What do cubism and coding have in common? Both can be viewed as art forms. Joel Moorhead, MD, PhD, CPC, details the three steps that the coding artist performs in reassembling medical record elements into abstracted form.
Physicians often use the acronyms IBS (which should indicate irritable bowel syndrome) and IBD (which should indicate inflammatory bowel disease) interchangeably even though they represent completely different conditions with different treatment and prognoses. Robert S. Gold, MD, and Drew K. Siegel, MD, CPC, offer tips on how to decipher documentation related to these two conditions.
CMS officially announced the Recovery Auditor prepayment review demonstration in November 2011, but then in January 2012 decided to delay the program by three months. Since then—despite rumors that the program could be coming soon —the official start date has been unknown to the public. This changed however, when CMS announced Friday, August 3, that Recovery Auditor prepayment reviews will begin August 27.
Q: A patient has been diagnosed with peritonsillar cellulitis and oropharyngeal cellulitis. The physician documents that he performed a “needle aspiration of the left peritonsillar abscess.” In the body of the operative report, the physician states, “An 18-gauge needle was inserted and 1 cc of pus was aspirated. This was sent for aerobic, anaerobic, C&S [culture & sensitivity], and gram stain. I then put the 18-gauge needle in again and multiple passes were obtained without any aspirate.” Because ICD-9-CM does not include a code for “aspiration of peritonsillar abscess” some coders wanted to use ICD-9-CM procedure code 28.0 (incision and drainage of tonsil and peritonsillar structures) while others want to report code 28.99 (other operations on tonsils and adenoids). Which code is correct?
Diseases of the ear and mastoid process are moving up in the ICD-10-CM world. They’re getting their own chapter. In ICD-9-CM, eyes and ears shared a section. You’ll find diseases of the ear in...
We’re one step closer to knowing whether the Department of Health and Human Services (HHS) will actually delay ICD-10 implementation and if so, by how long. The Office of Management and Budget (OMB)...
The dogs days of summer have arrived so the residents of Anytown descended on the dog park with their furry friends today. Sadly, not all of the puppies (and people) play well together and some of...
QUESTION: A patient complained of intractable pain from compression fracture (sustained the day prior to admission). The guidelines state if pain is not documented as acute or chronic, don't assign codes from the 338 category. Should we query the physician if the pain was acute or chronic rather than just using the fracture code if it appears that pain control was the main reason for the visit?
As part of the July update to the Intergrated Outpatient Code Editor, CMS reinstated HCPCS C1882 to the list of acceptable devices for CPT code 33249. Dave Fee, MBA, explains the implications of the change and reviews code changes included in the update.
Inpatient facilities received mixed news on proposed changes to the list of complications and comorbidities (CC) and major CCs (MCC) in the fiscal year (FY) 2013 Inpatient Prospective Payment System (IPPS) final rule , released August 1.
Physicians can perform three different types of wound debridement and coders will find different codes for each type. Gloria Miller, CPC, CPMA, and John David Rosdeutscher, MD, discuss the different types of debridement, as well as coding and documentation requirements.
Observation services can generate so much confusion that CMS actually asked for comments on observation and inpatient status as part of the 2013 OPPS proposed rule. Kimberly Anderwood Hoy, JD, CPC, and Deborah K. Hale, CCS, CCDS, help coders unravel the complexities of observation services.
When a physician places a device that takes the place of all or some of a body part, assign a code from ICD-10-PCS root operation replacement (third character R). Think of a total knee replacement or...
Patience may be a virtue, but knowledge is power. Okay, enough clichés. The bottom line is we’re still waiting for a new ICD-10 implementation date. HHS published the proposed rule, moving...
There is nothing new about stress; humans have felt stress since the beginning of time, and coders are certainly no exception. Lois Mazza, CPC, discusses how coders can mitigate the many effects of stress while they handle the pressures of their jobs and lives.
HCPCS code C1882 (cardioverter-defibrillator, other than single or dual chamber [implantable]) will once again meet the criteria to override the device-to-procedure edit for CPT® code 33249 (insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead[s], single or dual chamber).
Coders can run into two types of edits that may require them to append modifier -59 (distinct procedural service) to override: NCCI edits and medically unlikely edits (MUE).
The sheer number and detail of new fracture codes in ICD-10-CM is daunting, leaving many coders to wonder-and worry-about whether physicians will document the information they need to assign the correct codes.
A surgeon performs a diagnostic shoulder arthroscopy before repairing a patient’s rotator cuff. The surgeon knew ahead of time that he or she would be repairing the rotator cuff. Should a coder or biller append modifier -59 (distinct procedural service) to the CPT® code for the diagnostic shoulder arthroscopy to ensure reimbursement for both procedures?
