coding - ICD10monitor

Changes coming with 2019 Official Guidelines for Coding and Reporting of ICD-10-CM The 2019 Official Guidelines for Coding and Reporting of ICD-10-CM have been released, and they certainly encompass some notable changes, as always. Changes occur in the “Conventions,” the “General Guidelines,” and several chapter-specific guidelines as well. Narrative changes…
New codes to be presented at the September Coordination and Maintenance Committee meeting There is a lot of buzz in the industry about the possibility of ICD-11. We are so many years from that becoming a possibility, though, with our clinical modifications and political culture. And we still have a…
Document it right on the front end; avoid fighting a denial on the back end I was recently asked about a post from Hospital Performance regarding acute respiratory failure and airway protection (https://soundphysicians.com/blog/2018/06/20/from-the-appeals-desk-acute-respiratory-failure-part-1-2/), and I wanted to expand on what the author, Dr. Hesham Hassaballa, wrote. A key point is…
The industry knows that focusing more on SDoH reduces costs. Healthcare costs and coding have been married over 35 years, since the Social Security Act was amended to include a national Diagnostic Related Groups (DRG)-based hospital prospective payment system for all Medicare patients.  The culture of the healthcare industry changed…
An inspiring story about rebranding a facility’s CDI department To raise a torch to the strength of women working in healthcare I must share an introductory story on the transformation of a revitalized CDI Department that has pursued success through the strength of 23 women, and the celebrations are taking…
Physician documentation issues during an audit go beyond CDI. The issues are the chief complaint and HPI. Editor’s Note: This is the second piece in a four-part series that examines physician documentation issues as seen by an auditor. As I discussed in the first portion of our series on physician…
CCD is when the typical and customary documentation of a condition does not line up with the available codes or the indexing. Last week, I discussed the Type 2 MI issue. This week, I will address the higher-level problem of the “coding-clinical disconnect,” which I am going to refer to…
HIM coding can play a part in stopping the abuse and neglect of children Marking April as National Child Abuse Prevention Month, we note that the Center for Disease Control (CDC) reports that child abuse and neglect are significant public health issues in the United States. The CDC reports that…
It is highly recommended to self-audit first, internally, with qualified staff. EDITOR’S NOTE: This is the first in a four-part series on the importance of passing or failing an audit and avoiding being a red-flag to payers. One of the services I offer, aside from coding and billing education, is…
Type 2 MI is not a coding construct.  I received some correspondence regarding my Type 2 myocardial infarction article last week which prompted me to ponder the coding-clinical disconnect. Let us address the Type 2 MI concerns this week, and next week, I will tackle the broader picture. Historically, the…