The urinary system might not be one of the body systems people are most eager to discuss, but learning the anatomy of the urinary system is key in coding certain procedures, especially in the surgical and interventional radiology specialties. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
One of the most controversial changes to the 2017 ICD-10-CM guidelines was the contradictory guidance for the term “with,” and that issue is addressed in the 2018 version of the guidelines.
Q: Our team had a recent case that involved a small midline episiotomy which extended to a second-degree laceration which was repaired with 3-0 vicryl rapide sutures. Would we code the episiotomy and repair or just the repair, and why?
On Wednesday, August 2, CMS released the fiscal year 2018 IPPS final rule which featured updates to various quality initiatives, along with annual payment updates for inpatient services.
James S. Kennedy, MD, CCS, CDIP, CCDS, says that with the news codes available October 1, coders will face significant changes in documentation and coding practices. He discusses some of the additional new codes, including type 2 diabetes mellitus with ketoacidosis and pulmonary hypertension.
Crystal Stalter, CDIP, CCS-P, CPC, writes that with the release of the 2018 IPPS final rule, hospitals around the country are poring over it to see what impact the changes might bring to their case-mix index, quality initiatives, and overall reimbursement. In the midst of this are coders and CDI specialists who need to be kept abreast of these changes.
Peggy S. Blue, MPH, CPC, CCS-P, CEMC , reviews coding guidelines, signs, and symptoms of gastroparesis and helps coders avoid tricky guidance that can lead to reporting errors. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Q: What are the applicable modifiers that can be used when a test fails for medical necessity or if an Advance Beneficiary Notice (ABN) has been signed?
The 2018 OPPS proposed rule included potential changes to certain radiology modifiers used by CMS to identify services for data collection as well as reimbursement.
James S. Kennedy, MD, CCS, CDIP , discusses the new ICD-10-CM codes for FY 2018 and describes some of the changes that could be made to documentation and billing habits for these conditions.
Coding and billing for the transgender patient can be difficult even when society in general has become more aware of people who are transgender. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, covers some of the challenges coders may face when filing claims for transgender patients.
In the outpatient world, physicians are accustomed to seeing services as the key to reimbursement, but diagnoses and outcomes will increasingly factor into reimbursement as healthcare shifts toward value-based care. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
CMS wants your thoughts on its 2018 OPPS proposed changes. In various places in the proposed rule, CMS specifically asks providers to comment on the proposals. You may submit comments to the agency until September 11, 2017.
You may find significant changes to E/M reporting in the near future, including a pivot away from two key elements — history and physical exam — that largely determine a given level of service for your most common patient encounters.
The 2018 OPPS proposed rule includes potential changes to 340B drug discount payments, the inpatient-only list, packaging for low-level drug administration services, and more.
CDI professionals recognize the effect comprehensive CDI programs have on both payment and profiling outcomes in all healthcare settings. As a result, many organizations are forging ahead to apply CDI beyond the walls of the traditional acute care setting.
It’s that time of year again – when HIM directors, hospital administrators, and coding managers begin to wonder just how they will be affected come October 1.
