Remember those friends and family cell phone plans where you didn’t use minutes if you called people in your circle? You had to pick who you wanted in your group and they had to pick you. It was very...
CMS and the American Medical Association (AMA) may have made peace regarding ICD-10, but it seems some members of Congress didn’t get the memo. Reps. Marsha Blackburn, R-Tenn., and Tom E. Price, R-Ga...
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.
CMS announced a new incentive program designed to reduce complications from joint replacement surgery. The new proposed Comprehensive Care for Joint Replacement will require bundling of reimbursement for hip and knee surgeries, with profits tied closely to costs and quality metrics.
ICD-10-PCS root operations Drainage, Extirpation, and Fragmentation involve removing material from the body, but in different ways. A nita Rapier, RHIT, CCS, Kristi Stanton, RHIT, CCS, CPC, and James Fee, MD, CCS, CCDS, offer tips for distinguishing between the root operations.
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. J ames S. Kennedy, MD, CCS, CDIP, Anita Rapier, RHIT, CCS, and Sharme Brodie, RN, CCDS, highlight some important advice from Coding Clinic.
The optical system is the most complex organ system of the human body and is subject to specific disease processes. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer explains how to code some common eye diseases and treatments in ICD-10.
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...
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.
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.
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.
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...
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.
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.
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.