coding - ICD10monitor

Coders must ensure documentation supports the service, either moderate sedation or MAC. Coding moderate sedation (or conscious sedation) and monitored anesthesia care (MAC) is not difficult; however, distinguishing what the services provided are and deciphering conflicted information about which physicians can report what codes can be confusing for some coders…
When considering to use the T code, simply tell the truth. Is your institution reluctant to code a T code? Are your quality professionals concerned about being penalized for any complication that crops up during the patient stay? Are they asking the clinical documentation integrity (CDI) team to contrive by…
Facilities are urged to re-double coder training and education. Coders and auditors are taught to be diligent for the high frequency, high cost, and problem-prone cases as these topics are the focus on third-party reviewers. What does that mean for the new coder? The new coder may not be aware…
Ten things to consider before outsourcing your healthcare needs.  I have spent a good part of the past 10 years in the healthcare industry, immersing myself in the workings of foreign countries as it relates to coding, billing, compliance, HIPAA, Protected Health Information (PHI), etc., and have found that there…
Are there “Zs” in your spinal fusion coding? The fiscal year (FY) 2019 ICD-10-PCS updated an area that has not received much attention: Spinal fusion codes. During the Centers for Medicare & Medicaid Services (CMS) Coordination and Maintenance Committee meeting in September 2017, the topic of invalid spinal fusion codes…
Local radio station personality goes public with his cancer fight. In August 2018, Marty Griffin, KDKA radio personality, announced to his listening audience that he had cancer. His cancer is related to human papilloma virus (HPV), which infects 80 million people, according to the Centers for Disease Control and Prevention…
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…