Today I will focus on the chronological transition to ICD-10 readiness. My intent is to dispel myths and compare real-world experience in the ICD-10 planning space with the commonly disseminated...
Pneumonia is an inflammatory process that affects the lung tissue. Robert S. Gold, MD , and Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CHA, explain the clinical and documentation pieces of pneumonia coding.
Q: I’m in a little debate: Does documentation of the patient’s body mass index (BMI) need to come from an ancillary clinician, like the dietitian or nurse? I thought that we could use such ancillary documentation for clinical indicators supporting our physician query, but the treating physician needed to document the BMI. Can you help clarify this for me?
Our good friends at the Association of Clinical Documentation Improvement Specialists (ACDIS) have descended on Sin City for the seventh annual ACDIS conference. And while what happens in Vegas might...
One day after an apparent stealth announcement of the new ICD-10 compliance date, CMS confirmed October 1, 2015, as the new implementation date. According to a CMS statement: On April 1, 2014, the...
We may have a new ICD-10 implementation date…or maybe not. In the IPPS proposed rule , released April 30, CMS states on page 648, “The ICD-10-CM/PCS transition is scheduled to take place on October 1...
CMS’ 2015 IPPS proposed rule , released April 30, focuses on quality measures, such as the hospital-acquired condition (HAC) reduction, readmissions reduction, and hospital value-based purchasing (VBP) programs.
CMS’ 2015 IPPS proposed rule , released April 30, focuses on quality measures, such as the hospital-acquired condition (HAC) reduction, readmissions reduction, and hospital value-based purchasing and hospital readmissions reduction programs.
When outpatient hospitals and physicians switch to ICD-10-CM diagnosis codes October 1, they will still continue to use CPT® codes to report procedures. But some facilities are planning to use the new procedure code set, ICD-10-PCS, as well.
When outpatient hospitals and physicians switch to ICD-10-CM diagnosis codes October 1, they will still continue to use CPT ® codes to report procedures. But some facilities are planning to use the new procedure code set, ICD-10-PCS, as well.
A diabetic patient is admitted with gangrene. The physician does not specifically link the diabetes and the gangrene, but also does not document any other potential cause of the gangrene. Should you code both conditions?
Since January, providers have been struggling to reconcile conflicts between CMS' rules and regulations and those published by the CPT® Manual and other AMA publications.
This month’s issue focuses on the ICD-10 implementation delay and what it means for providers and coders. Members of the Briefings on Coding Compliance Strategies, as well as Robert S. Gold, MD, offer their takes on the delay. In addition, we highlight a new concept in ICD-10-CM—principal diagnoses that act as their own CC or MCC. And we answer your coding questions.
Congress needed just a week to throw a huge monkey wrench into the healthcare industry's plans for ICD-10 implementation. On March 26, House leadership introduced H.R. 4302, "Protecting Access to Medicare Act of 2014." By April 1, the bill had passed the Senate and been signed into law by President Obama.
The ears--more formally, the auditory system--have their own chapter in ICD-10-CM, no longer relegated to the end of the neurology codes. Codes in Chapter 8, Diseases of the Ear and Mastoid Process (H60-H95), are located between the chapters for the optical system and the circulatory system.
In January, I wrote about the perfect storm that led to the release of the 2014 OPPS final rule. We endured a later-than-usual release, errors in the data files and a release of updated files, a government shutdown, and a vastly shortened window between the release of the final rule and implementation on January 1. Judging by the confusion among providers?and corrections and clarifications coming from CMS on what seems like a weekly basis on a wide range of issues?we're still not in the clear.
At the time of this publication, the Protecting Access to Medicare Act of 2014 bill was recently passed. The status quo regarding physician reimbursement from Medicare has been maintained. So what? That system has been broken for 20 years. ICD-10 will be postponed for provider billing for another year. So what? Life will go on as it has for the past 36 years with ICD-9-CM. In other words, nothing has changed. We're good for another year. Pressure's off! ...Right?
When Congress passed the Protecting Access to Medicare Act of 2014, it mandated at least a one-year delay in ICD-10 implementation. Members of the Briefings on Coding Compliance Strategies editorial board, who represent a wide range of industry stakeholders, offered their thoughts on two questions related to the delay.
CMS’ 2015 IPPS proposed rule , released April 30, focuses on quality measures, such as the hospital-acquired condition (HAC) reduction, readmissions reduction, and hospital value-based purchasing and hospital readmissions reduction programs.
Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, reviews which diagnosis codes, in both ICD-9-CM and ICD-10-CM, Medicare recently approved to provide medically necessary for inserting pacemaker systems.
Providers struggle to reconcile conflicts between recent CMS regulations and the CPT® Manual and other AMA publications. Jugna Shah, MPH , Valerie A. Rinkle, MPA , and Linda S. Dietz, RHIA, CCS, CCS-P , look at specific areas of confusion and how to code them accurately.
The ICD-10 implementation delay has impacted training timelines for many providers. Rhonda Buckholtz, CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC , talks about how this time can be used to improve physician documentation, easing the transition for both coders and providers.
A review of Medicare CT scan claims from July 2011 to June 2012 found that 16% claims had an improper payment rate, according to the most recent Medicare Quarterly Provider Compliance Newsletter .
Q: I have been told to use the general surgery CPT ® codes in the 20000 series for reporting excisions of sebaceous cysts when the surgeon must cut into the subcutaneous layer. I don’t agree with this, since the 20000 codes do not give ICD-9-CM code 706.2 (sebaceous cyst) as a billable diagnosis code. Because a sebaceous, epidermal, or pilar cyst begins in the skin and may grow large enough to press into the subcutaneous layer, I think we should report an excision code from the 11400 series, and if need be, the 12000 codes for closure.
During AHIMA’s two-day ICD-10-CM/PCS and Computer-Assisted Coding Summit April 22-23, AHIMA ran some real-time polls with attendees texting in their responses. The results of the polls provide some...
Some body parts just need a little reinforcement. Or maybe a little augmentation. Use root operation Supplement (third character U) to report procedures that involve putting in or on biological or...
Rose Dunn, MBA, RHIA, CPA, CHPS, FACHE, FAHIMA, chief operating officer of First Class Solutions, started the second day of the AHIMA ICD-10 and CAC Summit with a rundown of ways HIM professionals...
Four ICD-10-PCS root operations involve procedures that put in, put back, or move some or all of a body part. Gerri Walk, RHIA, CCS, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, CHTS-CP, highlight the differences among Reattachment, Reposition, Transfer, and Transplantation.
Cheryl Ericson, MS, RN, CCDS, CDIP, discusses the difference between “after study” and “due to” when it comes to choosing the correct principal diagnosis .
Q: A patient is admitted with a high white blood count, tachycardia, tachypnea, and chills. The blood culture shows positive for methicillin-resistant Staphylococcus aureus (MRSA). The attending physician documents MRSA sepsis in the progress notes. Antibiotics are changed based on the blood culture and the patient is treated with appropriate antibiotics. Due to poor vascular access, a central venous catheter (CVC) is inserted and antibiotics are infused through this access. The patient responded slowly to treatment and CVC access becomes red and inflamed. The catheter is removed and cultured. The physician documents this to be an infection due to MRSA. What’s the diagnosis code for this?
The American Hospital Association (AHA), along with four hospital associations and several hospitals, filed two complaints April 14 in opposition of CMS’ 2-midnight rule for inpatient admissions, according to an AHA press release.
Healthcare facilities are subjected to a myriad of auditorswho scrutinize everything from how many units of a drug were billed to whether or not a patient actually needed to be admitted to the hospital. Trey La Charité, MD , explains how to turn every denial into a learning experience.
The first day of AHIMA’s ICD-10 and CAC Summit is in the books and although attendance is down this year, the speakers have provided some good food for thought. Here are some briefs highlights from...
Don’t blame the AMA for the most recent ICD-10 delay, says Steven Stack, MD , immediate past chair of the AMA Board of Trustees. Stack gave the keynote address at the AHIMA ICD-10 and CAC Summit in...
Coding for pressure ulcers in ICD-10-CM requires precise documentation of the ulcer’s location, which really shouldn’t surprise anyone. ICD-10-CM includes increased specificity for almost every...
Here comes Peter Cottontail, hopping down the bunny trail—and right into a gopher hole. Stupid rodents. Poor Peter limped his way into the Fix ‘Em Up Clinic to see Dr. Hop A. Long for an initial...
A patient undergoes a hysterectomy and experiences post-procedural bleeding. The surgeon cauterizes the bleed and evacuates a blood clot. In ICD-10-PCS, how do you code the cauterization? With the...
Don’t look now, but mumps are making a comeback . How do we code mumps in ICD-10-CM? Pretty much the same way we code them in ICD-9-CM. The codes just look a little different. In ICD-10-CM, we can...
Q: Our physicians document a diagnosis of pneumonia but do not normally make a specific connection with the patient's ventilator status, even when this is obvious from the record. For example, the patient's been on the ventilator support immediately prior to the diagnosis. Can I report this as ventilator-associated pneumonia in ICD-10-CM without the documentation specifically connecting the conditions?
In the wake of the latest ICD-10 implementation delay, coders and other healthcare professionals are looking for ways to continue with their implementation and training. They are also looking for ways to minimize the disruptions the delay may cause.
On the surface, you may think that transitioning from ICD-9-CM to ICD-10-CM for reporting schizophrenia, schizoid personality, and bipolar disorders is a dramatic change. However, Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, reveals that with some minor adjustments, the change can be a smooth one.
Plenty of uncertainty surrounds the ICD-10 implementation delay, but healthcare organizations shouldn’t put the brakes on their plans. Cheryl Ericson, MS, RN, CCDS, CDIP , William E. Haik, MD, FCCP, CDIP , Monica Lenahan, CCS , Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and James S. Kennedy, MD, CCS, CDIP, offer thoughts on how to keep moving forward with ICD-10.
ICD-10-CM includes more specificity than ICD-9-CM, but it still includes unspecified codes. Adele Towers, MD, MPH, Joanne Schade-Boyce, BSDH, MS, CPC, ACS, PCS, Michael Gallagher, MD, MBA, MPH, Rhonda Buckholtz, CPC, CPMA, CPC-I, CGSC, COBGC, CPEDC, CENTC , and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, explain when reporting an unspecified ICD-10-CM code is a good option.
Sometimes a physician just needs to take a look around a body part and see what’s what. If the physician’s sole objective is to examine a body part, either visually or manually, report the procedure...
We know we're facing at least a one-year delay in ICD-10 implementation. What you with that time? will directly affect how prepared you are for the eventual ICD-10 implementation. Here are some...
What a wild 12 days. On March 25, we were all preparing for the six-month-to-implementation milestone April 1. Some people were looking forward to that milestone more than others, but we had a plan...
If you code for pregnant patients and newborns, you may occasionally wonder which record to code a condition on. Is it something you code for the mother or for her offspring? ICD-10-CM divides the...
