The 2019 Medicare Physician Fee Schedule (MPFS) proposed rule, released July 12, introduces policies that focus on expanding the framework for reporting E/M visits and removing certain process measures under the Quality Payment Program (QPP).
This second article in a series reviews common procedures used to isolate back pain and reduce inflammation including nerve block injections, facet joint injections, and facet denervation. CPT coding for these procedures is complex and requires a detailed understanding of spinal anatomy and terminology as well as coding guidelines. Note : To access this article, you must first register here if you do not have a paid subscription.
Greek philosopher Heraclitus once said the only constant is change. With the release of the fiscal year (FY) 2019 IPPS proposed rule , and all of the changes it contains, CMS has certainly proven Heraclitus correct. The rule applies to 3,257 acute care hospitals, and once finalized, will affect discharges on or after October 1.
Q: In ICD-10-CM, how would you report a patient who is receiving hemodialysis and has chronic kidney disease (CKD) when a failed kidney transplant is also documented?
In many cases, knowing when to query is simple, but the more challenging cases contain clues that require additional interpretation. Drew Siegel, MD, CCDS, takes a look at a few of the more interesting and often undocumented diagnoses, including respiratory failure and acute kidney injury, and points out the diagnostic clues to form a compliant query.
Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS , writes that beyond auditing for code assignment, coding reviews also provide an opportunity for you to conduct a thorough compliance evaluation that not only addresses other components of the coding process but also the integrity of the patient’s record. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The Surviving Sepsis Campaign recently released a 2018 update to guidelines for the care of patients with sepsis. The update includes a new “hour-one bundle” which replaces previous versions of the Surviving Sepsis Campaign guidelines.
Erica E. Remer, MD, FACEP, CCDS, reviews recent Coding Clinic guidance surrounding the code assignment of a Salter-Harris type I physeal fracture of the third metatarsal bone of the left foot.
In inpatient coding, all diagnoses that affect the current hospital stay must be reported. In addition, the Uniform Hospital Discharge Data Set is commonly followed for reporting secondary diagnoses; it says that other (or additional) diagnoses are defined as "all conditions that coexist at the time of admission, that develop subsequently, or that affect the treatment received and/or length of stay."
Coding for pain management requires a detailed understanding of medical anatomy and terminology as well as the guidelines for reporting complex surgical procedures. Review ICD-10-CM coding for chronic and acute pain diagnoses and CPT coding for trigger point, joint, and epidural steroid injections. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS exceeded its goal of 90% participation in the first year of the Quality Payment Program (QPP), according to a May blog post from CMS Administrator Seema Verma.
To help bring JustCoding members together and let them learn more about their colleagues, JustCoding created a monthly member spotlight to appear in upcoming issues. The JustCoding team loves hearing...
Q: A physician performs wound debridement on a patient’s right foot, then applies bilateral, multilayer compression dressings to each leg. How should this be reported?
A July 2018 update to the OPPS clarifies that coders can report HCPCS code C9749 for an inherently bilateral procedure with modifiers -73 or -74 to indicate that the procedure was unilateral. Debbie Mackaman, RHIA, CPCO, CCDS, unpacks this seemingly contradictory guidance and addresses implications for coding and billing professionals.
Coding professionals will need to familiarize themselves with 2019 updates to the ICD-10-CM Manual , including significant changes to chapter two for neoplasms and chapter 5 for mental disorders. Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS , summarizes important 2019 ICD-10-CM updates , which will impact payment for claims submitted on or after October 1.
When building a successful proactive clinical documentation approach, the effort of setting up communication dynamics is essential and should certainly be a priority.
In the April 2018 OPPS update transmittal, CMS announced new HCPCS code C9749 (repair of nasal vestibular lateral wall stenosis with implant[s]), effective April 1, 2018.
The fiscal year (FY) 2019 ICD-10-CM code update, released on June 11, includes 279 code additions, 143 revisions, and 51 invalidations. The number of changes is significantly less than the past two years, which makes me think we are getting back to the “norm” of expected yearly changes.
Many HIM directors find that managing the coding team requires a different type of focus than other functions within the department. This may be true because coding professionals have advanced education, prefer a quiet work environment, and require less direction.
