Fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths in the U.S. Tonya Chandler, RHIT, examines ICD-10-CM reporting for fentanyl use, overdose, symptoms, and dependence through several coding scenarios.
As the COVID-19 public health emergency has ended, audits are likely to pick up steam. To prepare for this increase in audit activity, it’s essential for providers and coders to examine both current and upcoming trends.
Shelley Safian, PhD, RHIA, CCS-P, COC, CPC-I, defines hand-assisted laparoscopic surgery (HALS) procedures and how to report them according to new guidance in the 2024 ICD-10-PCS guidelines.
Surgical osseointegrated bone prostheses have emerged as a popular alternative to hearing aids. Debbie Jones, CPC, CCA, defines how these devices work and how to report implantation, removal, and replacement of these devices in CPT.
Coders saw extensive code changes and expansion for ICD-10-CM category O35.- in 2023. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG, reviews what coders need to know when reporting fetal conditions affecting the management of the mother.
Kate Siemens, RN, CMSRN, CCDS, conducts an interview with Majed Gharfeh, MD, to offer a physician’s perspective on queries and tips on how coders can receive the best results from querying their providers.
Julie Kyles, CPC, explains that CMS issued a modest set of hospital and practitioner procedure-to-procedure and medically unlikely edits in the latest quarterly update to the National Correct Coding Initiative (NCCI) edits, effective July 1
Surgical osseointegrated bone prostheses have emerged as a popular alternative to hearing aids. Debbie Jones, CPC, CCA, defines how these devices work and how to report implantation, removal, and replacement of these devices in CPT.
The Office of Inspector General (OIG) recently released the results of an audit of Medicare billing requirements for psychotherapy services submitted from March 2020 through February 2021 as providers adapted to changes introduced as a result of the COVID-19 public health emergency.
The aim of every hernia repair procedure is to manipulate the herniated organ back into its proper position. This article reviews procedures and 2023 CPT coding guidance for hiatal, inguinal, femoral, abdominal, and parastomal hernia repairs. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The term “stroke” or cerebrovascular accident (CVA) indicates an interruption in blood flow to the brain. Nancy Reading, RN, CPC, CPC-P , reviews strokes and explains how coders should report them and their treatment in ICD-10-CM and ICD-10-PCS. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Amanda Vincent , Javier Ortiz , and Teresa Brown, RN, CCDS, CDIP, CCS , identify various CMS quality programs, discuss common conditions these programs assess, and highlight their impact on patient safety through examples and coding case studies.
CMS’ FY 2024 ICD-10-PCS codes, guidelines, and conversion table were published June 6. The release featured minor guideline changes, 78 new codes, 14 revisions, and five deletions.
As the COVID-19 public health emergency has ended, audits are likely to pick up steam. To prepare for this increase in audit activity, it’s essential for providers and coders to examine both current and upcoming trends.
CMS released Transmittal 12053 in May, outlining CMS’ intended changes in the July 2023 OPPS update. The new HCPCS codes will be used to report gastric procedures, insulin pump equipment, echocardiography processing, and more.
Coders saw extensive code changes and expansion for ICD-10-CM category O35.- in 2023. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG, reviews codes in Chapter 15, section E: Fetal conditions affecting the management of the mother.
Q: A physician performs a lithotripsy on a stone in the ureter or removes a stone from the ureter through a transurethral approach, then performs a percutaneous nephrostomy and treats a stone in the kidney. Would both procedures be reported?
Julia Kyles, CPC, offers insights into the risk category of the medical decision-making (MDM) table with three scenarios presented by Peter Hollmann, MD, and Barbara Levy, MD, co-chairs of the CPT/RUC Workgroup on E/M.
This article defines types of hernias coders may encounter, including inguinal, femoral, congenital hiatus, congenital diaphragmatic, diaphragmatic hiatal, and what details coder will need to look for to accurately report them, per 2023 ICD-10-CM guidelines. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS recently published an MLN Fact Sheet that explains how providers can check Medicare claim status information. This quick reference guide also offers pointers on establishing an NPI, monitoring claims, when to check claims’ payment statuses, and more.
Antibiotic resistance occurs when bacteria become resistant to drugs designed to kill them. Deanne Wilk, MPS, BSN, RN, CCDS, CCDS-O, CDIP, CCS, offers guidance on querying physicians for antibiotic resistance organisms.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, explains the significance of reporting social determinants of health (SDoH) with examples related to health literacy, environmental factors, and living conditions.
Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS, describes how coding reviews provide an opportunity to conduct a thorough compliance review that not only addresses components of the coding process, but also the integrity of the patient’s record. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Encephalopathy refers to any disease of the brain that alters its function or structure. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBG, breaks down documentation requirements and ICD-10-CM coding for toxic, acute, and chronic encephalopathy.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, explains the significance of reporting social determinants of health (SDoH) with examples related to health literacy, environmental factors, and living conditions.
The term “stroke” or cerebrovascular accident (CVA) indicates an interruption in blood flow to the brain. Nancy Reading, RN, CPC, CPC-P , reviews strokes and explains how coders should report them and their treatment in ICD-10-CM and ICD-10-PCS.
Learn about the challenges faced and collaborative opportunities encountered by one organization when it began the process of improving its observed-over-expected mortality ratio.
Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS, describes how coding reviews provide an opportunity to conduct a thorough compliance review that not only addresses components of the coding process, but also the integrity of the patient’s record.
This article reviews the most common types of external diagnostic cardiology tests, examines relevant CPT coding guidelines, and offers reporting advice from an expert.
Revenue cycle leaders reported denials management as their most time-consuming revenue cycle task, followed by prior authorizations, according to a new survey by AKASA.
Key performance indicators are used by organizations to monitor the progress of CDI initiatives. Waldo Herrera, MD, MBA, MSc, FACP, SFHM, CHCQM-PHYADV , describes performance metrics that professionals at his facility use to track revenue cycle performance and opportunities for improvement.
Physicians have found ways to treat many congenital defects in utero, enabling the neonate to be born without defects. Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, details ICD-10-CM coding for common birth defects, and ICD-10-PCS and HCPCS Level II coding for their treatment.
Spinal fusions can effectively eliminate pain and restore stability to the spine. Learn how to apply ICD-10-PCS codes and guidelines for spinal fusions and related procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
This article reviews the most common types of external diagnostic cardiology tests, examines relevant CPT coding guidelines, and offers reporting advice from an expert. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Laura Evans, CPC , takes a deep dive into four CPT Category III codes that were released in the 2023 CPT Manual . Those codes are used to report cutting-edge regenerative musculoskeletal procedures, the use of animal implants, and facet joint replacements.
CMS published its first quarter 2023 HCPCS Application Summaries and Coding Recommendations April 27, which summarizes the final decisions on HCPCS Level II code assignments. CMS created 58 new HCPCS codes, deleted seven codes, and revised one code. Most changes will be implemented July 1.
Q: A patient with a history of prostatic hypertrophy and dysuria receives a laparoscopic prostatectomy conducted with robotic assistance. Which CPT code would be used to report this?
Modifier -25 is used to report a significant, separately identifiable E/M service by the same physician. Courtney Crozier, MA, RHIA, CCS, CDIP , reviews the American Medical Association’s guidance on correct reporting of modifier -25, and outlines when and how to report it.
Pneumonia is the eighth-leading cause of death in the U.S. This article outlines signs and symptoms of respiratory infection, pneumonia etiologies, and ICD-10-CM coding for complex pneumonia. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The gap between clinical reality and coding terminology can be addressed by empowering coders to use clinical judgment. Merle Zuel, RN, CCDS , discusses when it is appropriate for coders to interpret provider documentation and use their clinical judgment to code it in a certain way.
What may be considered a simple task, such as confirming present on admission status, can be complicated by discrepancies between coding and quality reporting criteria. Kate Siemens, RN, CMSRN, CCDS , outlines the ways in which coding and quality metrics do not align.
Q: A patient with fatty liver disease undergoes ultrasound cavitation. What diagnoses are treated using ultrasound cavitation and how is the procedure reported in ICD-10-PCS?
