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JustCoding.com provides coders, coding supervisors, and health information management (HIM) directors with educational resources to test their coding knowledge, employ correct coding guidelines, and stay abreast of CMS transmittals. To learn about the different levels of access to this site, click here.
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Code expansion on claim forms introduces challenges for coders
As of January 1, 2011, institutional claims processing will accommodate the expansion to 24 secondary diagnoses as well as 24 secondary procedure codes. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, CCDS, discusses reasons why the expansion of diagnosis codes on institutional claims introduces another level of complexity to coding. 
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V codes play an important role in painting an accurate picture of an admission and facilitating research and statistical tracking, but they pose challenges for inpatient coders. Nelly Leon-Chisen, RHIA, and Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA, discuss why it’s important for coders to review coding guidelines to avoid four coding traps and explain how V codes play an important role in preparing for and possibly avoiding recovery audit contractor audits.
It shouldn’t come as a surprise that HealthDataInsights—the Recovery Audit Contractor (RAC) for Region D—is taking a closer look at MS-DRGs 837–948 related to neoplasms. Paul Evans, RHIA, CCS, CCS-P, and Jane E. Werner, RHIT, CCS, explain how detailed coding guidelines and often insufficient documentation make them likely targets and share guidance for how to prepare for audits.
The term query has spawned a negative connotation for some coders and their facilities. Some organizations prefer to use synonyms such as "communication” or “clarification” to allay the feelings of frustration the term “query” may conjure. Whatever an organization calls them, proper queries are often an integral part of accurate code assignment. Gloryanne Bryant, BS, RHIA, RHIT, CCS, CCDS, and William E. Haik, MD, share tips to ensure queries are compliant and effective.
Aesop’s fable of the ant and the grasshopper teaches us the value of planning ahead. While the grasshopper sings the summer away, the ant is hard at work collecting food for the coming winter. When winter arrives, the ant eats from his reserve while the grasshopper dies of hunger. The story is a bit morbid, but the moral is clear, “To work today is to eat tomorrow.” Teresa Silversmith, RHIT, CCS, C-CDI, Christine Lewis, and Donna Wilson, RHIA, CCS, discuss how important it is for HIM directors to apply that message and get a jumpstart on planning for the switch to ICD-10-CM/PCS in 2013.
Urodynamic studies are a coding challenge. Differing physician terminology, unique documentation requirements, and new combination codes make for complicated reporting of these diagnostic procedures. Abraham Morse, MD, MBA, and Cynthia A. Trapp, CHFP, CMPE, CPC, CPC-I, CCS-P, CHC, discuss how to code different types of urodynamic studies.
An arteriovenous (AV) fistula is used to connect an artery and a vein, allowing for a high blood flow rate for dialysis. The AV fistula also needs to be easily accessible so nurses can use it for dialysis. David M. Dunn, MD, FACS, CIRCC, CPC-H, CCC, CCS, RCC, provides a detailed look at the correct way to code for various dialysis access procedures.
Fracture coding with ICD-10 requires knowledge of Gustilo-Anderson scale
September 2, 2010
When coding with ICD-10, there may be terms that neither your coders nor your physicians are used to using. Now is the time to pass on this knowledge to your medical staff so they can understand what details they’ll need to document for coders to be able to accurately assign ICD-10 codes. Note the following [...] 
Codes will change, so will your contracts
August 30, 2010
The switch to ICD-10-CM will change more than just your code choices. It will also change how physician offices practice medicine. All of your offices’ policies will have to be revised to fit ICD-10-CM, says Rhonda Buckholtz, CPC, CPC-I, CGSC, COBGC, CEPDC, CENTC, vice president of business and member development for the American Academy of Professional [...] 
ICD-10 Watch takes planning to the next level with ICD-10 Trainer!
August 27, 2010
As 2011 approaches, it's time to take planning for ICD-10 to the next level. Over the last few years, we’ve been watching as activity related to ICD-10 has started to ramp up. Perhaps some of you already have an organized task force and have started implementing various stages of your transition plan. We’re striving to [...] 
HealthcareNews: 5010 transaction standard testing to begin in January
September 1, 2010
On August 24, CMS issued a press release to remind to healthcare providers, health plans, clearinghouses, and vendors about approaching compliance dates related to transaction standard 5010, which is a necessary prelude to the switch to the ICD-10 coding system in 2013. Beginning in January 2011, entities covered under the Health Insurance Portability and Accountability Act should be ready to test practice management functionality and/or other related software featuring Version 5010 standards with their trading partners.
Healthcare News: CMS clarifies billing for implantable tissue markers
August 25, 2010
Two HCPCS codes for implantable tissue markers are separately billable and payable when billed by physicians but not IPPS or OPPS hospitals or ambulatory surgery centers (ASC), according to the August 6 transmittal 745 in the One-Time Notification Manual and MLN Matters article MM6968 from CMS.
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Check out what you're missing on JustCoding Platinum!
A list of new diagnosis codes in the Special Reports and News section:
- List of new 2011 ICD-9-CM diagnosis codes (including E and V codes)
Continuing education credits: To receive a 0.5 CE credit, take the quiz after reading the following articles:
- Code expansion on claim forms introduces challenges for coders
- Review query formats and retention processes to ensure compliance
- Don’t fall into these avoidable V code traps
- HealthcareNews: 5010 transaction standard testing to begin in January
- Q&A: Appropriate use of inpatient consultation codes
Editor’s note: Please note that JustCoding has issued a correction for the August 4 Q&A. |
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September 21, 2010
Cardiac and Pulmonary Rehab: Identify and Resolve Medicare Benefit Challenges
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