Cross-training coders has definitive short-term advantages, such as enhancing staff coverage during holidays and vacations and increasing the department's ability to handle periods of fluctuation in certain bill types. But coding managers might not realize that these benefits can also help hospitals with long-term preparation for ICD-10. Angie Comfort, RHIT, CCS, and Rose T. Dunn, MBA, RHIA, CPA, FACHE, explain the benefits of cross training coders as ICD-10 approaches.
Pain is an expected component of injuries, illnesses, and surgical procedures. In some instances, however, the patient's pain is unexpected or is worse than predicted. Sometimes, the pain can last well beyond the time it should have resolved. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, and Susan E. Garrison, CHCA, CHCAS, CHC, PCS, FCS, CCS-P, CPAR, CPC, CPC-H, provide tips and guidance to help coders accurately report pain management diagnoses and procedures.
Emergency Departments (EDs) see a wide range of illnesses and injuries, from minor to major, which may require critical care. Lois E. Mazza, CPC, details how critical care is defined, what elements providers must document, and under what circumstances critical care can be coded for ED patients.
With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in anatomy and physiology. To help coders prepare for the upcoming transition, we will provide an occasional article about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation. This month’s column addresses the anatomy of the eye.
The Rh factor of positive and negative can lead to problems between a mother and the developing fetus, a condition known as mother-fetus incompatibility. In some cases, the mother must receive the Rho(D) immune globulin. Lori-Lynne A, Webb, COBGC, CPC, CCS-P, CCP, CHDA , explains the diagnostic and procedure coding options for Rho(D) immune globulin.
The guiding principle is the definitive methodology used for all risk adjustment medical record reviews. Successful Medicare Advantage (MA) plans focus on early disease detection, coordination of care, and accurate reporting of members’ chronic conditions by primary care physicians, retrospective and prospective pursuits to drive and improve health outcomes. Holly J. Cassano, CPC, guides coders through the principles of risk adjustment for MA plans.
Coders will need very specific information in order to code for fractures in ICD-10-CM, including the type of fracture, specific bone fractured, and whether the patient is seen for an initial or subsequent visit. Robert S. Gold, MD, Sandy Nicholson, MA, RHIA, and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, detail the information physicians must document for accurate fracture code assignment.
The Bishop’s Score is primarily a scoring system to assess the viability and/or success of an induction of labor, odds of a spontaneous pre-term delivery, or whether a cesarean section should be considered instead of a vaginal delivery. Lori-Lynne Webb, CPC, CCS-P, CCP , explains how physicians tally the Bishop’s Score and what coders should look for in the documentation.
As charges become more specific to provide additional concrete and transparent cost data, providers must consider what procedures they routinely provide to patients and what procedures are specifically related to the patient's condition. Denise Williams, RN, CPC-H, and Kimberly Anderwood Hoy, JD, CPC, reveal tips for determining when to separately bill for ancillary bedside services provided to inpatients.
The transition to ICD-10-CM is coming. The only question is when. Despite the possible delay, coders and other HIM professionals must continue to prepare for the transition. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, Sandy Nicholson, MA, RHIA, Robert S. Gold, MD, Jennifer Avery, CCS, CPC-H, CPC, CPC-I, and Kim Felix, RHIA, CCS, provide information on how ICD-10-CM will—and will not—differ from ICD-9-CM.
