News

New guidance for coding vaping is retroactive to Oct. 1 discharges.   The Center for Disease Control and Prevention (CDC) has posted new coding guidance regarding e-cigarette lung injuries. This guidance, posted Oct. 17, 2019, is retroactive to Oct. 1, 2019 discharges.   The guidance states that coding professionals should report…
Conduct coding audits in all settings and check vendors’ coding credentials are among lessons learned under ICD-10. When we left ICD-9-CM, there were around 14,000 diagnosis codes in use across the healthcare industry – and then, on Oct. 1, 2015, we moved to approximately 69,000 codes. ICD-10-CM/PCS implementation was a…
During a recent conference call, the agency described assessing 64,883 ICD-10-CM diagnoses. I participated in the Centers for Medicare & Medicaid Services (CMS) conference call last Tuesday, explicitly focusing on complication and co-morbidity (CC) or major CC (MCC) designation methodology. This process is similar to how CMS originally determined comorbid…
EDITOR’S NOTE: Five Looking at Ten is a month-long series on ICD10monitor and Talk Ten Tuesdays that examines lessons learned since the nation’s healthcare system adopted ICD-10 – many of which are expected to come into play with the looming transition to ICD-11. George Vancore of Blue Cross Blue Shield…
There is a disconnect between what the doctor may have ordered and what the EHR read or translated. In my capacity as a healthcare consultant and auditor, I review patient records from all over the country – actually, the world, with the ever-growing popularity of offshore companies now performing coding…
There is a difference between mortality and morbidity and knowing the difference is essential for coders. Often, when used in the healthcare environment, the terms “mortality,” “morbidity,” and “severity of illness (SOI)” are interwoven. However, by definition, they are quite different. Those within the healthcare industry need to understand the…
Expanding clinical conversations to involve all players can only benefit the entire organization. EDITOR’S NOTE: This article is based upon Dr. Erica Remer’s remarks during a recent live Talk Ten Tuesdays Internet broadcast. A while back, I told readers about a fun activity I do with one of my clients.…
EDITOR’S NOTE: This is the first in a two-part series of articles highlighting detailed examples of two challenged denials that followed third-party healthcare audits. I shouldn’t be surprised.  I have been reviewing denials by insurance companies since the late 1980s. I’ve seen the same things over and over again, such…