10-CM changes in 2024 IPPS proposed rule

    May 3, 2023
    CMS released the fiscal year (FY) 2024 IPPS proposed rule on April 10. The document contains proposals for 395 new, 12 revised, and 25 invalidated ICD-10-CM codes.
    JustCoding Outpatient

    Take a first look at final 2021 ICD-10-CM/PCS and CPT code updates

    September 9, 2020
    The final 2021 CPT, ICD-10-CM, and ICD-10-PCS code sets were released last week, introducing new, revised, and deleted codes for diagnostic and procedural services and accompanying guideline changes. Read up on the changes, which will impact payment for hospital services in 2021.
    JustCoding Outpatient

    ICD-10-CM coding considerations for vaping-induced illnesses

    October 9, 2019
    One thousand eighty cases of respiratory illnesses and 18 deaths brought on by vaping have been reported in the U.S. as of October 1, according to the Centers for Disease Control and Prevention. Review provider documentation and ICD-10-CM reporting for vaping-induced illnesses. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
    JustCoding Outpatient

    Comply with medical necessity in outpatient hospital and physician clinic settings

    July 19, 2017
    With the increased focus on clinical documentation improvement in the outpatient arena, Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, shares her tips for proving medical necessity on claims.
    JustCoding Outpatient

    Items of interest for outpatient departments in the 2018 IPPS proposed rule

    May 24, 2017
    Traditionally, the OPPS rulemaking cycle has been the main vehicle for changes to outpatient coding and billing regulations and policy that hospitals need to pay attention to. But Jugna Shah, MPH , writes that, increasingly, CMS has been introducing or discussing changes relevant to outpatient hospitals beyond the scope of the OPPS rules.
    JustCoding Outpatient

    CMS debuts proposed ICD-10-CM codes for fiscal year 2018

    April 26, 2017
    CMS released the fiscal year 2018 IPPS proposed rule April 14, and with it came a bevy of new potential ICD-10-CM codes. Explore the new additions to the ophthalmologic, non-pressure chronic ulcer, maternity and external cause codes ahead of implementation October 1.
    JustCoding Outpatient

    A look at anatomy and ICD-10-CM coding for the eye

    March 1, 2017
    The human eye may be small, but it’s one of the most complex organ systems in the body. Review the anatomy of the eye and how to code for conditions affecting the system, including new details for 2017.
    JustCoding Outpatient

    Review chapter-specific updates in the 2017 ICD-10-CM guidelines

    September 28, 2016
    Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS, delves into chapter-specific guidance included in the updated 2017 ICD-10-CM guidelines, including changes for diabetes, hypertension, pressure ulcers, and more.
    JustCoding Outpatient

    Taking a look at 2017 updates to ICD-10-CM guideline general conventions

    September 28, 2016
    Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS, continues her review of the updated 2017 ICD-10-CM guidelines by explaining how changes to sections for laterality and non-provider documentation will impact coders and physicians. Note: To access this free article, make sure you first register here if you do not have a paid subscription. Once you have set up your free registration, you can log in and access this article by clicking here.
    JustCoding Outpatient

    Unravel complexities of billing self-administered drugs

    February 20, 2013
    As more patients are being impacted by noncoverage of self-administered drugs, coders and billers need to know when and how to report drugs and drug administration services. Kimberly Anderwood Hoy, JD, CPC, and Valerie Rinkle, MPA, discuss the differences in how drugs are paid under Medicare Part A and Part B.
    JustCoding Outpatient

    Correctly bill ancillary bedside procedures in addition to the room rate

    April 18, 2012
    As charges become more specific to provide additional concrete and transparent cost data, providers must consider what procedures they routinely provide to patients and what procedures are specifically related to the patient's condition. Denise Williams, RN, CPC-H, and Kimberly Anderwood Hoy, JD, CPC, reveal tips for determining when to separately bill for ancillary bedside services provided to inpatients.
    JustCoding Outpatient

    Defining 'integral' for self-administered drugs is challenging

    February 22, 2012
    In many instances, payers may consider a drug to be self-administered in some circumstances but not in others. As a result, coders must pay special attention to how these drugs are used within their setting. Kimberly Anderwood Hoy, JD, CPC, and Valerie Rinkle, MPA, offer some tips and suggestions for reporting self-administered drugs and determining when the drug is integral to the service.
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