Sometimes a physician just needs to take a look around a body part and see what’s what. If the physician’s sole objective is to examine a body part, either visually or manually, report the procedure...
We know we're facing at least a one-year delay in ICD-10 implementation. What you with that time? will directly affect how prepared you are for the eventual ICD-10 implementation. Here are some...
What a wild 12 days. On March 25, we were all preparing for the six-month-to-implementation milestone April 1. Some people were looking forward to that milestone more than others, but we had a plan...
If you code for pregnant patients and newborns, you may occasionally wonder which record to code a condition on. Is it something you code for the mother or for her offspring? ICD-10-CM divides the...
The Senate passed HR 4302 designed to patch the Sustainable Growth Rate that included a provision to delay ICD-10 implementation until at least October 1, 2015. The bill, approved by the House in a...
The fate of the October 1, 2014 ICD-10 implementation date will remain in limbo until Monday. The House of Representatives passed HR 4302 Thursday as a one-year fix to the Sustainable Growth Rate (...
The House of Representatives passed HR 4302 today using a controversial surprise voice vote, bringing another ICD-10 delay closer to reality. HR 4302 focuses on patching the Sustainable Growth Rate (...
CMS may be committed to an ICD-10 implementation date of October 1, 2014, but Congress may think otherwise. House of Representatives bill H.R. 4015 is designed to patch the Sustainable Growth Rate...
Sometimes a surgeon must take drastic action and amputate a patient’s upper or lower extremity. For these cases, we would use ICD-10-PCS root operation Detachment (third character 6). ICD-10-PCS...
Map (third character K) is a very narrowly defined ICD-10-PCS root operation. By definition, Map procedures are used to locate the route of passage of electrical impulses and/or locate functional...
The codes for complications of pregnancy, childbirth, and the puerperium appear in Chapter 11 in ICD-9-CM. They move to Chapter 15 in ICD-10-CM. But you will find some more significant changes than...
Holidays are always interesting times here at the Fix ‘Em Up Clinic. We get to see some of the most interesting cases. First up for St. Patrick’s Day is Sean, who at 8 years old thought it would be...
Is this a dagger I see before me? Why, yes, Caesar, that is a dagger aimed at your heart. And your head and just about everywhere else. Servilius Casca got in the first shot, hitting Caesar in the...
In ICD-9-CM, we have one base code for gestational diabetes: 648.8x (abnormal glucose tolerance). We need a fifth digit to specify the episode of care: 0, unspecified as to episode of care or not...
Almost all of the ICD-10-PCS root operations describe very specific intent. Think about the difference between root operations excision and resection. Excision involves removing some of a body part...
Inpatient coders are used to being able to code conditions documented as possible, probable, suspected, or rule out, as if they were in fact confirmed. Outpatient coders can’t do that. They need a...
Brush up on your knowledge of cardiovascular system anatomy as you learn how to code cardiovascular diseases in ICD-10-CM during the live, 90-minute webcast Reduce the Fear of ICD-10-CM...
I really want the t-shirt that says, “I only do what the voices in my head tell me” and its companion shirt, “The voices in my head don’t like you.” Sadly too many people I know might believe it...
CMS reversed course earlier this week and announced it will conduct end-to-end ICD-10 training with a sample of providers. Previously, CMS had stated it would not conduct any end-to-end testing...
One of the things that drives me crazy about how media, Congress, and the AMA discuss ICD-10 codes is their focus on the External Causes codes. Granted some of those codes are silly or strange or...
Maybe the AMA’s letter did the trick. Or maybe CMS just thought better of its decision not to conduct end-to-end testing prior to ICD-10 implementation. According to MLN Matters® SE1409 , CMS will...
What did you get for Valentine’s Day? Flowers? Chocolate? Mono? It is the kissing disease after all. ICD-9-CM includes only one code for infectious mononucleosis: 075. That code includes glandular...
Poor Paul, he just wanted to take his black Labrador Molly to the vet for her checkup. Instead he ended up needing a doctor. Paul put down a sheet in his truck so Molly wouldn’t have to sit on the...
/*--> */ In its continuing quest to halt ICD-10 implementation, the AMA is touting a new study by Nachimson Advisors that shows much higher costs to physician practices than initially estimated in...
Is this love that I’m feeling? Or do I have some deadly disease? What are my symptoms? Well, I feel lightheaded and dizzy. It could be the signs of new love or it could be acute mountain sickness...
There before me was a pale horse and its rider was named Reimbursement. Meet the final horseman of the ICD-10 Apocalypse and probably the one that keeps your C-suite up at night: Reimbursement. The...
It turns out that Punxsutawney Phil seeing his shadow, and thereby forecasting six more weeks of winter, wasn’t the most painful part of Groundhog Day. Phil picked a bad moment to suffer from stage...
Shoveling snow can be great exercise. You can burn a lot of calories (depending on how much snow you’re shoveling and how much effort you’re putting into it). However, shoveling snow can also be...
Baby, it’s cold outside. Really, really cold. And unlike polar bears and snow leopards, I am not a cold weather animal. So to offset the cold this morning (and motivate myself to crawl out from under...
You can stop holding your breath. Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I, CHA , AHIMA-approved ICD-10-CM/PCS trainer, and Tara L. Bell, RN, MSN, CCM, AHIMA-approved ICD-10-CM/PCS...
Our beloved (and much used) ICD-9-CM code 250.00 (unspecified diabetes) is going away soon. In fact, the whole idea of controlled or uncontrolled diabetes won’t matter either for coding purposes in...
What can we revise today at Stitch ‘Em Up Hospital? First, we need to know what falls under root operation revision in ICD-10-PCS. Is it a procedure where the physician alters a body part, such as a...
Odds are, most coders will never use ICD-10-PCS table 0W4. Why? Because root operation 4 is creation (making a new genital structure that does not physically take the place of a body part). Unless...
259 days. That’s the time remaining until we start using ICD-10. How far along are you? You’ve completed your coding assessments, right? Hopefully, you’ve already started your coder training. At the...
You’ve heard about temperatures so hot you can fry an egg on the sidewalk, right? (I don’t recommend eating the egg afterwards.) It turns out the polar vortex was so cold you could freeze boiling...
We’re on to the third horseman of our ICD-10 Apocalypse: productivity. More specifically, the anticipated upcoming decline in coder productivity. You’ve probably heard the horror stories about the 50...
Ann came in to Stitch ‘Em Up Hospital for a breast biopsy to confirm a diagnosis of breast cancer. Dr. Richards performed the biopsy and based on the results, decided to perform a partial mastectomy...
Fix ‘Em Up Clinic is open for 2014 and we’ve already seen some interesting post-New Year injuries. Rebecca is complaining of pain in her right ankle. Dr. Frost reviews her past medical history and...
It’s the gift-giving season and HCPro is giving you free on-demand access to the audio conference, ICD-10-PCS: Coding, Structure and Format, when you sign up for the January 10 live webcast, ICD-10-...
Recently, Dr. Seuss saw the Grinch for a variety of health concerns. Today, he’s seeing some others who are not in the holiday spirit. First is Mr. Scrooge, who complains he is being harassed by...
Christmas decorating can be a drag, especially when you get tangled in the string of lights and they literally drag you off the roof. Just ask poor Clark. First, he tripped over a root in the forest...
Today’s rehearsal for the children’s Christmas play at Anytown Middle School was unforgettable for all of the wrong reasons. Just look at the waiting room at the Fix ‘Em Up Clinic. First in to see Dr...
Good King Wenceslas looked out on the feast of Stephen And what a festive occasion it was! Participants are suffering from: Functional dyspepsia (K30) Nausea (R11.0) Projectile vomiting (R11.12)...
Dashing through the snow, in a one-horse open sleigh … oh, wait, maybe that’s not such a good idea. Little Bobby came down with chilblains, while Suzie developed frostbite. ICD-10-CM only gives us...
Worried that your vendors won't be ready for ICD-10? CMS has a tip sheet for talking with your vendors on its website. In addition, CMS recently added five new resources: Introduction to ICD-10...
Why in the world is Mr. Grinch so mean? Maybe the problem is his health. Let’s see if we can diagnose the Grinch’s health woes. First, he is as cuddly as a cactus. What does that mean? He’s covered...
Everybody likes a shortcut. We want to get things done faster, arrive home sooner, finish tasks more quickly. Generally shortcuts are good. Unless you’re talking about physician documentation. Then...
Ah, Black Friday, when shoppers go doorbusting for deals and then head to the Fix ‘Em Up Clinic for repairs. Today’s first wounded bargain hunter, Stephanie, comes in complaining of pain in her left...
Farmer Brown came in today to see Dr. Gobbler for some injuries sustained when he tried to prepare his Thanksgiving main course. It seems Farmer Brown’s turkey wasn’t interested in joining him as...
You may remember that the American Medical Association (AMA) has been pushing for an end to ICD-10 since 2012. During its recent House of Delegates meeting, the AMA reinforced its position that ICD-...
Conquest, War, Famine, and Death have nothing on the Four Horsemen of the ICD-10 Apocalypse: Accuracy Documentation Productivity Reimbursement How do you tame these terrors? With planning and...
A feral flock of wild turkeys has invaded New York City. Seriously. And with them, they bring all sorts ofcode-ready diseases and mishaps. First, turkeys can transmit fun infections such as...
CMS created a mini tempest in June when announced it would not conduct end-to-end testing for ICD-10. CMS has not reversed that decision, but will require MAC to conduct front-end testing in March...
The majority of respondents in our recent (unscientific) JustCoding poll identified physician documentation as their biggest concern heading into the ICD-10 transition. No one should be surprised by...
Mr. Jack O. Lantern underwent some significant surgery at Stitch ‘Em Hospital back on October 16. Dr. Carver removed Jack’s liver, stomach, large intestine, small intestine, appendix, and gall...
Which tasks have you completed on your ICD-10 implementation list? We want to know. Our sister publication , Medical Records Briefing, is conducting a benchmarking survey on ICD-10 implementation,...
Initially, we thought that outpatient coders didn’t have to learn to code in ICD-10-PCS. They would still use CPT® codes to report physician services in the outpatient world. Now it looks like that...
Poor Mr. Frank N. Stein, he’s literally falling to pieces. Not to worry, though, Dr. Shelly at the Stich ‘Em Up Hospital will have him back together in no time. Frank’s most obvious problem is that...
Our sister publication , Medical Records Briefing, is conducting a benchmarking survey on ICD-10 implementation, and we would appreciate your input. Please take a few moments to complete this survey...
Coder productivity was a hot topic of conversation during the AHIMA pre-conference in Atlanta October 26-27. We all know coders will be less productive initially after the transition to ICD-10. The...
Greetings from Atlanta! I spent the weekend collecting all kinds of tips and information about ICD-10 during the AHIMA Conference pre-conference sessions. These are just a few of the best tidbits...
Jacob comes into the Fix ‘Em Up Clinic with a hairy problem—namely too much hair. He’s covered in it, head to tail, I mean toe. He also reports a strange urge to howl at the moon and a severe allergy...
Sitting hunched in front of a computer can be a bad thing. Aside from missing all of the splendid fall foliage, you could also be straining your neck muscles and causing yourself plenty of pain. So...
Mr. Jack O. Lantern is here at Stich ‘Em Up Hospital to have his guts removed. Dr. Carver begins by removing a section of Jack’s skull, then begins to remove Jack’s guts. How would we code this...
Welcome to the Middle Ages, when your chance of dying from the plague is around 50-50. The bubonic plague likely wiped out 75-200 million people in Europe in the 14 th century alone. For the...
My brain is fried. Keeping up with all of the mandates and changes in healthcare is exhausting. So is learning the new ICD-10 codes. Maybe I’m just tired because it’s Wednesday. What does ICD-10-CM...
People are creatures of habit. Some of them are good, some not so good. Coders, too, are creatures of habit. We know certain codes without having to look them up. (Anyone know the code for...
By this time next year, we will be using ICD-10 codes. Where are you in your transition? What have you accomplished? What’s left on the to-do list? Here’s a better question: will you be ready? It...
CMS announced that it is postponing the eHealth Provider Webinar on ICD-10 compliance that was scheduled for October 1. CMS has not announced a reschedule date.
My head is going to explode. This is seriously epic, end of the world pain. It’s a 20 on the pain scale. It wouldn’t be so bad if I didn’t also feel like I was going to throw up. And the light is...
Ears are moving up in ICD-10-CM. In ICD-9-CM, they have to share space with the eyes. In ICD-10-CM, they get their own chapter. They also get a lot more codes. Fortunately, many of those additional...
We have just a little over a year remaining until ICD-10 implementation. How well do you know your ICD-10-PCS codes? ICD-10-CM shares a lot of similarities with ICD-9-CM. Sadly, ICD-9-CM procedure...
Last week, we looked at some strange causes of death in the ancient world and their associated ICD-10-CM codes. Let’s fast-forward to some odd Dark Ages deaths and see if we can code them. Some...
Death smiles at us all. All a man can do is smile back. (Kudos if you know I appropriated that from the movie Gladiator .) History is full of weird circumstances and odd injuries that lead to death...
CMS has been releasing ICD-10 National Coverage Determination (NCD) “omnibus” transmittals since September 2012, which gives providers some information about CMS’ coverage policies moving forward...
With the ICD-10 compliance date looming, can we find some fun in it all? We can play Coding “Jeopardy” as a fun learning tool, but if ICD-10 were a game, what game would it be? Some might liken it to...
Labor Day might mark the unofficial end of summer, but sadly, it's not the end of barbecue mishaps at the Fix 'Em Up Clinic. Matt, who last year survived flaming tomato napalm, decided to grill up...
Inpatient coders are used to assigning a present-on-admission (POA) indicator in ICD-9-CM. They will need to continue to assign POA indicators in ICD-10-CM. The POA indicators remain the same, but...
Do you ever feel like everything is on YouTube? In some cases, it’s more than you want to see, but the video site can be extremely helpful for coders who want to watch procedures. For example, search...
Paracelsus, the father of toxicology (among other things), once wrote: “Everything is poison, there is poison in everything. Only the dose makes a thing not a poison.” Cheery thought, right?...
Ah, the dogs days of summer. An evil time when, according to the ancient Romans, the sea boils, dogs grow mad, and men contract, among other diseases, burning fevers, hysterics, and frenzies,...
In ICD-9-CM, we know not to code solely from the Alphabetic Index. After all, the code could have additional digits or excludes notes or other coding directions (such as “code first” or “use an...
CMS added additional ICD-10 MLN educational resources to its website and will be hosting an ICD-10 National Provider Call August 22. The new MLN educational resources include two fact sheets and a...
It’s baby day at Fix ‘Em Up Clinic and Stitch ‘Em Up Hospital as we prepare to deliver new codes and guidelines for reporting pregnancy and delivery in ICD-10-CM and ICD-10-PCS. Our first patient,...
First we saw the new ICD-10-PCS codes and guidelines in May, followed by the new ICD-10-CM codes in June and the ICD-10-CM guidelines in July. Now we have updated general equivalence mappings (GEMs)...
Wile E. Coyote presented to the ACME ED this morning with more injuries suffered in his quest to catch the Roadrunner. You won’t believe what he tried this time. Wile E.’s plan involved dropping an...
Summertime means beach time and unfortunately for some, Fix ‘Em Up Clinic time. First into the clinic today is Eric. After swimming in the ocean yesterday, Eric developed a pruritic, erythematous,...
Apparently not everyone believes CMS’ claim that it will not move the ICD-10 implementation date again, based on our (completely unscientific) poll on JustCoding. We asked readers whether they...
ICD-10-CM is all about specificity, right? The increased detail is one of the reasons the U.S. is (finally) moving to the new system. So true or false: you should never report a nonspecific code...
October 1, 2014, is a little more than 14 months away. Where do your ICD-10 implementation plans stand? Do you know what resources you’ll need for the transition or when you should providing training...
One of the big changes to coding glaucoma in ICD-10-CM is the addition of laterality to the codes. ICD-10-CM includes options for right, left, bilateral, and unspecified. ICD-10-CM also includes...
In late June, CMS and the Centers for Disease Control and Prevention (CDC) released the 2014 ICD-10-CM codes without the updated guidelines. Those guidelines are now available on the CDC website ...
When we talk about root operations in ICD-10-PCS, we often focus on the 31 root operations in the Medical and Surgical section of the manual. After all, we’re going to use those codes the most and...
Everyone likes to think physicians are infallible (especially physicians), but accidents do happen, even during surgery. In ICD-9-CM, we can choose between two possible codes for a hemorrhage (998.11...
Ah, the Fourth of July, picnics, parades, and pryotechnics. What could be better? Well, not having your family and friends end up at Fix ‘Em Up Clinic the next day would be a good start. Alas,...
In ICD-10-PCS, coders will need to select the root operation based on the objective of the procedure (not what the physician calls it). If the physician’s objective is to strip out by force all of a...
Curious to know what changes the four cooperating parties made to the ICD-10-CM codes for 2014? You can now find out by downloading the 2014 ICD-10-CM codes from the Centers for Disease Control and...
HHS and the American Medical Association (AMA) seem to be playing a game of chicken when it comes to ICD-10 implementation. Last year, HHS swerved and the implementation date was moved from October 1...
Our patient Betsy returned to Stitch ‘Em Up Hospital today after suffering a ruptured brain aneurysm. Apparently, the previous treatment to restrict blood flow to the aneurysm was unsuccessful. So Dr...
Hello Mother, hello Father, Greetings from Camp Murky Water! Camp is very entertaining and they say we’ll have some fun if it stops raining. That better be soon. I just saw a flotilla of ducks take...