The American Health Information Management Association (AHIMA) continues to advocate for no delay in the implementation date for ICD-10-CM and ICD-10-PCS.
CMS instructed fiscal intermediaries (FI) and Medicare Administrative Contractors (MAC) to hold claims containing CPT ® code 33249 (insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead[s], single or dual chamber) and HCPCS code C1882 (cardioverter-defibrillator, other than single or dual chamber [implantable]).
CMS continues to add more screening services to the list of covered preventative services. The newest additions involve screenings for sexually transmitted infections (STI).
Coders who are preparing for the upcoming transition to ICD-10-CM should note some significant changes to the coding guidelines for glaucoma coding as part of the 2012 updates to the ICD-10-CM Official Guidelines for Coding and Reporting .
CMS added four new J codes for reporting drugs and biologicals that previously did not have specific codes available as part of the 2012 Outpatient Prospective Payment System updates ( Transmittal 2376 ).
Q: I have been told by our billers that infusion codes reported in the ED along with an E/M code that has modifier -25 (significant, separately identifiable evaluation and management service on the same day of the procedure or other service) require another modifier. I thought that -25 is the only modifier that should be submitted, unless the provider started a second infusion at a second site on the body. This is the first time I’ve been told the infusion coder need a modifier if the E/M has modifier -25 appended. All of my educational articles tell me that the two can be reported together. Have I missed an update somewhere along the way?
Q: I have a question regarding facility coding for evaluation and management (E/M) levels, not for an ED physician, but for facility-level nursing in the ED. If a specialist is called to evaluate or consult on a patient, the nursing intervention is what the facility-level criteria is based on. For example, a patient has difficulty walking, a nurse assists the patient to get an x-ray, takes vitals, does an initial assessment, then provides discharge instructions of moderate complexity. I would code this scenario as a level 3.
