Within the ICD-10-CM code set there are 21 chapters. The code range F01-F99 within Chapter 5 covers mental, behavioral and neurodevelopmental disorders. Within this chapter there are a variety of code blocks grouping mental disorders together and covering the following... Read more...
There are 20 pediatric sub-specialties recognized by the American Board of Pediatrics today, and that doesn’t include surgical or radiological sub-specialties recognized and accredited by other board agencies. Specialists, who practice exclusively at one of 183 pediatric hospitals or 68 National Cancer Institute-designated cancer centers nationwide, have unique...Read more...
Transitioning to ICD-10 has been an ongoing challenge to providers due to resource demands and time and monetary restraints. Various providers have performed an initial assessment and until recently had been proceeding to do the following...Read more...
October, 15 2013 / Kim Carr
Roseanne Barr once said that she likes facts and data because they help her think clearly. With dual coding, it is easy to rationalize the reasons and justify the means. But what really matters is the output. Dual-coding efforts must produce useful information to prepare your organizations for ICD-10. Measuring, monitoring, and tracking dual-coding data ensures that investments in time, money, and staff produce a solid return. Business intelligence gleaned from dual-coding data helps accurately measure ICD-10’s productivity, quality, and financial impacts. With dual coding already underway, now is the time to build your arsenal of ICD-10 data... Read more...
July 29, 2014 / Lisa Roat, RHIT, CCS, CCDS
One of the most sophisticated reimbursement models in the United States involves hierarchical logic for grouping a coded health record into a designated payment group based upon the Medicare Severity Diagnosis Related Group (MS-DRG). This is the basis of payment used in the Medicare Inpatient Prospective Payment System (IPPS). The undertaking by the Centers for Medicare & Medicaid Services (CMS) to switch from ICD-9 to ICD-10 is a significant project, and the preliminary results have been described... Read more...
June 03, 2013 / Paul Weygandt, MD, JD, MPH, MBA, CPE
On April 1, 2014, when the Protecting Access to Medicare Act of 2014 (Pub. L. No. 113-93) was enacted, most of us were caught off-guard. Along with once again patching the SGR methodology for physician payment, ICD-10 implementation was delayed at least until October 1, 2015. On May 1, CMS announced it would be publishing an interim final rule including a mandatory compliance date of October 1, 2015... Read more...
January 21, 2013 / Janis Oppelt
Just a year ago, the idea of actually being ready for ICD-10 implementation by October 1, 2014, seemed a distant dream, full of confusion and panic. Since then, a lot of people have done a lot of work to get the ball rolling in the right direction, and the guests on the January 13 edition of the “Talk-Ten-Tuesday” broadcast, produced by ICD10monitor, shared the progress they’re making in two important areas: payer readiness and physician education... Read more...
March 12, 2013 / Patricia Trela, RHIA
The “ostrich” approach will not work in this case, because ICD-10 is not going away. There is much to be done prior to implementation. Two different sets of ICD codes are required, one set for the IRF PAI, and another set for the UB-04.
The ICD-9-CM guidelines for assignment of codes for inpatient discharges by facilities paid under the Inpatient... Read more...
June 3, 2014 / Juliet A. Santos, MSN, CCRN, FNP-BC
One of the challenges of the previous October 1, 2014, deadline was the “rush factor” that seemed to cause organizations to circumvent the details of testing all systems, which could overwhelmingly affect their level of success. In addition, during the WEDI Conference in Hollywood, Calif., on May 12-15, participants once again discussed a major gap in healthcare IT today. Because healthcare has never really had an end-to-end test ... Read more...
July 22, 2014 / Billy Richburg, M.S., FHFMA
As expected, as usual – OK, as required by law – the Centers for Medicare & Medicaid Services (CMS) has published the proposed rules for all the various types of inpatient services and now is taking comments to incorporate into the final rule (which, also by law, should be available on Aug. 2). What is changing, assuming that most of the proposed rule carries over to the final rule? Not much, really, and nothing we didn’t expect. Here are a few key points to show... Read more...
Podcast Date: 8/27/2013 Are any payers saying they will require ICD-10-PCS for outpatient services? Response Ratio A. Outpt Surg/ED/GI 10% B. Observation 4% C. Ancillary Services 2% D. Combination of A, B and C 33% E. Not appliccable 51%...
July 9, 2013 / Lauri Gray, RHIT, CPC
Transient cerebral ischemia is defined as a temporary loss of blood flow to an area in the brain. In ICD-9-CM, codes for transient cerebral ischemia are classified under circulatory system diseases and are found in Chapter 7, Diseases of the Circulatory System. Conditions classified as transient cerebral ischemia are listed in category 435 and include basilar artery syndrome (435.0), vertebral artery syndrome (435.1), subclavian steal syndrome (435.2), and vertebro-basilar artery syndrome (435.3)... Read more
June 03, 2014 / Joseph C. Nichols, MD
There is a widely held belief that ICD-10-CM is much more “granular” and will require much greater specificity. It is true that ICD-10-CM will support the reporting of much more specific and detailed information about risk, severity, complexity, comorbidities, and complications, and other key parameters of patient evaluation. There’s a little secret that is seldom mentioned, however: You can be just as vague in ICD-10 as you were in ICD-9... Read more
April 1, 2014 / Angela Carmichael
Hospital inpatient procedure reporting is governed primarily by the Uniform Hospital Discharge Data Set (UHDDS) reporting criteria, in addition to payer-specific guidelines. The UHDDS indicates that all “significant procedures” should be reported in the short-term, acute-care hospital setting. It defines “significant procedures” as those that meet any of the following criteria: being surgical in nature, carrying a procedural or anesthetic... Read more
August 5, 2014 / Juliet A. Santos, MSN, CCRN, FNP-BC
We’ve got a date! Much of the healthcare industry was stunned on March 31, when Congress announced that due to passage of the Protecting Access to Medicare Act of 2014, ICD-10 could not be implemented before Oct. 1, 2015. Things looked dismal, as though all hope was lost for a time, with providers stuck not knowing whether ICD-10 was coming or going. Doubts, skepticism, confusion, and frustration initially... Read more...
July 23, 2013 / Janis Oppelt
If leaders from the Centers for Medicare & Medicaid Services (CMS) have said it once, they’ve said it a hundred times: The October 1, 2014, implementation date for ICD-10 will not change, and the healthcare industry must be ready or face the consequences. In fact, CMS’s attorneys have advised the agency that it cannot provide enforcement delays as it did for the 5010. This is just one of the messages that CMS representatives stressed during a July 15 agency listening session... Read more
Career Step has over 20 years of experience successfully training healthcare professionals. This experience in online adult learning has been combined with the ICD-10 expertise of YES HIM Consulting, Inc. in the development of The ICD-10 Solution, which is... Read more
November 26, 2013 / Lolita M. Jones, RHIA, CCS
ICD-10-PCS represents a major departure from ICD-9-CM procedure coding, and as such, many coding specialists find ICD-10-PCS much more challenging to learn than ICD-10-CM (which still shares many similarities with ICD-9-CM). In order to ease the transition from one code.... Read more
March 26, 2013 / Donna Richmond, BA, RCC, CPC
When October 1, 2014, rolls around, the ICD-10-PCS (procedural coding system) will replace the ICD-9-PCS currently used for inpatient procedures. Code assignments under this system will be very different for all inpatient coding professionals, starting with the idea that they will need to “build” a seven-character code—either for medical-surgical procedures or ancillary services, which include imaging, nuclear medicine, and radiation oncology... Read more
March 19, 2013 / Rebecca DeGrosky, RHIT
In the Medical and Surgical section (first character 0), there are 31 root operations with standardized terminology and no procedure names, no diagnostic information, and no eponyms. So far, we have covered 24 of them, and today will bring us to the remaining ones. We have gone over the notion that a fracture reduction is the root operation reposition, and that there is no appendectomy listing in ICD-10-PCS. Coders... Read more
July 1, 2014 / Tim McMullen, JD, CAE
Whether you were annoyed or relieved by the announcement of another delayed implementation of ICD-10, the benefit of having additional time to ensure a smooth transition can work to your favor. The expertise that is held by your practice management system (PMS) vendor is a key component that can contribute to a smooth transition. Many PMS vendors have integrated ICD-10 within their systems, so these vendors are ready and have the ability to test now. You likely have been getting updates from your vendor... Read more
August 11, 2014 / Lolita M. Jones, RHIA, CCS
The process of constructing codes in ICD-10-PCS is designed to be logical and consistent: individual letters and numbers called "values" are selected in sequence to occupy the seven spaces of the code, called "characters." In ICD-10-PCS sections 0 through F, the fourth character defines the body part, body system, body region, or treatment site – i.e., the specific anatomical site where the procedure or service... Read more
How to Use Coded Data to Meet the Needs of Non-Medicare Patients
Does your clinical documentation improvement program go beyond just reporting on Medicare patients to include working folks, young men, women and children whose lives are covered by commercial payers?
How to Help Your Physicians with Their Reporting Requirements
Physicians at your facility need your help. But don't count on them to come to you for assistance. They won't, but you can.
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