ICD-10 mirrors Y2K; speculation and anxiety surrounding new changes and the unknown. Just like Y2K, we all survived without catastrophic meltdown.Read More
Achieving a better night sleep and less work stress could definitely be added as the seventh and eighth reason to audit this year, but we suspect those will come as benefits to addressing the six reasons to audit in 2017.Read More
The 2017 ICD-10-CM is looking a bit more like ICD-9-CM thanks to the addition to some codes that were forgotten in the first release. As a heavy user of external cause codes and an ED coder at heart, I was so accustomed to using the E927 series that when ICD-10-CM came out I felt lost and forgotten. They may have forgotten the highly used code series; but fear not, they remembered them this year.Read More
As coders we face many struggles, including determining when the use of modifier 25 is appropriate.
Modifier 25 was designed to indicate a significant, separately identifiable evaluation and management (EM) service, by the same physician/specialty on the day of a procedure with a global period of 0/10 days. What can be challenging is knowing when to apply the modifier correctly.Read More
Lumbar spinal fusions are among the most challenging procedures to code, partly because the anatomy is difficult to conceptualize and due to the variety of approaches and combinations of procedures that can be done.
Let’s focus on fusion of the anterior column of the lumbar spine. That’s fusion of the joint (yes, the disc forms a “lower joint”) between the vertebral bodies. Whenever you see an “interbody fusion” you know you’re looking at an anterior column spinal fusion.Read More
Often times we find that some providers are not very specific in their diagnoses documentation. This has always been a concern, however with ICD-10 implementation, specificity has never been more important. Payers have stated that they will be more lax during the first year of ICD-10 implementation and allow for more non-specific codes. However, in the years coming, this relaxed policy is sure to change. That is where coders come in.Read More
Sepsis – every coder’s best friend! Many of us have faced the challenge of reconciling the variations that exist in defining sepsis between ICD-9, ICD-10, providers as a group, and even amongst providers at a single hospital. Change is in the air.
The most traditional concept of sepsis is a bacterial infection of the blood (septicemia) and the havoc this wreaks on the body. Indeed ICD-9 and ICD-10 both fit best to this idea as the codes for sepsis are found squarely among the bacterial infectious disease codes. Of course ICD-10 arguably clarified the situation somewhat...Read More
Question: I’m seeing a lot of physicians assigning diabetes with hyperglycemia for “uncontrolled” diabetes. Somehow this doesn’t seem right. Could someone explain to me what the criteria for hyperglycemia is?
Answer: Hyperglycemia has no strict definition and varies from patient to patient in different situations. Anything over a blood glucose over 100 can be considered “hyperglycemia”. In practice...Read More
Unclear code descriptions and undefined diagnostic terms abound in ICD-10 CM. How are coders and CDI specialists to know what do do?Read More
Are you frequently reviewing your post ICD-10 risk mitigations plan? Did you even create a post implementation risk mitigation plan for your revenue cycle? If the answer is no to either of these questions don’t worry it is not too late to do something. The greatest risk areas in the revenue cycle is a delay in cash flow. You can start a simple risk mitigation plan by asking yourself some simple questions:Read More
Mindy Harris, Physician & Outpatient Coder Audit and Training Manager with Healthcare Resource Group has successfully completed her AHIMA approved ICD-10 Train the Trainer exam. This accomplishment means Mindy is now an approved AHIMA ICD-10-CM/PCS Trainer.Read More