Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, writes about the 2023 updates coders will find in the “Mental, Behavioral, and Neurodevelopmental Disorders” chapter for dementia.
Coding professionals can get an early start to 2023 by reviewing CPT codes that will be added, revised, and deleted next year. Analysis of the 2023 Medicare Physician Fee Schedule proposed rule reveals changes to 10 chapters in the CPT Manual , in addition to the revisions to the E/M chapter.
Effective October 1, the ICD-10-CM code set will be updated to include over 1,100 new codes before counting code revisions and deletions. This article covers new codes for musculoskeletal and genitourinary conditions including muscle wasting, rib and sternal fractures, drug-induced neuropathy, and endometriosis.
Coders must be familiar with updates to the ICD-10-CM/PCS code sets for fiscal year 2023 . Audrey Howard, RHIA , reviews new codes and reporting guidelines for dementia, care complications, and vascular procedures as well as updates to MS-DRGs.
Arthroscopic procedures have been the topic of controversy and confusion in the coding community. This article covers relevant anatomy, common shoulder arthroscopy and arthroplasty procedures, and National Correct Coding Initiative edits to keep in mind. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Revenue erosion and denials are often easily prevented, but simple errors may evade traditional, reactive denials management processes. Coders are encouraged to shift focus to take a proactive approach that targets common errors in claim submission and charge capture and eliminates resource-intensive rework.
CMS published a notice in the Federal Register on August 9 stating that it will be suspending prior authorization requirements for specific durable medical equipment, prosthetics/orthotics, and supply (DMEPOS) codes under certain circumstances, beginning January 1, 2023. All claims submitted before that date will require prior authorization documentation.
Each year, coders must review updates to the ICD-10-CM code set including new, revised, and deleted codes and reporting guidelines. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, explains that for 2023, coders will find several new codes in the “Mental, Behavioral, and Neurodevelopmental Disorders” chapter for dementia.
Bronchus, lung, and lymph node biopsies are often performed via a bronchoscopic technique. Sarah Nehring, BS, RHIT, CCS, CCDS , breaks down ICD-10-PCS coding for brush, transbronchial fine needle aspiration, and transbronchial forceps biopsies.
Malnutrition includes undernutrition, inadequate vitamins or minerals, overnutrition, obesity, and diet-related noncommunicable diseases. Inpatient coders must be familiar with clinical criteria and ICD-10-CM coding for this condition as it is frequently the focus of clinical validation audits. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: Why isn't a secondary diagnosis of morbid obesity considered a complication or comorbidity (CC) by CMS? What obesity diagnoses are classified as CCs by CMS?
A recent audit conducted by the Office of Inspector General (OIG) found that Cariten Health Plan Inc. in Knoxville, Tennessee, received at least $9.2 million in net overpayments from 2016 to 2017 for incorrectly submitting selected high-risk diagnosis codes.
Interventional radiology describes a set of procedures that involve the insertion of medical devices and instruments to diagnose or treat disorders of blood vessels. This article covers common revascularization procedures, CPT codes associated with each vascular territory, and potential coding errors. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
In part two of this series, expert Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, COBGC, addresses the “nuts and bolts” of ICD-10-CM coding for anesthesia services, including how and when to append modifiers.
The American Medical Association (AMA) released the Category I vaccine product codes for monkeypox tests and vaccines. The organization made them effective immediately upon their approval by the CPT Editorial Panel on July 26. The new codes are scheduled to appear in the in the 2024 CPT Manual.
Coding professionals can get an early start to 2023 by reviewing CPT codes that will be added, revised, and deleted next year. Analysis of the proposed 2023 Medicare Physician Fee Schedule reveals changes to 10 chapters in the CPT Manual , in addition to the revisions to the E/M chapter.
CMS released the fiscal year (FY) 2023 IPPS final rule on August 1, increasing hospital payment rates by 4.3% and establishing three health equity-focused measures in hospital quality programs.
Inpatient coders have malnutrition on their mental list of diagnoses at risk of audits. Learn how to effectively work with dieticians and CDI staff to ensure accurate documentation and ICD-10-CM coding for malnutrition.
Q: When would you report an ICD-10-CM code from category I22 (subsequent ST elevation and non-ST elevation myocardial infarction [MI]) with a code from I21 (acute MI)?
A spinal fusion is used to permanently connect two or more vertebrae, eliminating motion between them. Read up on ICD-10-PCS guidance for reporting spinal fusions based on key details in the operative note. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Bronchoscopy is often performed in conjunction with other therapeutic procedures for the treatment of lung problems. Sarah Nehring, BS, RHIT, CCS, CCDS , breaks down ICD-10-PCS coding for bronchoscopy with bronchoalveolar lavage and suction of a mucus plug.
The 3-day payment rule is known to coders by various names such as the 72-hour rule, the 3-day payment window, or MS-DRG window policy. Kimberly Lee M.Ed., RHIA, CCS-P , describes how to navigate the rule’s nuances for billing purposes.
Capturing obesity as a CC Q: Why isn't a secondary diagnosis of morbid obesity considered a complication or comorbidity (CC) by CMS? What obesity diagnoses are classified as CCs by CMS? A: The...
Reconciling CDI reviews and queries against final coding is an important but sometimes overlooked step. Use these expert tips to refresh or develop your organization's CDI and coding reconciliation process.
A spinal fusion is used to permanently connect two or more vertebrae, eliminating motion between them. Read up on ICD-10-PCS guidance for reporting spinal fusions based on key details in the operative note.
A broken nose is a break in the bone or cartilage over the bridge of the nose or over the septum—the structure that separates the nostrils. Debbie Jones, CPC, CCA , explains how to select the most specific CPT codes for nasal fracture and dislocation treatments.
Because of the prevalence of eating disorders, coders should become familiar with their types, symptoms, codes, and relevant guidelines. They appear in ICD-10-CM under category F50 (eating disorders), but codes for individual symptoms appear throughout the manual.
The current year (CY) 2023 OPPS proposed rule, released July 15, details hospital payment updates, remote behavioral services, and enrollment requirements for rural emergency hospitals, among other proposals.
Because of the prevalence of eating disorders, coders should become familiar with their types, symptoms, codes, and relevant guidelines. They appear in ICD-10-CM under category F50 (eating disorders), but codes for individual symptoms appear throughout the manual. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Most coders never have the opportunity to code for anesthesia. Expert Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, COBGC, explains that ICD-10-CM coding for anesthesia services is interesting and straightforward, but can be confusing if an individual is unfamiliar with coding guidelines and terminology for anesthesia administration.
CMS proposes to adapt the 2023 AMA CPT guideline changes to the nursing facility (NF) codes into its Medicare policy structure next year, according to the 2023 Medicare Physician Fee Schedule proposed rule.
Twenty-five percent of hospitalized Medicare patients experience patient harm, and 43% of those harm events could have been prevented, according to a recent Office of Inspector General (OIG) report.
Sepsis and systemic inflammatory response syndrome are historically difficult to document and report in ICD-10-CM. Alba Kuqi, MD, CCS, CDIP, CCDS, CRCR, CICA, CSCM , breaks down sepsis definitions and outlines a process for query creation.
Hospital coders must be able to determine the reason for an admission and to differentiate conditions present on admission (POA) from those that develop during an inpatient stay. Learn how to effectively decipher documentation to identify the principal diagnosis and conditions that were POA.
Determining the most specific ICD-10-PCS code for a procedural service can be tricky given that there are 34 character values and over 78,000 ICD-10-PCS codes for 2022. This article breaks down potentially confusing ICD-10-PCS guidelines for obstetric and cardiovascular procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The American Medical Association’s (AMA) CPT Editorial Panel recently published changes to its E/M Services Guidelines. The update includes code revisions, additions, and deletions, which are scheduled to take effect January 1, 2023.
Q: We are getting some National Correct Coding Initiative (NCCI) edits for repeat laboratory services. What modifier do we use if a component of a panel test is repeated later?
A broken nose is a break in the bone or cartilage over the bridge of the nose or over the septum—the structure that separates the nostrils. Debbie Jones, CPC, CCA , explains how to select the most specific CPT codes for nasal fracture and dislocation treatments.
This article analyzes ICD-10-CM codes for diseases that can manifest from prolonged hypertension. These codes appear throughout the ICD-10-CM manual, but most are found in Chapter 9 (Diseases of the circulatory system). Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Payment cuts are in the offing for Part B providers in 2023, along with a series of other projected changes targeting E/M services, COVID-19-related billing flexibilities, and value-based care, according to the 2023 Medicare Physician Fee Schedule (MPFS) proposed rule released July 7.
Coders in acute care facilities must be comfortable assigning ICD-10-CM/PCS codes for abortions. Sarah Nehring, BS, RHIT, CCS, CCDS , breaks down ICD-10-CM/PCS codes for spontaneous and induced abortions and related complications.
