Coding for endovascular revascularization requires following a unique hierarchy and specific guidelines. Caren J. Swartz, CPC-I, CPC-H, CPMA, CPB , and Denise Williams, RN, CPC-H , look at the anatomy of the lower body and the necessary documentation to report these services.
The October update to the OPPS and Integrated Outpatient Code Editor (I/OCE) includes a payment correction, in addition to new HCPCS codes and other changes. Dave Fee, MBA, reviews CMS' changes and details the retroactive payment correction.
ICD-10-CM readiness goes beyond training coders on the new code set. Rhonda Buckholtz , Wendy Aiken, and Sid Hebert, look at the impact of implementation on physicians and payers, and how providers can ease the transition.
ICD-10 implementation will impact different specialties and hospital departments in distinct ways. Andrew D. Boyd, MD, and Neeta K. Venepalli, MD, MBA , recently conducted a pair of studies to determine the financial and informational impact of ICD-10 on a variety of specialties.
Most diabetes codes in ICD-10-CM include more details than ICD-9-CM codes, but coders also need to consider additional codes. Jillian Harrington, MHA, CPC, CPC-I, CPC-P, CCS, CCS-P, MHP , and Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC, review key aspects for coding diabetes in ICD-10-CM.
CMS recently updated the Medicare Claims Processing Manual , with changes announced in Transmittal 3020 , to include ICD-10-specific language ahead of next year's implementation.
Q: What if the provider states that diabetes is due to the adverse effects of a drug, but doesn't tell us which drug? How do we report that in ICD-10-CM?
Evaluation and management (E/M) services are one of the top areas of review by federal auditors. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about common errors found in audits and how providers can take steps to correct them.
The ICD-10-CM delay has at least one silver lining: the ability to spend more time on coding and documentation requirements before implementation. Providers may want to also think about aligning their ICD-10-CM efforts with outpatient clinical documentation improvement (CDI) during this time. Elaine King, MHS, RHIA, CHP, CHDA, CDIP, examines the benefits and challenges of outpatient CDI programs.
Q: We're not sure what to report in this situation: A patient comes to the ED and goes into respiratory failure. The respiratory therapist comes in to put patient on a vent in the ED, then the patient is transferred to another facility. We can’t report CPT ® code 94002 (ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day) because it is for inpatient/observation, per the definition. We wondered about using 94660 (continuous positive airway pressure ventilation [CPAP], initiation and management) for the CPAP. The lay description seems to be basically the same as 94002, except for “applies to ventilation assistance using adjustments in volume and pressure on the initial day…" Would 94660 be appropriate?
CMS is introducing four new HCPCS modifiers to specifically define subsets of modifier -59 (distinct procedural service), the most frequently used modifier.
The 2015 OPPS proposed rule includes new Comprehensive APCs, increased packaging, and many other changes. Kimberly Anderwood Hoy Baker, JD, and Jugna Shah, MPH , review the proposed rule and policies that may be finalized by CMS.
Coding depends on clear and accurate documentation, especially with the added specificity available in ICD-10-CM. Andrea Clark-Rubinowitz, RHIA, CCS, CPCH , highlights tactics for improving provider documentationahead of implementation.
Coding for arthroplasty can be challenging due to the multiple types of procedures and lack of specific CPT ® codes for many of them. Ruby O'Brochta-Woodward, BSN, CPC, COSC, CSFAC, and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, explain what to look for in documentation to report the correct codes.
Q: We're wondering about how to use CPT ® code 73225 (magnetic resonance angiography [MRA], upper extremity, with or without contrast material) in our hospital. When providing an MRA of an upper extremity with and without contrast material, should we bill this service twice (since CPT indicates with or without contrast material) or only once?
While coders have two options to report patella fractures in ICD-9-CM, they will find more than 400 options in ICD-10-CM. Review the anatomy of the lower leg and ankle, as well as ICD-10-CM coding concepts, to learn how to choose the most accurate ICD-10-CM code.
The codes for reporting pelvic fractures in ICD-10-CM have expanded, due to added specificity and classification systems that may be new to coders. Review the anatomy of the pelvis to prepare for coding pelvic fractures in ICD-10-CM.
The summer heat can lead to an increase in many sun and heat-related illnesses. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reviews common summer ailments and how to choose the right codes in ICD-9-CM and ICD-10-CM.
Hospitals will still use CPT ® codes to report procedures after ICD-10 is implemented, but some will also code with ICD-10-PCS. Andrea Clark, RHIA, CCS, CPC-H , reviews the advantages and challenges outpatient facilities may face when using ICD-10-PCS.
