We want your coding and compliance questions! The mission of Coding Q&A is to help you find answers to your urgent coding/compliance questions. To submit your questions, contact Briefings on Coding Compliance Strategies Editor Amanda Tyler at atyler@hcpro.com .
After missing a proposed fall start date, CMS announced last week that its Medicare Part B drug payment model from the Center for Medicare and Medicaid Innovation will not be going forward.
Coders have many more options to report diagnoses of the foot in ICD-10-CM, with the ability to include laterality, location, and other details related to the injury. Review the bones of the feet and tips for additional documentation details to note when choosing codes for foot fractures.
The shoulder girdle has the widest and most varied range of motion of any joint in the human body. That also makes it one of the most unstable. Read about the anatomy of the shoulder and which coding options exist for procedures of the shoulder.
Jugna Shah, MPH, and Valerie A. Rinkle, MPA, look at comprehensive APC (C-APC) expansion for 2017 and how that will lead to many new codes to be included in C-APCs. They also look at CMS’ new site-neutral payment policies for 2017 included in the latest OPPS final rule.
Q: For the new 2017 epidural injection CPT® codes, the longer-term injections (63234-62327) indicate they are to be used if they are administered on more than a single calendar day. What if we start the administration at 10 p.m. and then discontinue the administration at 1 a.m.? That would be two calendar days. Can we used those codes or should we use the shorter-term injection series (62320-62323)?
The world didn’t end on October 1, 2015. After years of postponement, the proverbial “deal with the devil” made between CMS and the AMA to push ahead with ICD-10-CM/PCS implementation was a year’s grace period during which physician practices could continue using unspecified codes without worrying about Medicare denials or auditor reviews.
After a year full of numerous coding changes, Laurie L. Prescott, RN, MSN, CCDS, CDIP , takes a closer look at 12 new guidelines that will affect CDI and helps coders better understand these recommendations.
Last week, CMS released an updated version of the Medicare Outpatient Observation Notice (MOON), which stated that effective March 8, 2017, hospitals will be required to present the MOON advisory in writing and verbally to Medicare beneficiaries who receive at least 24 hours of hospital services under outpatient status.
CMS announced that 70% of commercial payers have agreed to use the 30-day all cause acute myocardial infarction mortality outcome measure as one of the cardiology outcomes linked to payment. Shannon Newell, RHIA, CCS , writes about how CDI teams can best prepare for these upcoming changes.
Since the physician doesn't need to document a specific root operation, coders cannot rely solely on the terms the physician uses; thus it is important for each coder to fully understand each definition. This article takes a look at the root operations Inspection, Map, Dilation, and Bypass. Note: To access this free article, make sure you first register for the free content if you do not have a paid subscription.
Now that we’ve had over a year to get comfortable with our ICD-10-PCS manuals, the 2017 updates to the guidelines and tables turned a lot of what we learned onto its ear. The update brought 3,827 changes to ICD-10-PCS, with the majority of the changes occurring in the heart and great vessels section of the manual. Redefined body part characters, as well as additions of new device characters, left inpatient coders wondering: What does this all mean and how am I supposed to code it?
CMS made no changes for quality measures related to 2019 payment determinations that require reporting next year in the 2017 OPPS final rule. However, for payment determinations in 2020 and subsequent years, CMS is finalizing proposals on seven quality measures.
Chronic care management codes were adopted by CMS in 2015, but relatively few providers use them. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, writes about the criteria needed to code and bill these services, as well as how coders can work with providers to ensure documentation supports the codes.
The 2017 OPPS final rule brings the end of modifier –L1 for separately reportable laboratory tests, along with changes to CMS’ packaging logic. Jugna Shah, MPH, and Valerie A. Rinkle, MPA, review how these changes will impact providers.
Drug administration services are one of the most commonly coded and billed services, but that does not mean providers always include complete documentation. Review what physicians and nurses should be including in order to report the most accurate codes.
Bronchopulmonary infections, such as acute bronchitis and pneumonia, are frequent reasons for physician and facility encounters. These encounters result in ICD-10-CM code assignments that factor greatly in severity and risk adjustment inherent to the Patient Protection and Affordable Care Act and the recently implemented Medicare Access & CHIP Reauthorization Act of 2015.
