Many coders and CDI specialists memorized previous Official Guidelines for Coding and Reporting , Coding Clinic for ICD-9-CM and do not have to give them a lot of forethought before applying correctly to their day-to-day reviews. Although many of the Official Guidelines for Coding and Reporting remain the same in ICD-10, none of Coding Clinic's previous advice can be applied to the new code set. Without years of new Coding Clinic advice under their belts, it may take some time before the staff exhibits the same ease when applying ICD-10-CM/PCS codes to the documentation provided.
ICD-10 implementation requires organizational coordination from a variety of departments. Chloe Phillips, MHA, RHIA, and Kayce Dover, MSHI, RHIA, discuss how organizations can overcome challenges regarding staffing, productivity, and data analytics as they prepare for the change.
Despite all the uncertainty surrounding the implementation of ICD-10-CM/PCS, the Cooperating Parties (i.e., the American Hospital Association, AHIMA, CMS, and the National Center for Healthcare Statistics) nevertheless decided that the farewell issue of Coding Clinic for ICD-9-CM (which was published in the first quarter of 2014) will remain the farewell issue.
Coronary artery bypass graft (CABG) procedures are not the only ones coders will report using the root operation Bypass in ICD-10-PCS. Surgeons can create bypasses in other vessels of the body.
The anatomical definition of a body part may not be the same as the ICD-10-PCS identification of a body part. Jennifer Avery, CCS, CPC-H, CPC, CPC-I, Nena Scott, MSEd, RHIA, CCS, CCS-P, and Gretchen Young-Charles, RHIA, explain the guidelines for selecting the appropriate body part and how body parts can affect root operation selection.
The ICD-10 implementation delay mandated by Congress this spring granted providers an extra year to prepare their coders and clinicians on the requirements of the new code set, but a recent survey has found some organizations heading in the wrong direction.
Coders need to understand the different approaches for procedures in ICD-10-PCS because they're required and the new system does not include default or unspecified options. Laura Legg, RHIT, CCS, Nena Scott, MS, RHIA, CCS, CCS-P, and Gretchen Young-Charles, RHIA, explain the different approaches and address gray areas for selecting the most appropriate character.
ICD-10-PCS codes consist of seven characters, each of which identifies a unique, specific piece of information. For most of the codes in the Medical and Surgical section, each character represents the same information every time.
When a physician closes off varices, coders must determine the location and method the physician used to correctly build an ICD-10-PCS code. Nena Scott, MSEd, RHIA, CCS, CCS-P, and Gretchen Young-Charles, RHIA, review the components of different procedures for closing off varices and how to code those procedures in ICD-10-PCS.
If coders choose the wrong root operation in ICD-10-PCS, they will arrive at an incorrect code. Nena Scott, MSEd, RHIA, CCS, CCS-P, AHIMA-approved ICD-10-CM/PCS trainer, Gretchen Young-Charles, RHIA, Anita Rapier, RHIT, CCS, and Nelly Leon-Chisen, RHIA, discuss some of the root operation clarifications offered by Coding Clinic .
ICD-10 implementation and coding present plenty of challenges, especially when it comes to ICD-10-PCS. Sue Bowman, RHIA, CCS, and Donna Smith, RHIA, clear up some misconceptions about ICD-10 implementation and use.
ICD-10-PCS root operations Control and Repair are used when a procedure doesn’t really fit into a different root operation. Nena Scott, MSEd, RHIA, CCS, CCS-P, and Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS , discuss when coders should use these two root operations.
ICD-10 implementation and coding present plenty of challenges, especially when it comes to ICD-10-PCS. Plenty of myths are also floating around and some of them fairly prevalent. One way to make sure the most recent ICD-10 implementation delay is the last ICD-10 implementation delay is to bust some of these myths.
ICD-10-PCS requires coders to possess strong clinical knowledge as well as a solid foundation in anatomy and physiology. Coders need to understand what physicians are actually doing in certain...
ICD-10-PCS includes three root operations that involve taking out or eliminating solid matter, fluids, or gases from a body part. Donna Smith, RHIA, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, review root operations Drainage, Extirpation, and Fragmentation.
Hospitals will still use CPT ® codes to report procedures after ICD-10 is implemented, but some will also code with ICD-10-PCS. Andrea Clark, RHIA, CCS, CPC-H , reviews the advantages and challenges outpatient facilities may face when using ICD-10-PCS.
"Sometimes the questions are complicated and the answers are simple." ?Dr. Seuss This quote seemed an appropriate way to begin a discussion about outpatient encounters and ICD-10-PCS. You see, outpatient procedures will still be coded using CPT ® /HCPCS?the HIPAA-approved code set for reporting hospital outpatient procedures?regardless of when ICD-10 is implemented.
Q: A patient comes into the ED with sickle cell crisis and is in a lot of pain. The physician states the patient needed “aggressive” pain control for treatment, because what was given in the beginning provided only minimal relief. Could I code using CPT ® code 99285 (ED visit for evaluation and management of a patient, including a comprehensive history, comprehensive exam, and high complexity medical decision making)?
ICD-10-PCS will be a big change for inpatient coders. The best way to learn the new coding system is to practice, practice, practice. See how well you know ICD-10-PCS by assigning all applicable ICD-10-PCS codes for the following case.
Learning to code in ICD-10-PCS is in some respects like learning a language, you need a strong foundation in the rules. Sue Bowman, MJ, RHIA, CCS, FAHIMA , Gerri Walk, CCS-P , Nena Scott, MSEd, RHIA, CCS, CCS-P , and Jennifer Avery, CCS, CPC-H, CPC, CPC-I, discuss the guidelines related to root operations in ICD-10-PCS.
Both knee and shoulder replacement procedures include devices and fall under the ICD-10-PCS root operation Replacement (R). Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, CHTS-CP, and Nena Scott, MSEd, RHIA, CCS, CCS-P , review the definition of a device in ICD-10-PCS and review how to code for shoulder and knee replacements.
ICD-10-PCS root operations Occlusion, Restriction, and Dilation involve changing the diameter of a tubular body part. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Angie Comfort, RHIT, CDIP, CCS, review the definitions of these root operations and examine when they should be used.
The April 1 confirmation of the delay in implementing the ICD-10 code set until at least October 1, 2015, certainly took the wind out of many healthcare organizations' sails.
We won’t need to learn any new ICD-10-PCS codes or guidelines for 2015. CMS released the draft codes and guidelines and they include not much of anything. That’s not really a surprise since the code...
Some facilities plan to use both CPT ® and ICD-10-PCS to code procedures after implementation. Kristi Stanton, RHIT, CCS, CPC, CIRCC, and Angie Comfort, RHIT, CDIP, CCS, discuss the advantages and challenges of this strategy, and how to implement it.
When outpatient hospitals and physicians switch to ICD-10-CM diagnosis codes October 1, they will still continue to use CPT ® codes to report procedures. But some facilities are planning to use the new procedure code set, ICD-10-PCS, as well.
Congress needed just a week to throw a huge monkey wrench into the healthcare industry's plans for ICD-10 implementation. On March 26, House leadership introduced H.R. 4302, "Protecting Access to Medicare Act of 2014." By April 1, the bill had passed the Senate and been signed into law by President Obama.
When Congress passed the Protecting Access to Medicare Act of 2014, it mandated at least a one-year delay in ICD-10 implementation. Members of the Briefings on Coding Compliance Strategies editorial board, who represent a wide range of industry stakeholders, offered their thoughts on two questions related to the delay.
At the time of this publication, the Protecting Access to Medicare Act of 2014 bill was recently passed. The status quo regarding physician reimbursement from Medicare has been maintained. So what? That system has been broken for 20 years. ICD-10 will be postponed for provider billing for another year. So what? Life will go on as it has for the past 36 years with ICD-9-CM. In other words, nothing has changed. We're good for another year. Pressure's off! ...Right?
Four ICD-10-PCS root operations involve procedures that put in, put back, or move some or all of a body part. Gerri Walk, RHIA, CCS, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, CHTS-CP, highlight the differences among Reattachment, Reposition, Transfer, and Transplantation.
A patient undergoes a hysterectomy and experiences post-procedural bleeding. The surgeon cauterizes the bleed and evacuates a blood clot. In ICD-10-PCS, how do you code the cauterization? With the...
Plenty of uncertainty surrounds the ICD-10 implementation delay, but healthcare organizations shouldn’t put the brakes on their plans. Cheryl Ericson, MS, RN, CCDS, CDIP , William E. Haik, MD, FCCP, CDIP , Monica Lenahan, CCS , Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and James S. Kennedy, MD, CCS, CDIP, offer thoughts on how to keep moving forward with ICD-10.
Coding Clinic's Third and Fourth Quarter 2013 issues focus considerable attention on ICD-10-PCS procedure coding. On p. 18, Coding Clinic Third Quarter 2013 states that the coding of a peripherally inserted central catheter (PICC) depends on the end placement of the PICC line?that is, where the device ends up.
Coders may struggle to differentiate between ICD-10-PCS root operations Excision and Resection. Nena Scott, MSEd, RHIA, CCS, CCS-P, AHIMA-approved ICD-10-CM/PCS trainer, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, illustrate the details that will help coders arrive at the correct root operation.
Sometimes a surgeon must take drastic action and amputate a patient’s upper or lower extremity. For these cases, we would use ICD-10-PCS root operation Detachment (third character 6). ICD-10-PCS...
Map (third character K) is a very narrowly defined ICD-10-PCS root operation. By definition, Map procedures are used to locate the route of passage of electrical impulses and/or locate functional...
Coders may struggle to differentiate the ICD-10-PCS root operations excision and resection. Nena Scott, MSEd, RHIA, CCS, CCS-P, AHIMA-approved ICD-10-CM/PCS trainer, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, explain why excision is the root operation of choice for excisional debridement and sebaceous cyst removal.
Almost all of the ICD-10-PCS root operations describe very specific intent. Think about the difference between root operations excision and resection. Excision involves removing some of a body part...
ICD-10-CM root operations excision and resection are sometimes hard to differentiate. ICD-10-PCS defines excision (B) as cutting out or off, without replacement, a portion of a body part. Resection (T) is almost identical, but involves cutting out or off the entire body part.
CMS reversed course earlier this week and announced it will conduct end-to-end ICD-10 training with a sample of providers. Previously, CMS had stated it would not conduct any end-to-end testing...
ICD-10-PCS defines devices for coding purposes in a very specific way. Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Mark Dominesey, RN, BSN, MBA, CCDS, CDIP, CHTS-CP, explain how to assign the correct device character in ICD-10-PCS.
Inpatient coders will see an entirely new coding system October 1 when they begin officially using ICD-10-PCS. However, MS-DRGs are not changing. The only thing that is changing is what codes map to a particular MS-DRG.
Decreased productivity isn’t the only looming concern with the transition to ICD-10. Scot Nemchik, CCS , and Rachel Chebeleu, MBA, RHIA , reveal why accuracy will be just as important as productivity.
Odds are, most coders will never use ICD-10-PCS table 0W4. Why? Because root operation 4 is creation (making a new genital structure that does not physically take the place of a body part). Unless...
It’s the gift-giving season and HCPro is giving you free on-demand access to the audio conference, ICD-10-PCS: Coding, Structure and Format, when you sign up for the January 10 live webcast, ICD-10-...
Different studies using different methodologies all point to the same conclusion: Coder productivity will decrease after the switch to ICD-10. However, no one knows what will happen to coding accuracy.
