New CMS document features gems that fill risk adjustment voids for coding rules. Coders love rules. In risk adjustment coding, we live by the Official Guidelines for Coding and Reporting, the ICD-10-CM conventions for code lookup, and the AHA Coding Clinic for ICD-10-CM and ICD-10-PCS. Too often, though, we run…
CMS encourages providers to talk, test, and treat STDs. When it comes to sexually transmitted disease (STD) awareness, the Centers for Medicare & Medicaid Services (CMS) is encouraging providers to take three simple steps in protecting their patients through talk, testing, and treating: Talk openly about STDs with your partners…
Expansion of new ICD-10 codes has slowed. The 2019 Inpatient Prospective Payment System proposed rule covers many Medicare Severity Diagnosis-Related Groups (MS-DRGs) changes, in addition to changes to the Value-Based Purchasing (VBP), Hospital-Acquired Conditions (HACs), and Hospital Readmission Reduction program, as well as the post-acute care transfer policy. The length…
The importance of an effective outpatient CDI program cannot be overstated When working with a member of the sales force for a previous employer, I was asked, “What is the biggest problem coders encounter?” My answer, very simply put, was “physician documentation!” I should have added “or lack thereof!” We…
Anticipated schedule of the posting of new ICD-10 codes, including dates for public comment. Typically, after the annual Coordination and Maintenance Committee meeting, the next question is this: when will the new codes be published? The short answer is potentially near late April or early May. Final decisions regarding the…
Review your payer policies when performing these services. Pain management coding can be tricky.  Trigger point injection therapy is a common procedure performed by pain management specialists, orthopedic surgeons, physical medicine and rehab and other specialties. Trigger point injection therapy is used for the treatment of myofascial pain syndrome (MPS).…
Frustrations arise over inconsistent guidance from MACs and CMS. Every single day, I get numerous email notices from the Centers for Medicare & Medicaid Services (CMS) and the Medicare Administrative Contractor (MAC) for our jurisdiction on a wide variety of “priorities:” correct coding, quality measures, new reporting initiatives, and a…
The main burden for this change is on healthcare providers such as physicians, clinics, hospitals. The Centers for Medicare & Medicaid Services (CMS) will start issuing the new Medicare cards with the MBI (Medicare Beneficiary Identifier) number beginning April 1.  The Social Security Number (SSN) based HICN (Health Insurance Claim…
The ICD-10 code set is growing, and feedback from the medical community on the changes is needed. This is the second piece in a series of articles encompassing a review of the Coordination and Maintenance (C&M) Committee meeting held March 6 and 7, 2018. What follows is a review of…
The ICD-10 code set is growing, and feedback from the medical community on the changes is needed. This is the first in a series of articles encompassing a review of the Coordination and Maintenance Committee meeting, which was held March 6 and 7, 2018. First, we will review the procedure…