4/27/2015. Today s Presenter. ICD-10 Documentation

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1 ICD-10-CM Documentation and Diagnosis: Primary Care By Tammy Jones, CPC, COC Today s Presenter Tammy Jones, CPC, COC SVA Healthcare Services, LLC jonest@sva.com ICD-10 Documentation Objectives Practitioner impact Common pitfalls Keys to successful documentation ICD-10 specific examples Review impact, pitfalls and successful documentation of each example 1

2 ICD-10 Documentation Background Medical diagnoses identified by TNPCA Common and usual conditions Primary or secondary Typical for the FQHC environment Practitioner Impact Documentation productivity Practitioner queries EHR diagnosis entry Superbill/charge slip Pitfalls EHR/paper templates EHR diagnosis entry/superbills Thinking it s just not going to happen 2

3 Successful Documentation Today s education Key ICD-10 Concepts Small meaningful additions Documentation templates EHR or paper ICD-10 Concepts Type Temporal Severity Location/laterality/anatomy Caused by/complications/manifestations Episode Medical ICD-10 Endocrine Mental, Behavioral Eye and Adnexa Circulatory Respiratory Digestive Musculoskeletal Signs and Symptoms 3

4 Endocrine ICD-10 Chapter 4 ICD-10 codes E00-E89 Diabetes Hyperlipidemia Hypothyroidism Obesity Diabetes Mellitus ICD-9 Code range codes ICD-10 Code range E E codes Impact & Pitfalls Additional documentation Type (1, 2) Complications/Cause (ulcers, drug induced etc.) Templates Missing specificity (insulin use, assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? 4

5 Diabetes Mellitus Type TLCE DM due to underlying condition DM induced by drug/chemical DM type 1 DM type 2 DM other Diabetes Mellitus Complications (TLCE) Hyperosmolarity Ketoacidosis w or w/o coma Kidney Ophthalmic Neurological Circulatory Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Due to, caused by, with Type 1 or 2 Update templates/superbills Add common verbiage/codes 5

6 Assessment: Diabetes What s missing? E11.9 Diabetes type 2 without complications. Default coding if specificity is not documented = DM type 2 Assessment: DM 1 Better Subjective documents patient is on insulin (good!) and problem list indicates the patient also has neuropathy and neuro exam of the feet was performed. Coding query for relationship of DM and neuropathy E10.9 Type 1 diabetes without complications DM 1 w neuropathy E10.40 Type 1 diabetes mellitus with diabetic neuropathy, unspecified and Z79.4 Long term (current) use of insulin DM 1 & neuropathy E10.9 Type 1 diabetes without complications and G62.9 Polyneuropathy, unspecified and Z79.4 Long term (current) use of insulin 6

7 Hyperlipidemia ICD-9 Code range codes ICD-10 Code range E78.0 E codes Impact & Pitfalls Additional documentation Type (group a, b, etc.) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Hyperlipidemia Type TLCE Pure Hypercholesterolemia (grp A) Combined/Mixed (grp C) Group (ABC or D) Lipoprotein deficiency Other 7

8 Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Pure, mixed Update templates/superbills Add common verbiage/codes Assessment: Hyperlipidemia What s missing? E78.5 Hyperlipidemia, unspecified Assessment: Mixed hyperlipidemia Better E78.2 Mixed hyperlipidemia 8

9 Hyperlipidemia Hyperlipidemia E78.5 Hyperlipidemia, unspecified Mixed hyperlipidemia E78.2 Mixed hyperlipidemia Hypothyroidism ICD-9 Code range codes ICD-10 Code range E01.8 E03.9; E codes Impact & Pitfalls Additional documentation Type (congenital) Complications/Cause (postprocedural) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? 9

10 Hypothyroidism Type TLCE Congenital w or w/o goiter Iodine-deficiency Neonatal Caused by/due to (TLCE) Medicine/other exogenous substance Post-procedural Post-infectious Success Focus on TLCE contributing factors Key word(s) Small additions to documentation congenital Update templates/superbills Add common verbiage/codes Assessment: Hypothyroid What s missing? E03.9 Hypothyroidism, unspecified 10

11 Assessment: Hypothyroid caused by interferon Better History documents intentional overdose 2 months ago E03.2 Hypothyroidism due to medicaments and other exogenous substances Hypothyroidism Hypothyroidism E03.9Hypothyroidism, unspecified Hypothyroid caused by interferon T37.5x2D Poisoning by antiviral drugs, intentional self-harm, subsequent encounter and E03.2 Hypothyroidism due to medicaments and other exogenous substances Obesity ICD-9 Code range codes ICD-10 Code range E66.0 E codes 11

12 Impacts & Pitfalls Additional documentation Type (overweight vs obese) Cause (eating, drugs) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Obesity Type TLCE Overweight versus Obesity; Caused by (TLCE) Drug induced Excess calories Pituitary/adrenal gland disorder Other specified Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Due to Update templates/superbills Add common verbiage/codes 12

13 Assessment: Obese What s missing? Vitals document BMI of 53, coding query regarding morbidity and cause E66.9 Obesity, unspecified Assessment: Morbid obesity, overeating Better E66.01 Morbid (severe) obesity due to excess calories Obesity E66.9 Obesity, unspecified Morbid obesity, overeating E66.01 Morbid (severe) obesity due to excess calories 13

14 Mental & Behavioral ICD-10 Chapter 5 F01-F99 ADHD ADHD ICD-9 Code range codes ICD-10 Code range F90.0 F codes Impacts and Pitfalls Additional documentation Type (inattentive) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? 14

15 ADHD Type TLCE Predominantly Inattentive Hyperactive Combined Success Focus on TLCE contributing factors Key word(s) Small additions to documentation combined Update templates/superbills Add common verbiage/codes Assessment: ADD (or ADHD) What s missing? F90.9 Attention-deficit hyperactivity disorder, unspecified type 15

16 Assessment: ADHD combined Better Coding/auditing staff should not take documentation from subjective or exam to help determine specificity. F90.2 Attention-deficit hyperactivity disorder, combined type ADHD ADD/ADHD F90.9 Attention-deficit hyperactivity disorder, unspecified type ADHD combined F90.2 Attention-deficit hyperactivity disorder, combined type Eye and Adnexa Chapter 7 H00-H59 Visual refractive errors 16

17 Visual refractive errors ICD-9 Code range ; ; codes ICD-10 Code range H44.20; H52.00 H52.229; H codes Impacts & Pitfalls Additional documentation Type (regular, degenerative) Laterality (left, bilateral) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Astigmatism Type TLCE Regular Irregular Laterality TLCE Left Right Bilateral 17

18 Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Bilateral, regular Update templates/superbills Add common verbiage/codes Assessment: Astigmatism What s missing? Coding query for laterality H Unspecified astigmatism, unspecified eye Assessment: Regular astigmatism bilateral Better Coding/auditing staff should not take documentation from subjective or exam to help determine specificity. H Regular astigmatism, bilateral 18

19 Astigmatism Astigmatism H Unspecified astigmatism, unspecified eye Reg astigmatism, bilateral H Regular astigmatism, bilateral Hyperopia Laterality TLCE Right Left Bilateral Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Left Update templates/superbills Add common verbiage/codes 19

20 Example Assessment: Hyperopia What s missing? Coding Query for laterality H52.00 Hypermetropia, unspecified eye Example Assessment: hyperopia, left Better Coding/auditing staff should not take documentation from subjective or exam to help determine specificity. H52.02 Hypermetropia, left eye Hyperopia Hyperopia H52.00 Hypermetropia, unspecified eye Hyperopia, left H52.02 Hypermetropia, left eye 20

21 Myopia Type TLCE Degenerative Laterality TLCE Right Left Bilateral Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Degenerative, right Update templates/superbills Add common verbiage/codes Assessment: Myopia What s missing? Coding query for laterality H52.10 Myopia, unspecified eye 21

22 Assessment: Progressive myopia left Better Coding/auditing staff should not take documentation from subjective or exam to help determine specificity. H44.22 Degenerative myopia, left eye Myopia Myopia H52.10 Myopia, unspecified eye Progressive myopia left H44.22 Degenerative myopia, left eye Presbyopia No TLCE Assessment: Presbyopia H52.4 Presbyopia 22

23 Circulatory Chapter 9 I00-I99 Hypertension Hypertension ICD-9 Code range ; 416.0; codes ICD-10 Code range I10 I15.9; I27.0; I codes Impacts & Pitfalls Additional documentation Type (primary, secondary) Complications (with CKD) Templates Missing specificity (assessment options, CKD stages) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? 23

24 Hypertension Type TLCE Primary Secondary/Caused by - TLCE Renovascular/endocrine disease, etc. Hypertension Complications TLCE Heart Kidney Ocular Pregnancy Pulmonary Venous/Ulcers Success Focus on TLCE contributing factors Key word(s) Small additions to documentation With, due to, secondary Update templates/superbills Add common verbiage/codes 24

25 Assessment: HTN What s missing? I10 Essential (primary) hypertension Assessment: HTN, primary Subjective documents patient also has CKD but stage is not noted Coding query for CKD stage I12.9 Hypertensive CKD with stage 1 through stage 4 CKD, or unspecified CKD Hypertension HTN, primary I10 Essential (primary) hypertension HTN, CKD stage 3 I12.9 Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease and N18.3 Chronic kidney disease, stage 3 (moderate) 25

26 Respiratory Chapter 10 J00-J99 Bronchitis COPD Asthma Laryngopharyngitis Acute maxillary sinusitis Allergic Rhinitis Bronchitis ICD-9 Code range ; ; codes ICD-10 Code range J20.0-J20.9; J40-J42 15 codes Impacts & Pitfalls Additional documentation Type (acute, chronic-simple) Complications (with COPD) Templates Missing specificity (tobacco use, exposure) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? 26

27 Bronchitis Type/Temporal TLCE Acute/subacute Chronic Simple Mucopurulent Mixed Acute Bronchitis Caused by/complication - TLCE Bronchiectasis COPD Chemical H. Influenza Radiation Virus/strep/rhinovirus Assessment: Bronchitis What s missing? J40 Bronchitis, not specified as acute or chronic 27

28 Assessment: Simple chronic bronchitis Subjective documents tobacco exposure in home environment J41.0 Simple chronic bronchitis Bronchitis Bronchitis J40 Bronchitis, not specified as acute or chronic Simple chronic bronchitis J41.0 Simple chronic bronchitis and Z77.22 Contact with and (suspected) exposure to environmental tobacco smoke COPD ICD-9 Code range ; ; ; codes ICD-10 Code range J44.0-J44.9; J47.0-J codes 28

29 Impacts & Pitfalls Additional documentation Complications (exacerbation, with lower respiratory infection) Templates Missing specificity (tobacco use, exposure) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? COPD Complication TLCE Acute bronchitis Asthma Bronchiectasis Exacerbation Success Focus on TLCE contributing factors Key word(s) Small additions to documentation With, exacerbation Update templates/superbills Add common verbiage/codes 29

30 Assessment: COPD What s missing? J44.9 Chronic obstructive pulmonary disease, unspecified Assessment: COPD Subjective notes more coughing than usual and is producing yellow phlegm and worsening shortness of breath. Coding query for exacerbation J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation COPD COPD J44.9 Chronic obstructive pulmonary disease, unspecified COPD w exacerbation J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation 30

31 Asthma ICD-9 Code range codes ICD-10 Code range J45.20 J codes Impacts & Pitfalls Additional documentation Type/temporal (intermittent, persistent, mild, severe) Complications (exacerbation, status asthmaticus) Templates Missing specificity (tobacco use, exposure) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Asthma Type/Temporal TLCE Intermittent Persistent Mild, moderate, severe Allergic extrinsic Cardiobronchial Cough variant Stonemason s 31

32 Asthma Complication TLCE COPD Exacerbation Status asthmaticus Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Due to, with, intermittent, mild Update templates/superbills Add common verbiage/codes Assessment: Mild intermittent asthma What s missing? J Unspecified asthma, uncomplicated 32

33 Assessment: Exacerbation of moderate persistent asthma Better J45.41Moderate persistent asthma with (acute) exacerbation Asthma Asthma J Unspecified asthma, uncomplicated Mod Persistent asthma, exacerbation J45.41 Moderate persistent asthma with (acute) exacerbation Laryngopharyngitis ICD-9 Code range 465.0, 478.9; codes ICD-10 Code range J06.0; J37.0; J70.0-J codes 33

34 Impacts & Pitfalls Additional documentation Type/temporal (acute, chronic) Complications (external cause) Templates Missing specificity (tobacco use, exposure) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Laryngopharyngitis Type/Temporal TLCE Acute Chronic Laryngopharyngitis Caused by TLCE External agent Radiation 34

35 Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Acute, chronic Update templates/superbills Add common verbiage/codes Assessment: Laryngopharyngitis What s missing? J06.0 Acute laryngopharyngitis Assessment: Chronic laryngopharyngitis Better J37.0 Chronic laryngitis 35

36 Laryngopharyngitis Laryngopharyngitis J06.0 Acute laryngopharyngitis Chronic Laryngopharyngitis J37.0 Chronic laryngitis Acute maxillary sinusitis ICD-9 Code range 461.0; codes Sinusitis ; codes ICD-10 Code range J J01.01; J codes Sinusitis J01.00-J01.91; J32.0-J codes Impacts & Pitfalls Additional documentation Type/temporal (acute, chronic) Location (maxillary, frontal) Templates Missing specificity (tobacco use, exposure) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? 36

37 Acute Maxillary Sinusitis Type/Temporal TLCE Acute Chronic Recurrent Sinusitis Location TLCE Ethmoidal Frontal More than one sinus (not all) Maxillary Pansinusitis Sphenoidal Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Acute, recurrent, frontal Update templates/superbills Add common verbiage/codes 37

38 Assessment: Sinusitis What s missing? J32.9 Chronic sinusitis, unspecified Coding default coding is chronic Assessment: acute sinusitis Better Subjective documents 3 rd time this year with same symptoms. Exam shows tenderness over all sinuses on the left side. Coding query for recurrent and location J01.81 Acute recurrent pansinusitis Sinusitis Acute sinusitis J01.90 Acute sinusitis, unspecified Acute pansinusitis recurrent J01.41 Acute recurrent pansinusitis 38

39 Allergic Rhinitis ICD-9 Code range codes ICD-10 Code range J30.1-J codes Impacts & Pitfalls Additional documentation Type (seasonal or non-) Caused by (food, pollen) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Allergic Rhinitis Type TLCE Seasonal Non-seasonal 39

40 Allergic Rhinitis Caused by/complication - TLCE Asthma Exacerbation Status asthmaticus Due to Food Pollen Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Due to, seasonal Update templates/superbills Add common verbiage/codes Assessment: Rhinitis What s missing? J31.0 Chronic rhinitis Coding default is not allergic 40

41 Assessment: hay fever OK J30.1 Allergic rhinitis due to pollen Allergic Rhinitis Rhinitis J31.0 Chronic rhinitis Hay fever J30.1 Allergic rhinitis due to pollen Digestive System Chapter 11 K00-K95 Esophagitis reflux 41

42 Esophagitis Reflux ICD-9 Code range code ICD-10 Code range K code Impacts & Pitfalls Additional documentation Complication (inflammation) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Esophagitis Reflux Type (GERD) TLCE newborn Complication (GERD) - TLCE with or without esophagitis 42

43 Success Focus on TLCE contributing factors Key word(s) Small additions to documentation with Update templates/superbills Add common verbiage/codes Assessment: GERD What s missing? K21.9 Gastro-esophageal reflux disease without esophagitis Assessment: GERD w esophagitis K21.0 Gastro-esophageal reflux disease with esophagitis 43

44 Esophagitis Reflux GERD K21.9 Gastro-esophageal reflux disease without esophagitis GERD w esophagitis K21.0 Gastro-esophageal reflux disease with esophagitis Musculoskeletal Chapter 13 M00-M99 Fibromyalgia Myositis Neuritis Back and joint pain Fibromyalgia ICD-9 Code range code ICD-10 Code range M codes 44

45 Impacts & Pitfalls Additional documentation None Templates Possibly OK as is EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Fibromyalgia No TLCE Assessment: Fibromyalgia M79.7 Fibromyalgia Myositis ICD-9 Code range ; codes ICD-10 Code range M M codes!! 45

46 Impacts & Pitfalls Additional documentation Type (infective, interstitial) Cause (posture, ossificans) Location/laterality (you name it) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Myositis Type TLCE Infective Interstitial Mycotic Orbital Ossificans Progressiva Traumatica Myositis Caused by - TLCE Due to posture Myositis ossificans In/due to Burns Quadriplegia/paraplegia 46

47 Myositis Location/Laterality TLCE Shoulder; left, right Upper limb; left, right Forearm; left, right Hand/finger; left, right Thigh; left, right Lower limb; left, right Ankle/foot/toes; left, right Success Focus on TLCE contributing factors Key word(s) Small additions to documentation infective, right forearm Update templates/superbills Add common verbiage/codes Assessment: Myositis What s missing? M60.9 Myositis, unspecified 47

48 Assessment: myositis ossificans shoulder Better Subjective clearly states previous traumatic injury caused myositis & exam clarifies left shoulder M Myositis ossificans traumatica, left shoulder Myositis Myositis M60.9 Myositis, unspecified Myositis ossificans L shoulder, traumatic M myositis ossificans shoulder Neuritis ICD-9 Code range 723.4; 724.2; 729.2; ; Signs & symptoms Nervous system/sense organs 13 codes ICD-10 Code range M79.2; M54.10-M54.18; G61.0- G64 Musculoskeletal system Nervous system 24 codes 48

49 Impacts & Pitfalls Additional documentation Type (general, peripheral) Cause (diabetes) Location/laterality (lumbar, cranial nerves) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Neuritis Type TLCE General/multiple/polyneuritis Mononeuritis Peripheral Neuritis Caused by/comp - TLCE Diabetes Disc Displacement Gout (Location TLCE) Drug induced 49

50 Neuritis Location TLCE Brachial Lumbar Lumbosacral Thoracic Cranial nerves Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Due to, thoracic Update templates/superbills Add common verbiage/codes Assessment: Neuritis What s missing? M79.2 Neuralgia and neuritis, unspecified 50

51 Assessment: Polyneuropathy Better Subjective documents the patient s problem list which shows DM II Coding query to make connection G62.9 Polyneuropathy, unspecified Neuritis Neuritis M79.2 Neuralgia and neuritis, unspecified Diabetic polyneuropathy type 2 E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy Back pain ICD-9 Code range 723.1; ; codes ICD-10 Code range M53.3; M54.10-M54.2; M M54.6; M codes 51

52 Impacts & Pitfalls Additional documentation Complication (radiculopathy) Location/laterality (cervical) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Back Pain Complication TLCE Back pain Radiculopathy Sciatica Back Pain Location/Laterality TLCE Back Cervical Low back Thoracic Coccyx 52

53 Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Thoracic, radiculopathy Update templates/superbills Add common verbiage/codes Assessment: LBP What s missing? M54.5 Low back pain Assessment: Lumbar pain Subjective and exam confirm radiation of pain is present M54.16 Radiculopathy, lumbar region 53

54 Back pain LBP M54.5 Low back pain LBP w radiculitis M54.16 Radiculopathy, lumbar region Joint pain ICD-9 Code range codes ICD-10 Code range M M codes Impacts & Pitfalls Additional documentation Location/laterality (left knee) Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? 54

55 Joint Pain Location/Laterality TLCE Joint Ankle/foot/toe; left, right Elbow; left, right Finger/hand; left, right Hip; left, right Knee; left, right Shoulder; left, right Wrist; left, right Success Focus on TLCE contributing factors Key word(s) Small additions to documentation bilateral Update templates/superbills Add common verbiage/codes Assessment: Knee pain What s missing? M Pain in unspecified knee 55

56 Assessment: wrist pain Subjective states right wrist injury, exam shows left wrist ROM pain & right wrist with normal exam Coding query to clarify laterality M Pain in unspecified wrist Knee pain Knee pain M Pain in unspecified knee Left wrist pain M Pain in left wrist Signs and Symptoms Chapter 18 R00-R99 Malaise Fatigue 56

57 Malaise ICD-9 Code range code ICD-10 Code range R code Impacts & Pitfalls Additional documentation None Templates May be appropriate already EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Malaise No TLCE Assessment: Malaise R53.81 Other malaise 57

58 Fatigue ICD-9 Code range ; ; ; 797; ; 300.5; Signs & symptoms Musculoskeletal system Mental, behavioral health 7 codes ICD-10 Code range R49.8; R53.0; R53.82-R54; M62.89; F43.0; F48.8 Signs & symptoms Musculoskeletal system Mental, behavioral health 8 codes Impacts & Pitfalls Additional documentation Type (chronic, muscle) Cause (combat, neoplasm) Episode, possible for heat fatigue Templates Missing specificity (assessment options) EHR diagnosis entry/superbill How to find the correct diagnosis? Is the right code on the superbill? Fatigue Type/Temporal TLCE Chronic General Muscle Senile Voice 58

59 Fatigue Caused by TLCE Combat Heat (transient) Neoplasm Psychogenic Heat Fatigue Episode of care TLCE Initial encounter Subsequent encounter Sequela Success Focus on TLCE contributing factors Key word(s) Small additions to documentation Due to, chronic Update templates/superbills Add common verbiage/codes 59

60 Assessment: Fatigue What s missing? R53.83 Other fatigue Assessment: fatigue due to cancer Better No mention in documentation of type of cancer Coding query for type of cancer R53.0 Neoplastic (malignant) related fatigue Fatigue Fatigue R53.83 Other fatigue Fatigue due to small cell carcinoma of lung C43.90 Malignant neoplasm of unspecified part of unspecified bronchus or lung and R53.0 Neoplastic (malignant) related fatigue 60

61 Summary Coding concepts TLCE Key words & small additions Update templates & superbills Incorporate now Q & A References ICD-10-CM Official Guidelines wnloads/icd10cm-guidelines-2015.pdf 61

62 Thank you! Contact Information Tammy Jones, CPC, COC SVA Healthcare Services, LLC