The 2016 IPPS final rule includes many new claims-based measures for 2018 and 2019 payment determination. Shannon Newell, RHIA, CCS, provides an overview of those measures and additional changes to theHospital Value-Based Purchasing and Hospital-Acquired Conditions Reduction programs.
Q: I am having trouble with ICD-10-PCS coding for a perineal laceration repair. Some sources state that the correct code uses the perineal anatomic region, not muscle repair. Could you please clarify the correct ICD-10-PCS code for a second-degree obstetrical (perineum) laceration that includes muscle?
A 12-year-old male developed umbilical discomfort Monday and didn't eat much dinner. On Tuesday, he started vomiting at school and the pain shifted to his right lower quadrant. His parents brought him to the ED, where his vital signs showed:
Because CMS has not created any national ED E/M guidelines, providers must create their own criteria for each visit level. CMS has developed a list of 11 criteria that it uses when auditing facility E/M criteria.
A 12-year-old male developed umbilical discomfort Monday and didn't eat much dinner. On Tuesday, he started vomiting at school and the pain shifted to his right lower quadrant. His parents brought him to the ED, where his vital signs showed:
Each new CMS fiscal year, MS-DRG weight and classification changes in the CMS IPPS final rule are closely scrutinized by coders and CDI specialists to identify any potential impact on documentation capture and code assignment processes.
Heart disease is the most common cause of death for both men and women in the U.S., according to the Centers for Disease Control and Prevention (CDC). The most common type is coronary artery disease (CAD), which can lead to heart attacks, heart failure, angina, and arrhythmias, according to the CDC.
Sometimes people do their homework with setting up a new system, and sometimes they don't. Sometimes they do their homework, but not enough of it, and billions of dollars of wasteful spending occurs that could be avoided. But "they" won't listen.
Heart disease is the most common cause of death for both men and women in the U.S., according to the Centers for Disease Control and Prevention (CDC). The most common type is coronary artery disease (CAD), which can lead to heart attacks, heart failure, angina, and arrhythmias, according to the CDC.
When a patient suffers a traumatic injury or poisoning, we need to report how they became injured and where they were when it happened. You already know this from ICD-9-CM.
Dual coding. Reformatting queries. Educating physicians. Let's face it?the to-do list for ICD-10 preparation is pretty long, and can be a bit daunting. With ICD-10 implementation happening this month, there's one thing your facility should do: prioritize.
Most improper payments for diagnostic nasal endoscopies reviewed during a Comprehensive Error Rate Testing (CERT) special study occurred due to insufficient documentation, according to the latest Medicare Quarterly Compliance Newsletter .
Ready or not, ICD-10 is here. Sam Antonios, MD, FACP, FHM, CCDS, writes about how to talk to physicians about the transition in order to make it as seamless as possible.
Providers have to create their own ED E/M guidelines, which can present a variety of challenges for facilities. For coders, this means an understanding of how to calculate critical care and other factors in order to report the correct visit level.
Coders can no longer rely on the muscle memory and cheat sheets they developed working with ICD-9-CM for so long. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, reviews ways coders can update their processes for reporting certain OB/GYN services in ICD-10-CM.
Coders will need to master root operations in order to be successful in ICD-10-PCS. Cindy Basham, MHA, MSCCS, BSN, CCS, CPC, writes about which root operations will be most frequently used for cardiovascular procedures and how to interpret the guidelines related to them.
Q: How can our team prepare for potential productivity losses post-ICD-10 implementation, specifically regarding procedure codes? Should we consider hiring additional staff or staff with a surgical background?
