With reimbursement gains whittled down by CMS' attempt to remedy unlawful cuts to 340B drug payments, complying with updated Outpatient Prospective Payment System (OPPS) policies is key to protecting reimbursement. Take a closer look at CMS' latest policies and ensure your organization is in compliance.
Obesity has grown into a global epidemic with significant social and economic consequences. Review ICD-10-CM coding for obesity and other weight-related conditions, and ICD-10-PCS coding for surgical interventions used to maintain a healthy weight. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Obesity has grown into a global epidemic with significant social and economic consequences. Review ICD-10-CM coding for obesity and other weight-related conditions, and ICD-10-PCS coding for surgical interventions used to maintain a healthy weight.
Coding and CDI professionals should understand disease processes for common inpatient diagnoses. Ronald Singell, RN, BSN, CCDS , writes about clinical indicators of disease for diabetic ketoacidosis, gastrointestinal hemorrhage, and sequential organ failure.
The Office of Inspector General (OIG) recently released its annual report detailing its list of top unimplemented recommendations for 2022. The agency recommends that CMS increase scrutiny of inpatient hospital claims for severe malnutrition and other diagnoses that are vulnerable to upcoding.
The Centers for Disease Control and Prevention and the National Center for Health Statistics published updates to the ICD-10-CM coding guidelines and files, which take effect April 1. The updates include 42 new diagnosis codes, seven deletions, and one revision.
Alysia Minott, CIRCC, CCS, CDIP, explains that CPT coding for complex procedures performed using interventional radiology (IR) can be mastered; the first step is learning how to interpret applicable coding guidelines.
The new batch of diagnosis codes and revised guidelines for social determinants of health (SDOH) that will go into effect April 1 highlight the importance policymakers place on collecting this data. Julia Kyles, CPC, provides tips for capturing the SDOH using these new codes.
The American Medical Association's update to the 2023 CPT code set has brought three code additions, one revision, and one deletion to the integumentary chapter (CPT codes 10030-19499). This article provides procedure descriptions and coding guidance for the new and revised codes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
If a urinary tract infection is left untreated, it can spread to other organs and cause sepsis and septic shock. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down ICD-10-CM coding for this life-threatening diagnosis.
Auditors see assignment of certain MS-DRGs as a red flag and most often will pull these encounters for review. Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , describes these MS-DRGs and offers advice for ensuring accurate reporting of a principal diagnosis.
A retrospective medical record review published in JAMA Network Open in December found that nearly one-third of intentional firearm injuries resulting in emergency department admissions were inaccurately coded in ICD-10-CM as accidents.
Stacy Reck, MBA, RHIA, CDIP , and Ashley Wells, MN, RN, CMSRN, CCDS , describe common reasons for clinical validity denials and strategies they use to defend against them. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A urinary tract infection (UTI) is a common bacterial disease that affects the bladder and urethra. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, reviews urinary anatomy as well as diagnostic considerations and ICD-10-CM coding for UTIs.
The 2023 CPT code update introduced numerous code additions, revisions, and deletions that took effect January 1. This article covers new and revised codes in the respiratory and nervous system chapters of the CPT Manual. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS recently released Transmittal 11737, detailing January 2023 updates to the OPPS. The transmittal offers information on new COVID-19 vaccine and administration codes, dental coding updates, coding clarification, and remote behavioral health service codes.
Coders can reinforce their understanding of the 2023 CPT E/M medical decision-making (MDM) requirements with tips from Peter Hollman, MD , who oversaw the changes.
