Q: Can “in the setting of”' be interpreted as “due to” in ICD-10-CM? For example, the physician documented that the patient has a urinary tract infection in the setting of a urinary catheter.
Alas, poor urosepsis. I knew him, Horatio, a condition of infinite vagueness. And thankfully, one ICD-10-CM is putting out to pasture. Now, if only the physicians would get on board. Physicians...
People do some strange things on vacation. I mean, really, really strange things. Take Mike, for example. Mike just returned from his European vacation and has come into the Fix ‘Em Up Clinic for a...
Q: When the surgeon documents excision of a complex pilonidal cyst with rhomboid flap closure, is the flap closure coded separately or is it included in CPT ® code 11772 (excision of pilonidal cyst or sinus; complicated)?
Since CMS introduced comprehensive APCs in January, the agency has continued to tweak the logic and codes included in the process. Dave Fee, MBA, and Judith L. Kares, JD, describe those changes in CMS’ April quarterly updates and review code and edit updates.
Betty Hovey, CPC, COC, CPB, CPMA, CPC-I, CPCD, and Shelley C. Safian, PhD, RHIA, CCS-P, CPC-H, CPC-I, review anatomy details of the heart and how to report ICD-10-CM codes for atherosclerosis and conduction disorders.
CMS continues to move toward increased packaging with its policies in the 2016 OPPS proposed rule released July 2, with additional comprehensive APCs (C-APC) and extensive APC reconfigurations.
Despite no recent changes from CMS, many providers still struggle with when to report modifier -25 (significant, separately identifiable E/M service by the same physician or other qualified health care professional on the same day of the procedure or other service) . Jugna Shah, MPH, explains how providers can review claims to determine if they are using the modifier correctly.
After a vigorous, last-ditch push by the AMA for a two-year transition period after implementation to protect physicians from all ICD-CM coding errors and mistakes, CMS and AMA made a joint...
The Fourth of July is in the books for another year and once again, we saw an interesting assortment of patients in the Fix ‘Em Up Clinic over the weekend. Let’s take a look at some of the more...
We’re officially three months (okay, 91 days) away from ICD-10 implementation, so you need to give your surgeons a quick introduction to ICD-10-PCS. Do NOT try to teach them to code. That’s not the...
Physicians often use the terms acute renal failure (ARF) and acute kidney injury (AKI) interchangeably to describe an abrupt decrease in kidney function that is reversible within three months of loss of function.
PSI 12 evaluates the hospital's risk-adjusted rate of perioperative deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in surgical discharges for patients 18 years and older. Performance for PSI 12 contributes 25.8% of the PSI 90 composite score under the Hospital-Acquired Condition Reduction Program.
In an effort to accommodate the latest advances in technology and make the code set easier to modify for future technological changes, the AMA extensively overhauled codes for reporting drug testing in the 2015 CPT® Manual.
With fewer than 100 days until ICD-10-CM/PCS implementation, plenty of questions still remain about ICD-10-PCS coding. The AHA's Coding Clinic for ICD-10 continues to provide updates and guidance for a variety of inpatient procedures, both routine and not so routine. We examine some of that guidance in this article.
In this month’s issue, we review some of Coding Clinic’s advice for ICD-10, examine how clinical indicators can help coding for acute kidney injury, and discuss inclusions, exclusions, and coding and documentation vulnerabilities for PSI 12. Robert S. Gold, MD, explains why respiratory failure isn’t always respiratory failure.
Respiratory failure, whether acute or chronic and whether following surgery or not, is one diagnosis that is always an easy target for those who abuse the documentation and assignment of ICD codes.
Lately I've received a lot of questions from hospitals about how to determine when and if it's appropriate to report an E/M visit code on the same date of service as a scheduled procedure.
In an effort to accommodate the latest advances in technology and make the code set easier to modify for future technological changes, the AMA extensively overhauled codes for reporting drug testing in the 2015 CPT ® Manual.
Most coding professionals have heard modifier -59 (distinct procedural service) referred to as a modifier of last resort and to be cautious in using this modifier.
