According to a recent audit by the Department of Health and Human Services’ Office of Inspector General (OIG), Ohio State University Hospital received millions in overpayments during an audit period due to errors in coding, MS-DRG assignment, and billing.
To deal with the rising rate of infection and increased hospital admissions for extraordinarily sick patients due to the novel coronavirus (COVID-19), CDI teams have had to act quickly by adapting to remote work, modifying CDI practices, and more.
Q: We have a patient who gave birth while admitted for novel coronavirus (COVID-19). How should this be reported and sequenced in ICD-10-CM and which MS-DRG would this be assigned to?
Sarah Nehring, CCS, CCDS , says to ensure ICD-10-PCS coding accuracy and appropriate MS-DRG assignment, inpatient coders must understand the device being inserted and how to apply the coding conventions and guidelines for pacemaker-related procedure coding. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Joel Moorhead, MD, PhD, CPC , writes that certain clinical indicators provide strong support for a diagnosis of acute-on-chronic congestive heart failure (CHF) in adults. Because of this, it’s important for inpatient coders to familiarize themselves with baselines and clinical indicators in order to ensure accurate reporting.
Dawn Valdez RN, LNC, CCDS, reviews MS-DRG and code assignment for COVID-19-related pediatric multi-system inflammatory syndrome (PIMS), as well as common findings and treatments for the condition.
Q: We have a patient that was admitted with sepsis due to COVID-19 who also has human immunodeficiency virus (HIV). How should we report this in ICD-10-CM, and which MS-DRG would this be assigned to?
Cheryl Manchenton, RN, BSN, CCDS, CPHM, writes that when it comes it reporting novel coronavirus (COVID-19), our understanding of it and its sequelae/manifestations is continually evolving. There is one “manifestation” of COVID-19 that is of interest for experimental treatment: cytokines.
The ICD-10-CM Coordination and Maintenance Committee recently released the fiscal year (FY) 2021 ICD-10-CM code set, which includes 490 new, 58 deleted, and 47 revised ICD-10-CM codes. Along with updates to the Tabular index, these changes include new codes for reporting chronic kidney disease and body mass index.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, reviews Chapter 11 of the ICD-10-CM manual, Diseases of the Digestive System, as attention must be paid to the coding conventions and general coding guidelines when reviewing the manual for correct code assignment. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Julian Everett, RN, BSN, CDIP, writes that as some hospitals see revenue continue to decline due to the current COVID-19 pandemic, inpatient coders and CDI specialists need to brush up on the criteria, treatment, and ICD-10-CM reporting for malnutrition diagnoses to avoid any more loss in revenue.
Jannifer Owens, MSA, BSHA, CCS, and Denise Coast, RHIA, CCS, detail tips for reporting the novel coronavirus (COVID-19) and say that we have a plethora of ICD-10-CM codes to help describe the patient story and we should use them to ensure optimal coding and enhanced data capture. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS’ recently released the fiscal year (FY) 2021 IPPS proposed rule which included proposals for the creation and revision of various MS-DRGs. In particular, CMS proposed the creation of a new MS-DRG for cases involving chimeric antigen receptor T-cell (CAR-T) therapies.
Alba Kuqi, MD, CICA, CCS, CDIP, CCDS, CRCR, CSMC , gives guidance to CDI teams working on clinical validation, denials prevention, and appeals processes to help ensure proper reimbursement for their hospitals.
Laurie L. Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , reviews Coding Clinic , First Quarter 2020, guidance, which includes topics such as reporting vaping-related disorders, malnutrition, and bariatric procedures.
Sarah A. Nehring, CCS, CCDS, writes that an inpatient coder’s first concern regarding the reporting of novel coronavirus (COVID-19) is to code all confirmed cases and only confirmed cases. In this article, Nehring details guidelines on how to accomplish this.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, details coding guidelines and instructional notes in Chapter 9 of the ICD-10-CM manual, which contains codes for diseases of the circulatory system, including rheumatic fever, hypertension, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS recently released the fiscal year (FY) 2021 ICD-10-PCS code set and ICD-10-PCS Official Guidelines for Coding and Reporting . The ICD-10-PCS code update includes new codes for Fragmentation and Drainage, while the guidelines update includes new and revised guidelines for certain root operations, approach values, and device combinations.
Q: If an inpatient is transferred before we receive a positive novel coronavirus (COVID-19) lab result, do we need to query the provider to amend the discharge summary to state “COVID-19 positive”?
