Michael Malohifo’ou, RN, MBA, PhD, explains how excessive use of emergency departments can result in unfavorable outcomes . He also assesses the complicated relationships between EDs, social determinants of health ICD-10-CM coding, and mental and behavioral health CPT services.
Amanda Vincent, MBA, CCS, CPC, CCDS, CRC, explains the differing definitions of “complication” for providers vs. coders, reviews types of complications, and codes an intraoperative laceration case study.
Providers can receive additional revenue when they check a patient for social determinants of health, but the service requires patient selection, a standardized tool, and follow up. Julia Kyles, CPC, explains how practices can report this service with a new HCPCS code for 2024.
The 2024 ICD-10-CM update added 36 codes to the now nearly 400 codes in category M80.- (osteoporosis with current pathological fracture). The additional codes add further specificity for pelvis fractures due to age-related osteoporosis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A recent ProPublica article found that nearly 30,000 Medicare patients may have received atherectomy procedures prematurely or unnecessarily, resulting in millions of dollars in reimbursement.
Anemia describes a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient. Review the types of anemia, diagnostic criteria, treatment, and ICD-10-CM coding. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The healthcare setting can feel like a courtroom in the denials and appeals arena. By assessing the effort that goes into an appeal and the difference that comes out of them, coders and CDI specialists may find that the chasm between clarifying a patient record and defending it isn’t as wide as they think.
After years of working to engage providers and get them on board with CDI efforts, every seasoned CDI professional knows there’s no one-size-fits-all solution.
Anemia describes a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient. Review the types of anemia, diagnostic criteria, treatment, and ICD-10-CM coding.
The Journal of the American Medical Association recently released a study that analyzed social determinants of health and other conditions associated with lower-limb amputation in the U.S.’ most populated areas. The study found that several factors corresponded with an increased risk of amputation.
Q: I’ve heard some facilities are beginning to incorporate ICD-11, even though it is not yet implemented in the U.S. How can coders help their providers transition to ICD-11?
Medical coding practices can vary widely between countries, with different code sets, regulations, and policies governing the process. However, there are some commonalities when comparing medical coding in the U.S. to other countries, which this article explores.
Debbie Jones, CPC, CCA , examines the cause, prognosis, and treatment options for desmoid tumors, in addition to reviewing the ICD-10-CM codes designed to identify them with specificity. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
As more health systems have been forced to reckon with the undeniable impacts of socioeconomic status on health outcomes, CDI and coding practices have followed in kind. Analyze recent developments with reimbursement and ICD-10-CM coding for social determinants of health (SDOH).
A recent Office of Inspector General audit of inpatient and outpatient Medicare claims estimated that nearly 20% of cases including codes for abuse or neglect were not reported to law enforcement.
Children diagnosed with acute respiratory distress syndrome (ARDS) had a readmission rate of 27.8% in the first year after discharge, with half of those readmissions occurring within two months, according to a recent study in JAMA Network Open.
Colder weather is approaching, which brings an increase in respiratory infections. Shelley C. Safian, PhD, RHIA, CCS-P, COC, COC-I, clarifies the pathogenic causes of pneumonia, specifically those with recent additions to ICD-10-CM, and those with antibiotic resistance. She also reviews how to report treatment methods in ICD-10-PCS.
Medical coding practices can vary widely between countries, with different code sets, regulations, and policies governing the process. However, there are some commonalities when comparing medical coding in the U.S. to other countries, which this article explores.
Does the data collected by your healthcare system truly represent the patient you are caring for? Andrew B. Maigur, MD, CHCQM-PHYADV, CMPC, writes about how documentation is critical to capturing data for accurate coding and quality metric reporting.
CDI departments have long been involved with the denials management process. As with any expansion of CDI responsibility, those looking to venture into a new area can glean valuable knowledge from those already on the cutting edge.
Kate Siemens, RN, CMSRN, CCDS , discusses the clinical indicators for malnutrition during end-of-life care with Taylor Kuykendall, MS, RD, LD . She covers relevant ICD-10-CM codes and proper reporting methodologies for the condition.
Despite sepsis being the leading cause of hospital readmissions and in-hospital deaths in the U.S., its extensive history of clinical definitions and criteria can cause confusion for even the most experienced coders. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The 2024 ICD-10-CM update brought new codes to classify Lafora progressive myoclonus epilepsy and chronic migraines. Review the conditions, symptoms, causes, and reporting requirements of these disorders. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: Are coders required to report a social determinants of health (SDOH) ICD-10-CM code when a CPT code for an E/M service level is based on medical decision-making (MDM)?
Gastroparesis is a condition that affects stomach motility. Sarah Gould, CPC , explains how to report the condition and its complications in ICD-10-CM, in addition to treatment methods in ICD-10-PCS. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Craniosynostosis, a congenital premature fusion of cranial sutures in infants, poses a complex challenge to the child’s appearance and health. Debbie Jones, CPC, CCA , explains the condition, as well as how to report its many types in ICD-10-CM and associated surgical correction procedures in CPT.
Despite sepsis being the leading cause of hospital readmissions and in-hospital deaths in the U.S., its extensive history of clinical definitions and criteria can cause confusion for even the most experienced coders.
Alba Kuqi, MD, CCS, CDIP, CCDS, CRCR, CICA, CSCM , reviews coding, CDI, and clinical validation challenges associated with acute kidney injury cases and gives insight into how coders and physicians can work together to increase accuracy.
Clinical validation has become one of the hottest targets in payer auditing. Denise Wilson, MS, RN, RRT, writes about strategies facilities can use to appeal clinical validation denials.
CMS recently published an infographic that defines social determinants of health (SDOH), explains the significance of capturing them, and lists which SDOH codes will go into effect October 1.
Reporting malnutrition correctly is a constant challenge that faces increasing payer scrutiny. Kate Siemens, RN, CMSRN, CCDS, defines malnutrition and its unique applicability to end-of-life care, documentation tips, and how to report associated conditions in ICD-10-CM. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
There is one tell-tale sign that fall is here: the October implementation of the ICD-10 coding updates. Courtney Crozier, MA, RHIA, CCS, CDIP , explains the highlights of the update for fiscal year 2024, including 395 new codes, 25 deletions, 22 revisions, and 131 new headers.
The U.S. has experienced extreme weather events in recent years, including cataclysmic hurricanes and tornadoes. Terry Tropin, MSHAI, RHIA, CCS-P , explains how coders should use and sequence external cause codes in ICD-10-CM for injuries caused by these storms. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The 2024 Medicare Physician Fee Schedule proposed rule received more than 17,000 stakeholder comments. Julie Kyles, CPC , highlights some of the major concerns that commenters expressed, such as requests for more telehealth policy flexibility and community health integration services.
Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , summarizes the highlights from the newest installment of Coding Clinic, which includes guidance on reporting pancytopenia, inherent conditions, ORIF, and neurally adjusted ventilatory assist devices.
It can be advantageous for patients and facilities to capture social determinants of health (SDOH) alongside medical conditions. Joscelyn Thomas, RHIT , explains how incorporating screening tools into facilities can help providers and coders promote better health outcomes, reduce disparities, and increase patient engagement.
The 2024 ICD-10-CM update brings almost 400 code changes, including new codes for sickle-cell retinopathy and orbital muscle entrapment. This article delves into the causes, symptoms, and reporting methods for these two ocular conditions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , summarizes the highlights from the newest installment of Coding Clinic, which includes guidance on reporting pancytopenia, inherent conditions, ORIF, and neurally adjusted ventilatory assist devices.
Coders should take note of hundreds of updates to the tabular addenda that serves as an instruction guide to the 2024 ICD-10-CM code set. Both take effect October 1.
There is one tell-tale sign that fall is here: the October implementation of the ICD-10 coding updates. Courtney Crozier, MA, RHIA, CCS, CDIP , explains the highlights of the update for fiscal year 2024, including 395 new codes, 25 deletions, 22 revisions, and 131 new headers.
Diabetes mellitus is a common condition that occurs when a patient’s blood sugar (blood glucose) is consistently too high. Sarah Gould, CPC , delves into the disorder and covers how to report some of its many complications in ICD-10-CM. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The fiscal year (FY) 2024 IPPS final rule, released in August, provides updates on inpatient hospital reimbursement, ICD-10-CM/PCS coding and DRG changes, quality and reporting programs, and more.
The heart is a restless organ whose constant rhythm is integral to normal bodily functions. Unfortunately, there are many maladies that can occur, as Linda Martien, CPC, CPC-I, COC, CPMA, CRC, explains through her review of normal cardiac pathophysiology and how to report common rhythm abnormalities in ICD-10-CM.
As coders witness annually, the ICD continues to evolve over its decades of use. This article covers the history of disease classification, current coding techniques, and possible future technologies of the industry. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
As the summer temperatures continue to soar worldwide, so does the number of patients with heat-related illnesses (HRI). This article defines common HRIs and includes guidance on how to report them correctly in ICD-10-CM. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Terry Tropin, MSHAI, RHIA, CCS-P , reviews the biggest changes to the 2024 ICD-10-CM guidelines and tabular list set to take effect October 1, including deletions of certain COVID-19 screening guidelines, and additional direction for new resistant hypertension and myocardial infarction codes.
Parkinson's disease is a chronic and progressive neurodegenerative disorder that affects the central nervous system. Debbie Jones, CPC, CCA , explains the symptoms, treatment, and how 2024 ICD-10-CM coding changes will affect reporting for this disease.