Coding - ICD10monitor

As we near the end of what some consider the most unprecedented year in coding, there are more updates to review and decipher in preparation for 2021.   As the science around the COVID-19 pandemic continues to evolve, there remain many unknowns of post-COVID-related conditions. There is an ongoing and…
New procedure codes do not impact the MS-DRG assignment. The Centers for Medicare and Medicaid Services (CMS) released 21 new ICD-10-PCS codes that apply to the vaccination or treatment of COVID-19. These codes are effective January 1, 2021.  The procedure codes introduce six specific medications that can be used for…
Dysrhythmias like complete heart block, AF, and SSS all fall into HCC 96, with a risk adjustment factor of 0.268. Our listeners and readers ask the most interesting questions! One named Dena recently wrote me and said, “I am an HCC coder, and there is a hot debate about coding…
Some third-party payers have reimbursed and will continue to reimburse providers for this new CPT code; others won’t. The American Medical Association (AMA) published a new CPT® code on Sept. 8 that accounts for extra provisions to ensure patient and provider safety during a public health emergency (PHE).  The code is effective immediately: CPT 99072 – Additional supplies, materials, and clinical…
If a patient has COVID-19 and pneumonia, he or she should be admitted to a skilled nursing facility (SNF) at the hospital until the patient tests negative. There are frequent coding questions for non-acute care facilities posted in coding listservs. One official resource that will assist in answering questions for…
November is Diabetes Awareness Month. November is Diabetes Awareness Month, and it seems additionally appropriate to review diabetes when there is a focus on chronic diseases.     According to the World Health Organization (WHO), diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin…
The mood of the country impacts claims. There are a few words that can be associated with the pandemic and the election. These words are the following: Stress – a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances Anxiety – a feeling of…
Federal approval of the Pfizer vaccine, believed to be better than 90 percent effective, could occur before the end of the month. When the long-awaited and much-anticipated COVID-19 vaccine becomes available in the U.S., a development that could take place before the end of the year, a set of new…
There are false negatives; there are false positives; there are untested individuals with disease.  I am in the process of developing a 90-minute COVID-19 webinar for ICDUniversity in December to outline new codes and updates, and my inbox is replete every day with articles about the coronavirus. On Sunday, I…
Coding audits provide insight into the process of coding itself. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has developed several healthcare compliance programs, and within the key elements of these programs you will find forms of auditing, along with monitoring. Auditing is viewed…