ICD-10-CM implementation is less than a year away and coders should be starting their ICD-10-CM code training if they haven't already. Coders don't need to learn the specific codes right now, but they should be familiar with some of the conventions and guidelines in ICD-10-CM.
Our experts answer questions about followup visits in the ED, skin substitutes, flu vaccines, osteoporosis and fractures in ICD-10-CM, ICD-10-CM external cause code, modifier for discontinued cardioversion, and modifier -25
In this month's issue, we review ICD-10-CM guidelines, illustrate how neoplasm coding will and won't change in ICD-10-CM, identify elements for appropriate ED E/M level selection, and answer your coding questions.
In this month's issue, we explain how coders will report sepsis in ICD-10-CM, go beyond pressure ulcers for coding wound care, review the importance of PEPPER, and reveal how to uncover and correct documentation deficiencies before ICD-10 implementation. Dr. Robert Gold introduces you to SIRS and our coding experts answer your questions.
Coders may find assigning codes for sepsis somewhat easier in ICD-10-CM, but they will still face some challenges. The first of those challenges, and probably the biggest, centers on physician documentation.
If you're not already actively using your hospital's PEPPER (Program for Evaluating Payment Patterns Electronic Report), you're missing out on a lot of valuable data.
Over and over, one gets frustrated that professional coders are told that they are smart and educated and know about anatomy, physiology, and pharmacology, and then the same people turn around and say, "You code what the doctor documented and it's not up to you to question the physician."
Poor Mr. Frank N. Stein, he’s literally falling to pieces. Not to worry, though, Dr. Shelly at the Stich ‘Em Up Hospital will have him back together in no time. Frank’s most obvious problem is that...
Our sister publication , Medical Records Briefing, is conducting a benchmarking survey on ICD-10 implementation, and we would appreciate your input. Please take a few moments to complete this survey...
Coder productivity was a hot topic of conversation during the AHIMA pre-conference in Atlanta October 26-27. We all know coders will be less productive initially after the transition to ICD-10. The...
Greetings from Atlanta! I spent the weekend collecting all kinds of tips and information about ICD-10 during the AHIMA Conference pre-conference sessions. These are just a few of the best tidbits...
The ICD-10-PCS Official Guidelines for Coding and Reporting address four specific circumstances when coders will report multiple procedures. Jennifer Avery, CCS, CPC-H, CPC, CPC-I, and Mark N. Dominesey, MBA, RN, CCDS, CDIP, HIT Pro-CP, explain the guidelines and how they differ from the current ICD-9-CM guidelines.
Approach is the fifth character in the ICD-10-PCS code. Laura Legg, RHIT, CCS, AHIMA-approved ICD-10 CM/PCS trainer , reviews the seven approaches used in ICD-10-PCS.
Coders will use an ICD-10-PCS table to build a code for a hip or knee replacement. As with any procedure, coders must first determine the root operation. Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CPCD, COBGC, CCS-P, CDIP, and Wanda L. Cidor, guide you through coding for these procedures.
Jacob comes into the Fix ‘Em Up Clinic with a hairy problem—namely too much hair. He’s covered in it, head to tail, I mean toe. He also reports a strange urge to howl at the moon and a severe allergy...
Sitting hunched in front of a computer can be a bad thing. Aside from missing all of the splendid fall foliage, you could also be straining your neck muscles and causing yourself plenty of pain. So...
Mr. Jack O. Lantern is here at Stich ‘Em Up Hospital to have his guts removed. Dr. Carver begins by removing a section of Jack’s skull, then begins to remove Jack’s guts. How would we code this...
Some of the most sweeping changes in OPPS history were proposed in the 2014 rule, including new packaging rules, quality measures, and changes to evaluation and management. Jugna Shah, MPH, and Dave Fee, MBA, look at some of the changes and how they could impact providers.
Packaging still causes confusion amongst healthcare providers and the number of packaged services will greatly expand if CMS finalizes certain parts of the 2014 OPPS proposed rule. Valerie A. Rinkle, MPA, and Kimberly Anderwood Hoy Baker, JD, CPC , discuss what changes could come in 2014 and how to avoid common packaging errors.
New CPT ® codes introduced for 2014 will give healthcare providers new ways to report pain management services and treatments. Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer , reviews some of the codes, including new evaluation and management and Category II codes.
Q: The patient has had a previous bilateral mastectomy and is now coming in for a revision of bilateral areola with a dermal fat graft to the left nipple and excision of excessive skin and subcutaneous tissue from both breasts. This would be CPT ® code 19380 (revision of reconstructed breast) with modifier -50 (bilateral procedure) and 19350-50 (nipple/areola reconstruction) for both procedures. I cannot locate information that tells me if the nipple revision on the reconstructed breast is part of the 19380 or can be separately coded with 19350.
Small and mid-sized hospitals are increasing their ICD-10 training for staff, according to a recent Health Revenue Assurance Associates (HRAA) survey of 200 healthcare professionals. However, many still lag behind CMS’ timeline for dual coding and other implementation aspects.
Welcome to the Middle Ages, when your chance of dying from the plague is around 50-50. The bubonic plague likely wiped out 75-200 million people in Europe in the 14 th century alone. For the...
My brain is fried. Keeping up with all of the mandates and changes in healthcare is exhausting. So is learning the new ICD-10 codes. Maybe I’m just tired because it’s Wednesday. What does ICD-10-CM...
CDI specialists shouldn’t focus on reimbursement, yet the reality is that improved documentation often does lead to higher payments for the hospital. Darice Grzybowski, MA, RHIA, FAHIMA, and Jon Elion, MD, offer tips on how CDI programs can mitigate ethical quandaries and demonstrate best practice.
Although ICD-10-CM resolves some problematic areas of coding, it isn't a panacea. Robert S. Gold, MD reviews how respiratory insufficiency will continue to challenge coders.
Physicians often use different terms interchangeably when documenting sepsis. Robert Gold, MD , and Gloryanne Bryant, RHIA, RHIT, CCS, CDIP, CCDS, define the different terms and review when to query for additional clarification.
In order for coders to report ICD-9-CM procedure code 96.72 (continuous invasive mechanical ventilation for 96 consecutive hours or more), the provider must document that the patient received more than 96 hours of continuous ventilation. A recent OIG report found that 96% of claims incorrectly included code 96.72 between 2009 and 2011.
People are creatures of habit. Some of them are good, some not so good. Coders, too, are creatures of habit. We know certain codes without having to look them up. (Anyone know the code for...
The implementation of ICD-10-CM will bring more specificity to coding, which will mean more data for facilities. Michael Gallagher, MD, MBA, MPH, and Andrea Clark, RHIA, CCS, CPC-H, look at how to handle that data and its benefits for providers and patients.
Jeanne L. Plouffe, CPC, CGSC , and Jennifer Avery, CCS, CPC-H, CPC, CPC-I , review procedures performed on the gallbladder and how to determine the correct ICD-9-CM diagnosis codes.
Like the skin, dermatology coding has several layers. Betty Hovey, CPC, CPC-H, CPB, CPMA, CPC-I, CPCD, says that coders need to pay attention to the type of procedure, site, size, and more in order to accurately report each encounter.
With less than a year until ICD-10 implementation, many facilities have yet to even begin training. A recent Association of Clinical Documentation Improvement Specialists survey shows how far along facilities are and their concerns as October 1, 2014, nears.
By this time next year, we will be using ICD-10 codes. Where are you in your transition? What have you accomplished? What’s left on the to-do list? Here’s a better question: will you be ready? It...
CMS released its FY 2014 IPPS final rule in August, and with it comes a whole slew of changes for inpatient hospitals. Set aside a good amount of time to scroll through the 2,000-plus page document. Yes, that's right: There are more than 2,000 pages of information to absorb before the rule goes into effect on October 1, 2013.
Despite its apparently straightforward definition in the CPT ® Manual , modifier -59 (distinct procedural service) can be deceptively difficult to append properly.
Each physician may have his or her own way of describing a stroke. However, consistent terminology leads to accurate data to describe the care provided as well as the mortality, length of stay, and cost statistics.
Our experts answer questions about NCCI edits for injections, modifier -25, modifier -59, laminotomy with insertion of Coflex distraction device, billing mammogram for needle placement, and auditing electronic orders.
ICD codes are the ultimate source of information for the healthcare industry. Coders in every setting-inpatient, outpatient, and physician services-report the exact same ICD codes to describe a patient's condition.
CMS added modifier -AO (provider declined alt payment method) and new HCPCS codes to the I/OCE as part of the October 2013 quarterly update found in Transmittal 2763.
Does the patient really have sepsis? Experts say coders often struggle with this question because physicians don't sufficiently document clinical indicators.
CMS released its FY 2014 IPPS final rule in August, and with it comes a whole slew of changes for inpatient hospitals. Set aside a good amount of time to scroll through the 2,000-plus page document. Yes, that's right: There are more than 2,000 pages of information to absorb before the rule goes into effect on October 1, 2013.
In this month’s issue, we provide tips for wrapping your hands around data analytics before the transition to ICD-10-CM, review the October updates to the I/OCE, and discuss the correct use of modifier -59. In addition, our experts answer your coding questions.
