Hospital Outpatient Articles

Below is a complete listing of all Hospital Outpatient articles that have appeared in JustCoding News.

  • Understand anatomy to transition reporting hypertension from ICD-9-CM to ICD-10-CM

    April 30, 2013

    According to the Centers for Disease Control and Prevention, 31% of all American adults have high blood pressure, so odds are coders see the condition documented often. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, AHIMA-Approved ICD-10-CM/PCS Trainer, compares coding for hypertension in ICD-9-CM and ICD-10-CM.

  • Audits help lock down processes, clarify coding

    April 16, 2013

    More and more entities are auditing healthcare claims-Recovery Auditors, Medicare Integrity Contractors, MACs, FIs, commercial payers, and on and on. ­Andrea Clark, RHIA, CCS, CPC-H, CEO, Debbie Mackaman, RHIA, CHCO, and Peggy Stilley, CPC, CPMA, CPC-I, COBGC, ACS-OB, explain how coders and their organizations can benefit from internal audits.

  • Q&A: ICD-9 coding for screening pap

    April 16, 2013

    Q: A physician's office collects a pap specimen and sends the specimen to the hospital lab for processing. The physician's office lists ICD-9-CM code V72.31 (general gynecological examination with or without Papanicolaou cervical smear) as the diagnosis for this service. What is the proper diagnosis code for the hospital to use for billing when only processing the specimen?

  • New molecular pathology coding still complex

    April 16, 2013

    At first glance, the new CPT® codes for reporting molecular pathology services might seem simple. They certainly look easier than the old stacking codes that focused on methodology and processes, resulting in multiple codes and quantities being used to report a single test. Jugna Shah, MPH, and Michelle L. Ruben, detail some of the nuances of correct code assignment for molecular pathology tests.

  • Local Coverage Determinations provide the missing link to complement coding guidelines

    April 16, 2013

    The missing link to correct coding is coder knowledge and practical application of Local Coverage Determinations (LCDs). Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS, reveals how LCDs compliment official coding guidelines for compliant coding.

  • Healthcare News: CMS adds codes to conditionally bilateral list

    April 16, 2013

    CMS added seven CPT® codes to the conditionally bilateral list as part of the April update to the Integrated Outpatient Code Editor. When a provider performs a conditionally bilateral service bilaterally, coders must append modifier -50 (bilateral procedure) to the code.

  • CMS changes Medically Unlikely Edits

    April 2, 2013

    CMS is making a significant change to the Medically Unlikely Edits (MUE) by changing some of them from line-item edits to date-of-service edits, effective April 1. Jugna Shah, MPH, Kathy Dorale, RHIA, CCS, CCS-P, John Settlemyer, MBA/MHA, and Valerie Rinkle, MPA, explain how the change could affect coding and reimbursement.

  • Q&A: ICD-9 codes for lumbrosacral radiology

    April 2, 2013

    Q: We received an outpatient radiology report (exam performed 7/11/12) where the radiologist states:

    CLINICAL INDICATION: LUMBOSACRAL NEURITIS
    EXAM: LUM SPINE AP/LAT
    CLINICAL STATEMENT: LUMBOSACRAL NEURITIS
    COMPARISON: MAY 23, 2012
    FINDINGS: There is posterior spinal fusion L-3-L-5 with solid posterolateral bridging bone graft. Pedicle screws and rods are stable in position. There are bilateral laminectomy defects at L3-L-4. The vertebral body and disc space heights are preserved. The spinal alignment is maintained without evidence of spondylolisthesis. No acute fracture is identified. No lytic or blastic lesions are seen. The sacroiliac joints are unremarkable.
    IMPRESSION: Stable postsurgical changes with solid posterolateral fusion graft.
     

    Would you use the following ICD-9 codes: V67.09, 724.4. or 724.4, V45.4? Our coders disagree.

  • Scrutinize documentation for clues to code breast biopsies

    April 2, 2013

    Breast biopsies should be easy to code because coders have so few codes to assign, but it is one area where documentation is lacking. Stacie L. Buck, RHIA, CCS-P, RCC, CIC, reveals what key elements coders should look for in a breast biopsy note.

  • Use case studies to determine ED E/M level

    April 2, 2013

    With no national guidelines in place for facilities to use to determine evaluation and management (E/M) level, coders must apply their facility’s guidelines when coding an outpatient visit. Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, and Joanne M. Becker, RHIT, CCS, CCS-P, CPC, CPC-I, use three ED case studies to highlight potential pitfalls for ED E/M leveling.