Q: I’ve heard that queries differ between critical access and short-term acute care hospital settings. Is this true, and if so, where can I find more information?
A sequela is the residual effect (condition produced) after the acute phase of an illness or injury ends. ICD-10-CM includes codes specifically designed to report sequela, such as I69.953 (hemiplegia...
Being a Jedi knight is hard work. And it’s dangerous, especially when your father is out to kill you and your friend gets encased in carbonite. Intrepid coders that we are, we will brave the frozen...
Coders will find plenty of changes throughout the musculoskeletal, respiratory, and cardiac sections of the CPT® Manual for 2013, as well as guidelines changes, deletions, and editorial revisions. Andrea Clark, RHIA, CCS, CPC-H, Georgeann Edford, RN, MBA, CCS-P, and Marie Mindeman walk through some of the major changes for 2013.
CMS announced changes to reporting therapy services—the biggest operational change for 2013—in the Medicare Physician Fee Schedule final rule instead of the OPPS final rule. Jugna Shah, MPH, and Valerie Rinkle, MPA, explain the changes to therapy reporting and molecular pathology coding.
The American Medical Association completely overhauled the CPT ® Manual’s psychiatry subsection for 2013. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, explains the new codes and guidelines associated with psychiatric services.
Coding for stent placement procedures will look very different in 2013. The American Medical Association deleted the two CPT ® codes used to report nondrug-eluting intracoronary stent placement procedures.
Q: How should we bill for the physician in the following situation? A patient who has end-stage renal disease (ESRD) comes into a hospital’s emergency department (ED) with an emergent condition (dialysis access clotted or chest pain that is ruled out), but misses his or her dialysis treatment. Part of the treatment is dialysis performed in the ED or as an outpatient. The hospital bills G0257 (unscheduled or emergency dialysis treatment for an ESRD patient in a hospital outpatient department that is not certified as an ESRD facility) as per CY 2003 OPPS Final Rule guidelines and Pub 100-04, Chapter 4, section 200.2
So far, we’ve covered three different ICD-10-PCS guidelines for multiple procedures. We’ve looked at how to report multiple procedures involving: Same root operation, different body parts as defined...
Happy 2013! We survived the Mayan apocalypse and received a one-year extension on ICD-10 implementation (which according to some people is more of an apocalyptic event than 12-21-12). Where do your...
Providers and coders seem to speak two different languages-clinical and coding. Providers already have issues parsing ICD-9-CM "coder speak," so how can you get them to understand ICD-10?
After a six-month delay, the Recovery Auditor prepayment review demonstration program began in August 2012. The program continues through August 2015, at which point CMS will determine the potential for a national rollout.
In this month's issue, we review the major changes to OPPS for 2013, discuss the potential impact of CMS' packaging clarification, examine therapy, molecular pathology changes, offer suggestions on how to begin teaching providers to speak ICD-10, and answer your coding questions.
The biggest operational change for outpatient facilities for 2013 does not appear in the 2013 OPPS final rule. Instead, CMS announced changes to reporting therapy services in the 2013 Medicare Physician Fee Schedule (MPFS) final rule.
Hospitals earned a big win with drug payments this year in the 2013 OPPS final rule, released November 1. CMS decided to finalize its proposal to follow the statute and reimburse facilities at the average sales price (ASP) plus 6%.
After a six-month delay, the Recovery Auditor prepayment review demonstration program began in August 2012. The program continues through August 2015, at which point CMS will determine the potential for a national rollout.
Upon quick glance, the FY 2013 ICD-10-CM Official Guidelines for Coding and Reporting probably look very familiar to coders. They're comparable in length to the ICD-9-CM guidelines. They also follow the same format.
As part of the 2013 OPPS final rule, CMS finalized a clarification to 42 CFR 419.2(b) that could cause confusion in the future if hospitals are audited by third-party payers or by Medicare contractors who do not fully understand the intent of the language or how CMS develops payment rates, says Jugna Shah, MPH, president of Nimitt Consulting based in Washington, D.C.
