ICD-10-CM has brought codes to more specifically report obesity and related conditions. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, describes these codes and when to report them, while also taking a look at operative reports for bariatric surgeries.
Q: A patient has multiple labs on the same date of service. We receive the following NCCI edit: “Code 80048 is a column two code of 80053. These codes cannot be billed together in any circumstances.” Should we only bill code 80053?
CMS issued a final rule last week to revamp the way it pays for tests under the Clinical Laboratory Fee Schedule, though the agency has pushed the start date back a year and worked to ease administrative burden based on public comments.
In addition to laterality modifiers for right and left (-RT and –LT, respectively), coders can also report bilateral procedures with modifier -50. Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, analyzes the guidelines for these modifiers and offers tips on how and when to report them.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, looks at the different types of bariatric surgical procedures and documentation details providers may include for them. She also reviews which CPT codes can be used to report these procedures
Michelle M. Wieczorek, RN, RHIT, CPHQ, discusses how documentation and coding can impact your facility’s data reported for hospital-acquired conditions and present on admission indicators.
Kimberly Cunningham, CPC, CIC, CCS , and other professionals comment on commonly seen MS-DRGs and inpatient conditions, including which terms coders need to look for in documentation to arrive at the most accurate MS-DRG and codes. Note: To access this free article, make sure you first register if you do not have a paid subscription.
Shannon Newell, RHIA, CCS , AHIMA-approved ICD-10-CM/PCS trainer, writes about significant changes to PSI 90 in the 2017 IPPS proposed rule, one of which is a new name–The Patient Safety and Adverse Events Composite.
Q: I am never sure of correct sequencing when the admission is for flu, pneumonia, and asthma. Can you suggest proper sequencing, and if queries are needed?
The value modifier is having an increasing effect on physician payments and coding each patient’s severity is key to accuracy. Richard D. Pinson, MD, FACP, CCS, writes about how the value modifier impacts payment and conditions coders should be aware of that quality scores.
Providers should already be aware they will have to report more specific ICD-10-CM codes when CMS ends its grace period for physicians later this year, but the agency will also be excluding certain unspecified codes from reporting in 2017.
Anatomical CPT modifiers aren’t used just to distinguish laterality. Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, reviews how to report modifiers –LC, -LD, -LM, -RC, and –RI for percutaneous coronary interventions.
CMS recently announced changes to require providers to report modifier -JW (drug amount discarded/not administered to any patient) when appropriate. Jugna Shah, MPH, looks at when providers will need to use the modifier and how to remain compliant.
On April 18, CMS issued its anticipated IPPS proposed rule for FY 2017. This year's proposed rule is very dense, including multiple coding fixes and updates, changes to payment provisions, quality updates, and even something for utilization review.
The FY 2017 IPPS proposed rule includes updates to payment rates and quality initiatives, but some of the most extensive changes pertain to proposals for certain MS-DRG classifications and relative weights.
The FY 2017 IPPS proposed rule released April 27 is replete with modifications and expansions to claims-based quality and cost outcome measures. Although many of these proposed changes are for future fiscal years, ICD-10 codes reported for current discharges will impact the future financial performance for our organizations.
Katy Good, RN, BSN, CCDS, CCS, Paul Evans, RHIA, CCS, CCS-P, CCDS, Laurie Prescott, MSN, RN, CCDS, and Gloryanne Bryant, BS, RHIA, CDIP, CCS, CCDS, all comment on how over-querying is a common concern in clinical document improvement, and how over-querying can cause delays in documentation and coding processes.
