Labor Day might mark the unofficial end of summer, but we have plenty of summer-related injuries today at the Fix ‘Em Up Clinic. Our first guest of the day, James, went rock climbing for the first (...
Welcome to Stitch ‘Em Hospital, where we’re preparing for ICD-10-PCS by actually coding some of our procedures using the new system. We want to make sure we’re ready to go on October 1, 2014, and...
We’ve all heard of deranged killers, but have you ever heard of a deranged knee? Better yet, can you code for it? Coding for a derangement isn’t new. We have derangement codes in ICD-9-CM. For...
HHS will delay implementation of ICD-10 by one year, from October 1, 2013 to October 1, 2014. HHS announced the delay August 24 as part of the Administrative Simplification: Adoption of a Standard...
Penny came into the Fix ‘Em Up emergency department Friday, complaining of tingling and numbness in her face and arm. She was also somewhat unsteady on her feet. Her husband Dave also reported Penny...
We’ve hit the middle of August and Anytown’s summer adult baseball league is winding down its season. Just like the pros, though, our players haven’t escaped injury free. Randy, the league’s top...
Diseases of the ear and mastoid process are moving up in the ICD-10-CM world. They’re getting their own chapter. In ICD-9-CM, eyes and ears shared a section. You’ll find diseases of the ear in...
We’re one step closer to knowing whether the Department of Health and Human Services (HHS) will actually delay ICD-10 implementation and if so, by how long. The Office of Management and Budget (OMB)...
The dogs days of summer have arrived so the residents of Anytown descended on the dog park with their furry friends today. Sadly, not all of the puppies (and people) play well together and some of...
When a physician places a device that takes the place of all or some of a body part, assign a code from ICD-10-PCS root operation replacement (third character R). Think of a total knee replacement or...
Patience may be a virtue, but knowledge is power. Okay, enough clichés. The bottom line is we’re still waiting for a new ICD-10 implementation date. HHS published the proposed rule, moving...
What happens in Vegas might stay in Vegas, but when things go wrong in Atlantic City, people end up at Fix ‘Em Up Clinic. Today, we have several bachelor party victims who made the clinic their first...
Why hello there, Mr. Coyote. Long time, no see. Are you still chasing that roadrunner? You are? Well, you are certainly persistent, I’ll give you that. So what brings you into the Acme Clinic today?...
The American Osteopathic Association (AOA) House of Delegates has joined the American Medical Association’s (AMA) crusade to crush ICD-10 implementation. Back in November 2011, the AMA’s House of...
Over the weekend, Matt decided to grill up dinner, which sounds at first like a good idea. He started with chicken, then added some vegetables, unfortunately including some cherry tomatoes. While he...
Epilepsy affects nearly 3 million Americans and 50 million people worldwide, so you may see some of these patients come through your facility or practice. In ICD-9-CM, you find many of the epilepsy...
The National Center for Health Statistics, the Centers for Disease Control and Prevention, and CMS have posted some updated files for ICD-10-CM for 2013. The following files are available for...
I grew up in Western Pennsylvania coal country, where coal mines at one time were prevalent and back in the day, you could smell the hydrogen sulphide (at least according to my mother). A lot of the...
We’re having a heat wave, a tropical heat wave, here at Anytown, which means the Fix ‘Em Up Clinic is seeing plenty of heat-related illnesses. Meredith, our first patient, comes in complaining of a...
In ICD-10-PCS, coders will only report a device when the device remains in the patient after the procedure. If it’s removed, it’s not a device and your sixth character will be Z. For many procedures...
Does even the mere thought of coding in ICD-10-CM give you a pounding headache? Well, you’re in luck. ICD-10-CM has plenty of codes for reporting that headache. In order to code for a headache, we...
One advantage to using ICD-10-PCS is increased specificity. Coders will find increased specificity for the procedure, approach, device, and even anatomical region or body system. In the Medical and...
The eyes are the windows to the soul, but even the best windows can get cloudy or scratched or suffer some other type of trauma. Suppose a patient comes in with cloudy vision. The patient could be...
As expected, not much has changed for 2013 with ICD-10-PCS codes. The updated code set is now available on the the CMS website . CMS confirmed in April that the code freeze will hold until ICD-10-CM/...
Remember when your grade school English teacher drilled the rule of punctuation into your head? Instead of an English lesson, consider this an ICD-10-CM punctuation lesson. Brackets are used in the...
Until HHS issues a clear and direct statement on a final ICD-10-CM/PCS implementation date, some healthcare entities will stop any progress to compliance with new ICD-10 requirements, according to...
Mother’s Day and Father’s Day have already passed (and Grandparents Day isn’t until September), but we still see plenty of babies (and grouchy parents) here at Fix ‘Em Up Clinic. Sativa brings in...
The ICD-10-CM makes a distinction between burns and corrosions. The burn codes are for thermal burns, except sunburns, that come from a heat source, such as a fire or hot appliance. You also report e...
Anytown High School held its commencement ceremony over the weekend and it turned out to be a memorable event for more than the usual reason. Class president Marina decided to wear a pair of really,...
When a physician performs a procedure designed to put in a device without doing anything else to a body part, coders will report ICD-10-PCS root operation insertion (third character H in the medical...
The ICD-10-CM Official Guidelines for Coding and Reporting now include guidelines for coding methicillin resistant Staphylococcus aureus (MRSA), so let’s look at how to code MRSA. The physician...
ICD-10-CM includes some specific guidelines to help coders decide when to code for a current malignancy or a personal history of malignancy. The physician excises a primary malignancy but the patient...
Summer means sand and sun for many people, but a day at the beach can result in a visit to the Fix ‘Em Up Clinic. Danielle hit the beach, but forgot her sunscreen. As a result, she ended up with a...
Some ICD-10-PCS root operations encompass a wide range of procedures. Think biopsy, excision, and extraction. Others cover a much smaller range of possible procedures, including fusion. Coders will...
A patient comes in for a face lift or another cosmetic procedure. What root operation should you code the procedure to in ICD-10-PCS? The answer: alteration (third character 0). The goal of an...
A writer paints a picture with words. The English language alone offers somewhere in the neighborhood of a quarter of a million words. But really how many does the average person use? According to...
Summer semi-officially arrived this week with Memorial Day and that means plenty of sun and sand related illnesses at the Fix ‘Em Up Clinic. Our first patient is Todd, who was trying to grill up the...
When a physician performs a procedure intended to narrow the diameter of a tubular body part or orifice, coders will select the root operation restriction in ICD-10-PCS. Restriction includes both...
Our Town Zoo hosted its annual black tie fundraiser and things got a little, well, wild as the patients at the Fix ‘Em Up Clinic prove. Tiffany made a fashion statement with a bright blue shimmering...
In ICD-10-CM, coders must report two codes to fully describe certain conditions. They will find “Use additional code” notes in the Tabular List at codes when they need to report a secondary code to...
So we’ve survived the zombie apocalypse, but we’re not out of the undead woods yet. It seems a group of vampires is trying to one-up the zombies. But, never fear, vampires can actually be regular...
Gregory House, MD, is hanging up his stethoscope before the transition to ICD-10-CM. I loved House MD when Fox first starting airing it in 2005, but the last few seasons, not so much. Let’s ask Dr...
Coders often report signs and symptoms when physicians document them in the patient’s medical record. However, coders should not always report additional codes for signs and symptoms. How can coders...
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. ICD-10-CM coding conventions for such conditions require coders to report...
When a physician performs a procedure to enlarge the diameter of a tubular body part or orifice, coders will report root operation dilation with 7 as the third character in the medical and surgical...
Home repair and improvement can be hazardous to your health. Just ask the residents of Calamity Condos who are visiting the Fix ‘Em Up Clinic. Tom and Wendy decided to repaint the living room of...
Braaaaains! Braaaaains! Don’t look now, but the Centers for Disease Control and Prevention was right about the zombie apocalypse . It’s here! Run for your lives! Okay, we’re not about to be overrun...
...and the documentation coach will turn into a pumpkin if you're not on time. As a CDI specialist, what has been your approach to ICD-10? Are you hoping it will go away? Are you waiting for 2014?...
Happy Monday! I hope you had a great weekend because it’s time to dive into coding for today’s visitors to the Fix ‘Em Up Clinic. Our first patient, nine-year-old Chris, arrived with a really nasty...
A surgeon performs an open reduction of right tibia fracture for an inpatient. Which ICD-10-PCS root operation should be reported? In this case, it’s fairly easy: reposition. In a reposition...
ICD-10-CM and ICD-10-PCS contain a significant number of new codes, which shouldn’t be news to anyone at this point. Most of the codes are longer than the current ICD-9-CM codes, which could increase...
[caption id="attachment_2698" align="alignright" width="150" caption="Hey, look, it's a friend of Wile E.!"] [/caption] Wile E. Coyote is back in the Acme ED, this time with a broken arm, leg, pelvis...
Not all of the ICD-10-PCS root operations are complicated or confusing. Take reattachment for example. The root operation is pretty much what you would expect. The official definition of reattachment...
A one-year delay in ICD-10-CM/PCS isn’t a slam dunk. “We’re recommending it, but it’s not [guaranteed],” said Denise Buenning, group director CMS Office of E-Health Standards and Services. Buenning...
After HHS proposed year-long delay of ICD-10, questions emerged regarding the current ICD-9-CM code freeze. CMS confirmed that the code freeze will hold until ICD-10-CM/PCS is implemented regardless...
Don’t trust the squirrels in the park. They may look cute and friendly, but they are really covert operatives on a mission to steal your food. [caption id="attachment_2676" align="alignright" width="...
Do you suffer from triskaidekaphobia, paraskevidekatriaphobia or friggatriskaidekaphobia? In other words are you afraid of the number 13 or Friday the 13 th ? More importantly, can you code for those...
And the new proposed ICD-10-CM/PCS implementation date is (drum roll, please)…October 1, 2014. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the new date as part...
When a physician moves a body part to a new place without disrupting its vascular and nervous supply, coders will code to root operation Transfer in ICD-10-PCS. The root operation is indicated by the...
My feet are killing me. I wonder what the problem is. Let’s see what it could be and how we would code it in ICD-10-CM. I got a new pair of shoes, so maybe the problem is a blister. That should be...
Several years ago, a pharmaceutical company came under fire because its sales reps were pushing the company’s drugs using Tigger and Eeyore, two popular characters from the "Winnie the Pooh" series...
Spring is in the air and Anytown just held its combined Spring Festival and Easter egg hunt. I’m sad to say things did not go smoothly, judging by the number of patients in the Fix ‘Em Up outpatient...
When a physician completely closes the orifice or lumen of a tubular body part, coders will look to the root operation occlusion in ICD-10-PCS. The orifice can be a natural orifice or an artificially...
"What's in a name? That which we call a rose by any other name would smell as sweet." [caption id="attachment_2635" align="alignright" width="150" caption="It's Pandemonium!"] [/caption] Ah, dear...
Poor Wile E. Coyote ® . He just came into the Acme ED with a skull fracture caused by a falling boulder. It seems the Roadrunner ® got away again. Dr. Frankenbean documents a closed fracture of the...
The Department of Health & Human Services (HHS) may do more harm than good by delaying ICD-10-CM/PCS implementation, according to survey, Industry Reaction to Potential Delay of ICD-10 ,...
The American Health Information Management Association (AHIMA) has urged CMS not to delay ICD-10-CM/PCS implementation in its February 23 letter to HHS Secretary Kathleen Sebelius . Meanwhile, the...
Who knew St. Patrick’s Day was such a dangerous holiday? Take a look around the Fix ‘Em Up Clinic and see for yourself. First, we have Bobby, who was looking for a four-leaf clover. Unfortunately, he...
The Office of E-Health Standards and Services (OESS) announced a second delay in the enforcement of HIPAA 5010, CMS announced March 15 . OESS announced the first enforcement delay November 17, 2011...
ICD-10-CM is full of oddly specific codes for causes of injuries. Some of them are funny (I’m talking to you, W61.43, pecked by turkey) and others are so strange that most coders will probably never...
The ICD-10-PCS defines root operations excision and resection in a very similar way. Excision is cutting out or off, without replacement, a portion of a body part. Coders should report the qualifier...
Coders use ICD-9-CM E codes to describe the accident, circumstance, event, or specific agent that caused a patient’s injury. In ICD-10-CM, these codes will not be prefaced with the letter ‘E,’ and...
Can you begin to imagine how complex a piece of great literature would be if we had to include complete documentation of each medical incident? Or have to stop every time we have to develop physician...
Some of the ICD-10-PCS root operations are very similar—think excision (cutting out or off, without replacement, a portion of a body part) and resection (cutting out or off, without replacement, all...
In honor of Dr. Seuss' birthday, we present: Oh, the ICD-10-CM codes you’ll find Hit by a truck? Bit by a duck? There’s an ICD-10-CM code for that. Liver contused? Wrong substance infused? There’s an...
I love the National Public Radio (NPR) program, "Wait, Wait, Don't Tell me" (WWDTM), a fun look a the news. The program features a panel of amusing well-knowns who answer questions and try to win a...
Don’t let rumor steer you away from the goal of being ready for ICD-10-CM/PCS implementation. By now, everyone has heard that CMS plans to issue a proposed rule with a new ICD-10-CM/PCS...
Even though this kink (the possible implementation delay) has been presented to everyone, I think we need to remember that the likelihood of continuing status quo for a lengthy amount of time using...
So CMS may or may not change the October 1, 2013 implementation date for ICD-10-CM/PCS. We’re still waiting to hear more from CMS and the Department of Health and Human Services. While we’re waiting...
Physician queries are considered communications between coding (or coding-related) professionals and physicians to clarify or increase specificity in the documentation to ensure good clinical...
The transition to ICD-10-CM/PCS has not been cancelled, just delayed. And we’re not even sure for how long. Some industry experts offer their thoughts on what organizations should do while we wait...
It’s no longer a mere possibility; HHS has confirmed its intent to delay the ICD-10 compliance deadline, according to its latest press release . “We have heard from many in the provider community who...
After years of repeatedly saying the implementation date for ICD-10-CM/PCS wasn’t changing, the Department of Health and Human Services (HHS) and CMS are rethinking their stance. HHS Secretary...
A patient comes in with displaced fracture of base of second metacarpal bone of his right hand. The physician treats the patient and sends him home. The coder would report ICD-10-CM code S62.310A for...
CMS is looking at the timeline for ICD-10 implementation, acting administrator Marilyn Tavenner told attendees at the American Medical Association (AMA) National Advocacy Conference in Washington, DC...
Big news regarding the ICD-10-CM/PCS implementation timeline came out this morning during the American Medical Association (AMA) National Advocacy Conference in Washington, DC. Per CMS acting...
Inpatient coders currently can default to “not otherwise specified” (NOS) codes in ICD-9-CM Volume 3, but they won’t have that option as frequently in ICD-10-PCS. Coders report NOS codes when the...
What’s in a name? That which we call a rose by any other name would smell as sweet. At least Shakespeare says so. And that has what to do with coding in ICD-10-PCS you might ask. Well, you won’t find...
Outpatient coders are getting very familiar with combination codes when it comes to procedure coding, thanks to the AMA. Coders have been seeing more and more combined procedures in recent years in...
When the American Medical Association (AMA) made it clear back in November that it wanted to delay the transition to ICD-10-CM/PCS, the first thing that came to mind was ... are you kidding me?...
Here are the top 10 reasons you should attend the JustCoding Virtual Summit: ICD-10-CM and ICD-10-PCS February 29-March2. 10. October 1, 2013 is getting closer all the time Remember when CMS...
The only thing we have to fear is fear itself, according to Franklin D. Roosevelt. We certainly shouldn’t fear the transition to ICD-10-CM/PCS. Unfortunately, however, it seems to be a common...
Physicians use devices all the time during procedures. For example, they may place a temporary catheter in a patient, insert a drug-eluting stent, or insert a central line. So when do you report a...
When you hear the word 'transplant', what do you think of first? Many people probably think of organ transplants. If you’re one of those people, you’re all set for the ICD-10-PCS root operation...
Have you heard that not all payers will be ready for the ICD-10-CM/PCS coding system on October 1, 2013? What a headache, huh? All payers were required to be ANSI X12 Version 5010 compliant by...
While working on various projects related to ICD-10-PCS, I have discovered many areas where I think coders are going to struggle because the rules either go against the way we code now in ICD-9-CM...
The 2012 ICD-10-CM updates include significant narrative changes for primary malignant neoplasms overlapping site boundaries and malignant neoplasm of ectopic tissue, as well as smaller narrative...
Removal sounds like it should be an easy root operation in ICD-10-PCS. Removal means taking something out, right? Physicians remove things all the time—your appendix, a cyst, the toy your son stuck...
When a physician frees a body part from an abnormal physical constraint by cutting or by use of force, coders will use the root operation release (N) in ICD-10-PCS. Keep in mind, though, that you...
The Medicare Code Editor (MCE) is software that detects and reports errors in the coding on claims that are submitted for payment. All Part A inpatient discharges and transfers pass through the MCE...
