ICD-10 Implementation Toolkit Supporting you Over the Hurdles

Size: px
Start display at page:

Download "ICD-10 Implementation Toolkit Supporting you Over the Hurdles"

Transcription

1 ICD-10 Implementation Toolkit Supporting you Over the Hurdles Introduction October 1, 2015, is the deadline for ICD-10. If you have questions or have fallen behind in your preparations and training, this toolkit is for you. Chiropractic Care of Minnesota Inc. has created and gathered an abundance of educational and supporting resources to assist chiropractors through the transition from ICD-9 to ICD-10. This toolkit combines the most valuable resources to help guide you over the ICD-10 hurdles. Contents Implementation Checklist + Quick Tips ICD-10 for the Chiropractic Procrastinator Chiropractic ICD-10 Common Codes List Frequently Asked Questions Additional Resources List ICD-10 Implementation Toolkit Chiropractic Care of Minnesota, Inc.

2 ICD-10 Implementation Checklist + Quick Tips Watch ChiroCare s Gauging ICD-10 Readiness webinar with your staff members. This recording provides a quick 60-minute overview of the transition basics. Compile a list of all the places (paper and electronic) ICD-9 codes are used in your clinic today. Some examples may include routing slips, billing paperwork, accounts receivable, etc. Refer to ChiroCare s Chiropractic ICD-10 Common Codes List codes (included in this toolkit and available online) for a preliminary list of common ICD-10 codes chiropractic diagnoses. Use the inventory sheet of ICD-9 codes you collected from February to identify what processes, forms and systems need to change for the October 1, 2015 deadline. Modify these policies and procedures. Revise these paper forms and templates. Just about everyone in your office will need some sort of training, including medical coders and clinical staff. Make sure everyone is comfortable with codes as well as workflow changes especially if you have new or upgraded systems. Conduct internal tests. Review ChiroCare s ICD-10 Internal and External Testing Procedures document offers some great tips to help get you started. Work out any testing errors internally or with vendors. Practice coding with ICD-10 and validate supporting clinical documentation processes Quick Tips Bill by date of service (DOS) use ICD-9 codes for DOS until 9/30/2015; and ICD-10 codes should be used on all claims with DOS on or after 10/1/2015 Claims for DOS on or after 10/1/2015 that use ICD-9 codes will be denied there is no grace period Chiropractic manipulation codes are the M99.XX codes Some codes have three digits and others have seven digits to be complete. Double-check the tabular list to be certain the code is a complete code! Combination Codes are new with ICD-10 (e.g., lumbago with sciatica (right) is one code M54.1) Watch for exclusion codes o Excludes 1 = mutually exclusive code - consider these codes INSTEAD (e.g., 54.5 low back pain excludes S low back strain) o Excludes 2 = not includes - consider this code IN ADDITION (e.g., strain S16.1xxx and sprain S13.4xxx may both be diagnoses) ICD-10 Implementation Toolkit Chiropractic Care of Minnesota, Inc.

3 ICD-10 for the Chiropractic Procrastinator Presented By Chiropractic Care of Minnesota, Inc. (CCMI) Authored By Dr. Evan Gwilliam, DC, MBA, BS, CPC, CCPC, NCICS, CCCPC, CPC-I, CPMA, MCS-P Introduction You have put it off long enough. It is time to become proficient with ICD-10 or face the risk of claims not being paid for dates of service beginning October 1, The following pages contain tips and suggestions on how to get started with the new coding approach. However, remember that learning ICD-10 is a bit like learning to speak a new language - it cannot be taught in a few pages. Be sure to also check out additional resources at the end of this Guide to support you over the ICD-10 hurdles.

4 Table of Contents ICD-10 Structure & Fundamentals. 2-3 ICD-10 Terminology & Definitions..3-5 General Tips..6 Strategies for Finding the Right Codes 6-7 How to Use the ICD-10 Coding for Chiropractic Book..7 Where to Find More Information..7 ICD-10 Structure & Fundamentals ICD-10 codes are organized into chapters, separated by body system or condition, just like ICD-9. Chiropractors will mostly use codes from the following chapters of the official Tabular List, which is abridged in ChiroCode s ICD-10 Coding for Chiropractic book: Chapter 6 (G Codes Diseases of the Nervous system), Chapter 13 (M Codes Diseases of the Musculoskeletal System and Connective Tissue), Chapter 18 (R Codes Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified), Chapter 19 (S Codes - Injury), and maybe Chapter 20 (V, W, X, and Y Codes External Causes of Morbidity). ICD-10 codes contain up to seven characters and they contain numbers as well as letters. The first three characters are the category; all codes in the same category are a related condition (i.e. M47 is the category for Spondylosis). ICD-10 for the Chiropractic Procrastinator 2

5 The next three characters provide detail about things like the anatomical site and severity; in some cases, they may be replaced by the x to ensure that the seventh character remains in the seventh position. Be careful about specifying the difference between the number zero 0 and the letter O. The same is true of 1, L, and I. The sixth character frequently denotes laterality (1=right; 2=left). When there is no bilateral code, you need to list the right and left code separately. The seventh character for certain injury codes (encounter or episode of care) will usually only be used by chiropractors for sprain and strain codes (i.e. S23.3xx_ Sprain of Ligaments of Thoracic Spine.) The _ underscore indicates that a seventh character is required. They usually include the following three options. o A Initial encounter: patient is receiving active treatment. Payers may recognize this as a phase of care, rather than a single visit. It may be required when establishing medical necessity for chiropractic care. o D- Subsequent encounter: routine care during the healing or recovery phase/support care. This may be considered appropriate for all visits after the initial visit, or it may be viewed as maintenance care. o S Sequela: complications or conditions that arise as a direct result of the condition. This would be applied to a condition which is no longer present, but it led to another problem, which is the primary reason for the encounter. ICD-10 Terminology & Definitions Acute Conditions - The medical conditions characterized by sudden onset, severe change, and/or short duration. Additional Diagnosis - The secondary diagnosis code used, if available, to provide a more complete picture of the primary diagnosis. And - Means "and/or" when it appears in a title or narrative statement. Example: S33 says Dislocation and sprain, which can mean either sprain and/or dislocation. Bilateral - For bilateral sites, the final character of the codes in the ICD-10-CM indicates laterality. An unspecified side code is also provided should the side not be identified in the medical record. If no bilateral code is provided and the condition is bilateral, assign separate codes for both the left and right side. Brackets [ ] - Punctuation found in both the Tabular List and the Alphabetic Index surrounding manifestation codes to indicate that the manifestation should be sequenced after the disease code. Chronic Conditions - Medical conditions characterized by long duration, frequent recurrence over a long period of time, and/or slow progression over time. ICD-10 for the Chiropractic Procrastinator 3

6 Code Also - Instruction that tells the coder that more than one code could be assigned, but it does not imply any sequencing guidance. Generally the most serious condition should be listed first. Code First - Instructs the coder to assign the code for the underlying disease before the code for the manifestation of the disease and generally accompanies a manifestation code. This note is not common for musculoskeletal codes. Colon : - Punctuation found in the Tabular List when a term must be modified by the addition of another term in order to qualify it for assignment of a specific code or to a category. Combination Codes - A single code used to classify any of the following: two diagnoses; a diagnosis with an associated secondary process (manifestation); or a diagnosis with an associated complication. Crosswalk/mapping - Moving from one code set to another. This is generally done with GEMs, but can be customized. Excludes - "Excludes" as used in ICD-9-CM indicates that the code should not be used, because another code may be more appropriate. "Excludes" notes usually include suggestions of more appropriate codes or code ranges. ICD-10-CM introduces two types of excludes: "Excludes1" and "Excludes2". o o o Codes/conditions listed in the "Excludes1" notes should not be used because the two conditions do not occur together. It may be helpful to think of the Excludes1 list to be codes that might be suggested instead. Codes/conditions listed in the "Excludes2" notes indicate that the conditions being excluded are not considered part of the subject condition, but that another code should also be assigned. It may be helpful to think of Excludes2 codes to those that might need to be added to provide full detail. Codes may have both, either or neither Excludes1 and Excludes2 notes. GEMs - Generated by the National Center for Health Statistics, this reference mapping attempts to include all valid relationships between the codes in the ICD-9-CM diagnosis classification and the ICD-10-CM diagnosis classification. CMS warns not to code directly from GEMs, as they only provide approximations. Note that GEMs frequently point to unspecified ICD-10 codes, which may lead to denied claims. Includes - Term that is accompanied by conditions that are examples of what may be included in a specific category. NEC - Not elsewhere classified or other specified is used when the information in the medical record provides detail for which a specific codes does not exist. Example M53.86 Other specified dorsopathies, lumbar region might be used for facet syndrome. The code does not name the condition, but the documentation does. Nonessential Modifiers - Terms that may coexist with the main term but do not change the code assignment for the condition. These are generally contained within parentheses. ICD-10 for the Chiropractic Procrastinator 4

7 NOS - Not otherwise specified or unspecified is used when the information in the medical record is insufficient to assign a more specific code. Example: M54.9 Dorsalgia unspecified. The code is vague, but so is the documentation. Manifestation Codes - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. However, these are uncommon for musculoskeletal diagnoses that are most likely to be used by chiropractors. Medical Necessity - Services or supplies that: are proper and needed for the diagnosis or treatment of a medical condition; are provided for the diagnosis, direct care, and treatment of a medical condition; meet the standards of good medical practice in the local area; and are not mainly for the convenience of the patient or doctor. Diagnosis codes convey this information. Parentheses ( ) - Punctuation found in both the Tabular List and the Alphabetic Index that surrounds nonessential modifiers. Example: M99.1- subluxation complex (vertebral). The word vertebral is not essential to the code description. Principle Diagnosis - First-listed/primary diagnosis code. The code sequenced first on a medical record defines the primary reason for the visit as determined at the end of the encounter. Signs/Symptoms - Codes that describe symptoms and signs, as opposed to diagnoses, are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider. See - Term used in the Alphabetic Index to instruct the coder to refer to another term. See Also - Term used in the Alphabetic Index to instruct the coder to refer to another term if desired. Sequelae - A late effect is the residual effect (condition produced) after the acute phase of an illness or injury has terminated. There is no time limit on when a late effect code can be used. The residual may be apparent early, such as in cerebral infarction, or it may occur months or years later, such as that due to a previous injury. With - Term used in the alphabetic index immediately following the main term, but not necessarily in alphabetic order in the Alphabetic Index. It is defined as associated with or due to. If not specified in the documentation, the default is without. ICD-10 for the Chiropractic Procrastinator 5

8 General ICD-10 Tips Claims for dates of service prior to October 1, 2015 must use ICD-9 codes. Claims for dates of service after October 1, 2015 must use ICD-10 codes. The ICD-10 code set was last updated in 2012, and will not change again until 2016 Personal Injury insurance policies and workers compensation plans are not required to adopt ICD-10 codes, but it is expected that they will. You are encouraged to contact them directly to make sure. Do not code diagnoses documented as probable, suspected, questionable, rule out, or working diagnosis or other terms indicating uncertainty. Example: if you suspect a disc herniation, you may need MRI to confirm before using a disc related diagnosis code. Signs and symptoms (mostly Chapter 18, R codes) should only be coded if a more definitive diagnosis has not been identified, or if they are not routinely associated with other codes assigned to the encounter. External Cause codes (Chapter 20, V, W, X, and Y) o Do not provide a diagnosis, rather they provide data about the location, activity, or circumstances of an injury or poisoning o Are not mandatory, but voluntary reporting is encouraged o May be used by chiropractors with acute injuries, such as auto accidents or worker s comp claims o Are always listed last on a claim form Strategies for Finding the Right Codes General Strategies 1. Use GEMs mapping in the ChiroCode book (pages ) or your EMR software. Then confirm the choice in the Tabular List. Be wary of unspecified codes. 2. Use the Common Codes list in the ChiroCode book (pages 44-56). Then confirm the choice in the Tabular List. Be sure to review all the instructional notes within the Tabular List. 3. Look up the key terms from the provider documentation in the Alphabetic Index (pages ). Then confirm the code(s) in the Tabular List. Consider synonyms if you can t find the term you are looking for. Improving ICD-10 documentation 1. Find ICD-10 codes for existing records in your office. 2. Compare the existing documentation to the new codes. 3. If inadequate, add details to a practice record. 4. For every patient that presents in the future with that condition, include the new details in your documentation. ICD-10 for the Chiropractic Procrastinator 6

9 Administrative steps Be prepared for the possibility of delayed payments due to issues regarding processing and payer policies for new codes. Consider securing financing to allow you to meet obligations should revenue temporarily decline. Reach out to payers and your clearinghouse and ask if they will accept test claims prior to October 1, Plan to train your entire office a little each week. Consider using articles from trade journals or reading the first 43 pages of the ChiroCode ICD-10 book. How to use the ICD-10 Coding for Chiropractic Book The first 43 pages summarize all you need to know about ICD-10: detailed explanations of the terms identified in this guide. The Commonly Used Codes (about 12 pages) section provides you with a shortcut list sorted by anatomical region. Note that this list is only a best guess, since ICD-10 has not actually been used yet. The Code Mapping (about 90 pages) section provides you with GEMs tables to translate from ICD-9 to ICD-10 codes. Watch out for unspecified codes. The Tabular List (about 300 pages) contains an abridged version of the full code set. Most of the codes included are musculoskeletal conditions and acute injury codes (sprains and strains). o An arrow at the bottom of a page means highest specificity and if the code is bold, it means it is complete (right number of characters). o Pay particular attention to instructional notes at the level of each code character. The Alphabetic Index (about 20 pages) can be used to find codes by key terms that are included in the documentation. Beware that the index usually only provides the first three or four characters of a code. The Appendix (about 40 pages) contains an abbreviated version of the official guidelines for ICD-10 coding. Where to Find More Information Visit CCMI s ICD-10 Transition Support web page for articles and other resources Go to ChiroCode.com and use coupon code CCMI20 to get $20 off ChiroCode s ICD-10 Coding for Chiropractic book. It contains everything you need to make the transition. (Please contact ChiroCode directly with any questions regarding your order or the coupon code at (602) and allow one week for delivery.) Visit CMS Road to 10 web page for free ICD-10 resources from Medicare ICD-10 for the Chiropractic Procrastinator 7

10 Chiropractic ICD-10 Common Codes List This is a preliminary list of common ICD-10 codes for chiropractic diagnoses. This is a common code list to be used as a guide for coding and is not intended to represent all ICD-10 codes accepted by ChiroCare. Using codes on this list does not guarantee that the claim will not be denied. Using valid ICD-10 codes can facilitate authorization, claims payments and support the medical necessity of the service in case of review, audits or litigation. Codes must support neuromusculoskeletal (NMS) conditions, and represent the body regions requiring treatment. Please list the diagnosis primarily responsible for the treatment in the primary position on the claim form. ChiroCare further recommends that the secondary, tertiary and quaternary diagnosis positions on the claim form be used to report additional conditions/regions that are being treated. ICD-10 Code Description/Condition Name Diagnosis Code Headache R51 Headache G Tension-type headache, unspecified, intractable G Tension-type headache, unspecified, not intractable G Migraine without aura, not intractable, with status migrainosus G Migraine without aura, not intractable, without status migrainosus G Migraine without aura, intractable, with status migrainosus G Migraine without aura, intractable, without status migrainosus G Migraine with aura, not intractable, with status migrainosus G Migraine with aura, not intractable, without status migrainosus G Migraine with aura, intractable, with status migrainosus G Migraine with aura, intractable, without status migrainosus Cervical M54.2 Cervicalgia M99.01 Segmental and somatic dysfunction of cervical region S13.4XXA Sprain of ligaments of cervical spine, initial encounter S16.1XXA Strain of muscle, fascia and tendon at neck level, initial encounter M50.11 Cervical disc disorder with radiculopathy, occipito-atlanto-axial region M50.12 Cervical disc disorder with radiculopathy, mid-cervical region M50.13 Cervical disc disorder with radiculopathy, cervicothoracic region M50.31 Other cervical disc degeneration, occipito-atlanto-axial region M50.32 Other cervical disc degeneration, mid-cervical region M50.33 Other cervical disc degeneration, cervicothoracic region M48.01 Spinal stenosis, occipito-atlanto-axial region M48.02 Spinal stenosis, cervical region Chiropractic ICD-10 Common Codes List Chiropractic Care of Minnesota, Inc.

11 Cervical, Continued M48.03 Spinal stenosis, cervicothoracic region M43.6 Torticollis M Spondylosis without myelopathy or radiculopathy, offipito-atlanto-axial region M Spondylosis without myelopathy or radiculopathy, cervical region M Spondylosis without myelopathy or radiculopathy, cervicothoracic region M Juvenile idiopathic scoliosis, cervical region M Juvenile idiopathic scoliosis, cervicothoracic region M Adolescent idiopathic scoliosis, cervical region M Adolescent idiopathic scoliosis, cervicothoracic region M41.41 Neuromuscular scoliosis, occipito-atlanto-axial region M41.42 Neuromuscular scoliosis, cervical region M41.43 Neuromuscular scoliosis, cervicothoracic region M53.81 Other specified dorsopathies, occipito-atlanto-axial region M53.82 Other specified dorsopathies, cervical region M53.83 Other specified dorsopathies, cervicothoracic region M54.11 Radiculopathy, occipito-atlanto-axial region M54.12 Radiculopathy, cervical region M53.1 Cervicobrachial syndrome G54.0 Brachial plexus disorders Thoracic and Ribs M54.6 Pain in thoracic spine M99.02 Segmental and somatic dysfunction of thoracic region M99.08 Segmental and somatic dysfunction of rib cage S23.3XXA Sprain of ligaments of thoracic spine, initial encounter S23.41XA Sprain of ribs, initial encounter S23.421A Sprain of chondrosternal joint, initial encounter M51.14 Intervertebral disc disorders with radiculopathy, thoracic region M53.84 Other specified dorsopathies, thoracic region M Juvenile idiopathic scoliosis, thoracic region M Adolescent idiopathic scoliosis, thoracic region M41.44 Neuromuscular scoliosis, thoracic region Lumbosacral & Pelvic M54.5 Low back pain M99.03 Segmental and somatic dysfunction of lumbar region M99.04 Segmental and somatic dysfunction of sacral region M99.05 Segmental and somatic dysfunction of pelvic region S33.5XXA Sprain of ligaments of lumbar spine, initial encounter S33.6XXA Sprain of sacroiliac joint, initial encounter S33.8XXA Sprain of other parts of lumbar spine and pelvis, initial encounter S33.9XXA Sprain of unspecified parts of lumbar spine and pelvis, initial encounter S39.012A Strain of muscle, fascia and tendon of lower back, initial encounter M51.15 Intervertebral disc disorders with radiculopathy, thoracolumbar region M51.16 Intervertebral disc disorders with radiculopathy, lumbar region M51.17 Intervertebral disc disorders with radiculopathy, lumbosacral region Chiropractic ICD-10 Common Codes List Chiropractic Care of Minnesota, Inc.

12 Lumbosacral & Pelvic, Continued M51.36 Other intervertebral disc degeneration, lumbar region M51.37 Other intervertebral disc degeneration, lumbosacral region M Spondylosis without myelopathy or radiculopathy, lumbar region M Spondylosis without myelopathy or radiculopathy, lumbosacral region M54.31 Sciatica, right side M54.32 Sciatica, left side M54.41 Lumbago with sciatica, right side M54.42 Lumbago with sciatica, left side M54.16 Radiculopathy, lumbar region M54.17 Radiculopathy, lumbosacral region M53.3 Sacrococcygeal disorders, not elsewhere classified M53.85 Other specified dorsopathies, thoracolumbar region M53.86 Other specified dorsopathies, lumbar region M48.06 Spinal stenosis, lumbar region M48.07 Spinal stenosis, lumbosacral region M Juvenile idiopathic scoliosis, thoracolumbar region M Juvenile idiopathic scoliosis, lumbar region M Juvenile idiopathic scoliosis, lumbosacral region M Adolescent idiopathic scoliosis, thoracolumbar region M Adolescent idiopathic scoliosis, lumbar region M Adolescent idiopathic scoliosis, lumbosacral region M41.45 Neuromuscular scoliosis, thoracolumbar region M41.46 Neuromuscular scoliosis, lumbar region M41.47 Neuromuscular scoliosis, lumbosacral region Upper Extremity M99.07 Segmental and somatic dysfunction of upper extremity G56.01 Carpal tunnel syndrome, right upper limb G56.02 Carpal tunnel syndrome, left upper limb M75.01 Adhesive capsulitis of right shoulder M75.02 Adhesive capsulitis of left shoulder M75.51 Bursitis of right shoulder M75.52 Bursitis of left shoulder M77.01 Medial epicondylitis, right elbow M77.02 Medial epicondylitis, left elbow M77.11 Lateral epicondylitis, right elbow M77.12 Lateral epicondylitis, left elbow S43.51XA Sprain of right acromioclavicular joint, initial encounter S43.52XA Sprain of left acromioclavicular joint, initial encounter S43.411A Sprain of right coracohumeral (ligament), initial encounter S43.412A Sprain of left coracohumeral (ligament), initial encounter S43.421A Sprain of right rotator cuff capsule, initial encounter S43.422A Sprain of left rotator cuff capsule, initial encounter S46.011A Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter S46.012A Strain of muscle(s) and tendon(s) of the rotator cuff of left shoulder, initial encounter S46.091A Other injury of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter S46.092A Other injury of muscle(s) and tendon(s) of the rotator cuff of left shoulder, initial encounter Chiropractic ICD-10 Common Codes List Chiropractic Care of Minnesota, Inc.

13 Upper Extremity, Continued S46.811A Strain of other muscles, fascia and tendons at shoulder and upper arm level, right arm, initial encounter S46.812A Strain of other muscles, fascia and tendons at shoulder and upper arm level, left arm, initial encounter S43.81XA Sprain of other specified parts of right shoulder girdle, initial encounter S43.82XA Sprain of other specified parts of left shoulder girdle, initial encounter M Pain in right shoulder M Pain in left shoulder M Pain in right elbow M Pain in left elbow M Pain in right wrist M Pain in left wrist M Pain in right arm M Pain in left arm M Pain in right upper arm M Pain in left upper arm M Pain in right forearm M Pain in left forearm M Pain in right hand M Pain in left hand M Pain in right finger(s) M Pain in left finger(s) Lower Extremity M99.06 Segmental and somatic dysfunction of lower extremity M76.61 Achilles tendinitis, right leg M76.62 Achilles tendinitis, left leg M Anterior tibial syndrome, right leg M Anterior tibial syndrome, left leg M Anterior tibial syndrome, unspecified leg M Posterior tibial tendinitis, right leg M Posterior tibial tendinitis, left leg M Posterior tibial tendinitis, unspecified leg S73.191A Other sprain of right hip, initial encounter S73.192A Other sprain of left hip, initial encounter S76.011A Strain of muscle, fascia and tendon of right hip, initial encounter S76.012A Strain of muscle, fascia and tendon of left hip, initial encounter S83.401A Sprain of unspecified collateral ligament of right knee, initial encounter S83.402A Sprain of unspecified collateral ligament of left knee, initial encounter S83.501A Sprain of unspecified cruciate ligament of right knee, initial encounter S83.502A Sprain of unspecified cruciate ligament of left knee, initial encounter S83.91XA Sprain of unspecified site of right knee, initial encounter S83.92XA Sprain of unspecified site of left knee, initial encounter S93.411A Sprain of calcaneofibular ligament of right ankle, initial encounter S93.412A Sprain of calcaneofibular ligament of left ankle, initial encounter S93.421A Sprain of deltoid ligament of right ankle, initial encounter S93.422A Sprain of deltoid ligament of left ankle, initial encounter S93.431A Sprain of tibiofibular ligament of right ankle, initial encounter Chiropractic ICD-10 Common Codes List Chiropractic Care of Minnesota, Inc.

14 Lower Extremity, Continued S93.432A Sprain of tibiofibular ligament of left ankle, initial encounter S96.811A Sprain of other specified muscles and tendons at ankle and foot level, right foot, initial encounter S96.812A Sprain of other specified muscles and tendons at ankle and foot level, left foot, initial encounter M Pain in right leg M Pain in left leg M Pain in right thigh M Pain in left thigh M Pain in lower right leg M Pain in lower left leg M Pain in right foot M Pain in left foot M Pain in right toe(s) M Pain in left toe(s) M Pain in right hip M Pain in left hip M Pain in right knee M Pain in left knee M Pain in right ankle M Pain in left ankle Other Diagnoses (do not use as primary code) M Muscle spasm of back M79.1 Myalgia M79.7 Fibromyalgia Chiropractic ICD-10 Common Codes List Chiropractic Care of Minnesota, Inc.

15 ICD-10 Transition Frequently Asked Questions 1. When is the ICD-10 compliance deadline? The ICD-10 deadline is October 1, Is it the Date of Service (DOS) that determines ICD-9 or 10? Yes. DOS before October 1, 2015 are submitted using ICD-9. DOS on or after October 1, 2015 are submitted using ICD What happens if I submit ICD-9 for DOS after October 1, 2015? The claim will be denied. 4. Is there any grace period to submit ICD-9 after October 1, 2015? No. For DOS on and after October 1, 2015 ICD-10 is required. 5. Do ICD-10 codes need to be reported for all products? Yes. ICD-10 codes must be used for all services provided on or after October 1, 2015, regardless of the type of insurance product the member holds. 6. Codes change every year so why is the transition to ICD-10 any different from the annual code changes? ICD-10 codes are completely different from ICD-9 codes. Currently, ICD-9 codes are mostly numeric and have 3 to 5 digits. ICD-10 codes are alphanumeric and contain 3 to 7 characters. The change is significant, so it is wise to begin your transition process now. 7. Will ICD-10 replace Current Procedural Terminology (CPT) coding? No. The transition to ICD-10 is for diagnostic codes and does not affect CPT coding for outpatient procedures and practitioner services. 8. Why is the switch to ICD-10 happening? The Centers for Medicare & Medicaid Services (CMS) is requiring the transition to ICD-10 because it allows for more accurate description of the patients medical condition and creates a structure of ICD codes that can expand the number of diagnostic codes available. I info@chirocaremn.org I MN Office: I WI Office:

16 9. What should I do to prepare for the transition to ICD-10? Buy the ICD-10 Coding for Chiropractic book, from ChiroCode or the American Chiropractic Association (ACA) Attend a Seminar: See ChiroCare.com/Events Prepare a budget for transition and claim delays Set up a staff transition team and timeline Talk about the clinic work flow and where ICD codes are being used Check with software and billing vendors and clearinghouses on their ICD-10 readiness 10. Where can I find ICD-10 codes and crosswalks? Find a Code: Findacode.com (phone app) American Association of Professional Coders (AAPC): aapc.com Disclaimer: ICD-10 mapping or crosswalks for ICD-9 codes often do not directly code to ICD-10 and requires a clinical analysis to determine which code should be selected 11. What is my timeline? In order to avoid costly claims denials and rejections, begin the transition early. The recommendation is to be ready for internal ICD-10 testing in June and do external testing with vendors in July. This will provide time to identify errors and find solutions before the October 1 deadline. 12. Where can I find more ICD-10 Resources? ChiroCare: chirocare.com/icd-10 ChiroCode: chirocode.com American Chiropractic Association: acatody.org (Electronic toolkit available for purchase) Centers for Medicare and Medicaid Services: cms.gov The Small Practitioners Practice s Route to ICD-10: roadto10.org (Free Interactive website with good clearinghouse/vendor questions lists and timeline recommendations.) Minnesota Chiropractic Association: mnchiro.com Healthcare IT News and Healthcare Finance News: icd10watch.com I info@chirocaremn.org I MN Office: I WI Office:

17 ICD-10 Additional Resources List ChiroCode American Chiropractic Association Centers for Medicare and Medicaid Services American Association of Professional Coders (AAPC) Find a Code Healthcare IT News and Healthcare Finance News ChiroCare Helping you over the ICD-10 Hurdles and through the finish line. ICD-10 Implementation Toolkit Chiropractic Care of Minnesota, Inc.

Chiropractic ICD-10 Common Codes List

Chiropractic ICD-10 Common Codes List Chiropractic ICD-10 Common Codes List This is a preliminary list of Common ICD-10 Codes for chiropractic diagnoses. This is a common code list to be used as a guide for coding and is not intended to represent

More information

Current ICD-10 Codes

Current ICD-10 Codes Current ICD-10 Codes Description (Facet Syndromes) M53.81 Other specified dorsopathies, occipito-atlanto-axial region M53.82 Other specified dorsopathies, cervical region M53.83 Other specified dorsopathies,

More information

For more information call , or visit

For more information call ,  or visit Target Coding ICD-10 List for Chiropractic HEADACHE G43: Migraine G43.0: Migraine without aura (common migraine) G43.009: Migraine without aura, not intractable, without status migrainosus (migraine without

More information

Top 100 Diagnosis Codes as Reported by HNS Physicians (Revised 08/30/16)

Top 100 Diagnosis Codes as Reported by HNS Physicians (Revised 08/30/16) Top 100 Diagnosis Codes as Reported by HNS Physicians (Revised 08/30/16) Disclaimer: The information in the HNS Code Translator is based on the General Equivalency Mapping (GEM) files published by CMS,

More information

National Imaging Associates, Inc. Clinical guidelines CHIROPRACTIC SERVICES. Original Date: Page 1 of FOR CMS (MEDICARE) MEMBERS ONLY

National Imaging Associates, Inc. Clinical guidelines CHIROPRACTIC SERVICES. Original Date: Page 1 of FOR CMS (MEDICARE) MEMBERS ONLY National Imaging Associates, Inc. Clinical guidelines CHIROPRACTIC SERVICES CPT4 Codes: Please refer to pages 2-10 LCD ID Number: L35424 Novitas: J-H: DC, DE, MD, NJ, PA J-L: AR, CO, LA, MS, NM, OK, TX

More information

Top 100 Diagnosis Codes as Reported by HNS Physicians

Top 100 Diagnosis Codes as Reported by HNS Physicians Top 100 Diagnosis Codes as Reported by HNS Physicians Disclaimer: The information in the HNS Code Translator is based on the General Equivalency Mapping (GEM) files published by CMS, and are not intended

More information

JAW. R68.84 Jaw pain M26.60 Temporomandibular joint disorder, unspecified

JAW. R68.84 Jaw pain M26.60 Temporomandibular joint disorder, unspecified HEAD, JAW AND NECK HEADACHE M53.0 Cervicocranial Syndrome R51 Headache (excludes migraine and other headache syndromes) G44.209 Tension-type headache, unspecified, not intractable G44.309 Post-traumatic

More information

ChiroCredit.com / OnlineCE.com presents Documentation 101 Part 4 of 10 Instructor: Paul Sherman, DC

ChiroCredit.com / OnlineCE.com presents Documentation 101 Part 4 of 10 Instructor: Paul Sherman, DC Online Continuing Education Courses www.onlinece.com www.chirocredit.com ChiroCredit.com / OnlineCE.com presents Documentation 101 Part 4 of 10 Instructor: Paul Sherman, DC Important Notice: This download

More information

Medicare Regulations for Chiropractors. Presented by Clinic Pro Software Inc. Marilyn K. Gard. CEO, MBA

Medicare Regulations for Chiropractors. Presented by Clinic Pro Software Inc. Marilyn K. Gard. CEO, MBA Medicare Regulations for Chiropractors Presented by Clinic Pro Software Inc. Marilyn K. Gard. CEO, MBA Use AT modifier which means active treatment. Claims submitted for Chiropractic manipulative treatment

More information

Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Jurisdiction Texas. Retirement Date N/A

Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Jurisdiction Texas. Retirement Date N/A Local Coverage Determination (LCD): Chiropractic Services (L35424) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information Contractor

More information

INDIANA HEALTH COVERAGE PROGRAMS

INDIANA HEALTH COVERAGE PROGRAMS INDIANA HEALTH COVERAGE PROGRAMS PROVIDER CODE TABLES Note: Due to possible changes in Indiana Health Coverage Programs (IHCP) policy or national coding updates, inclusion of a code on the code tables

More information

ICD 10 CM. Objectives: Session 2 Make the transition to ICD 10 CM as painless and seamless as possible. Questions from Session 1 9/4/2012

ICD 10 CM. Objectives: Session 2 Make the transition to ICD 10 CM as painless and seamless as possible. Questions from Session 1 9/4/2012 ICD 10 CM SESSION 2: Planning Develop an ICD 10 transition plan for your office and practice. Objectives: Session 2 Make the transition to ICD 10 CM as painless and seamless as possible Timeline for implementation

More information

Contractor Information

Contractor Information Local Coverage Determination (LCD): Chiropractic Services (L35424) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information CONTRACTOR

More information

ICD-10 Essentials It s a Marathon, Not a Sprint!

ICD-10 Essentials It s a Marathon, Not a Sprint! ICD-10 Delay ICD-10 Essentials It s a Marathon, Not a Sprint! Dr. Dianne Baynes RN, DC, MCS-P, CPPM Start Here: What s ICD-10? Why in the World Do We Have to Change? WHO says so! US is the only civilized

More information

ICD-10-CM (GEM) ICD10Data.com CMS.gov/icd10 ICD10CODEsearch.com

ICD-10-CM (GEM) ICD10Data.com CMS.gov/icd10 ICD10CODEsearch.com ICD-10-CM (GEM) General Equivalency Mapping (GEM): Bidirectional conversions between ICD-9 vs. ICD-10 Not intended to be crosswalks. A tool to help map/code accurately Clinical judgement & decision making

More information

MORE FOR BACKS PROGRAM. User guide for chiropractors and chiropractic code list (ICD-10-AM codes)

MORE FOR BACKS PROGRAM. User guide for chiropractors and chiropractic code list (ICD-10-AM codes) MORE FOR BACKS PROGRAM User guide for chiropractors and chiropractic code list (ICD-10-AM codes) APRIL 2017 WELCOME TO THE MORE FOR BACKS PROGRAM This program reimburses 100% of the agreed charge for an

More information

Anesthesia Top 50 Diagnoses (In Order of Usage) ~ 2014 ~

Anesthesia Top 50 Diagnoses (In Order of Usage) ~ 2014 ~ 722.52 Degeneration of lumbar or lumbosacral M51.36 Other intervertebral disc generation lumbar intervertebral disc M51.37 Other intervertebral disc generation lumbosacral 721.3 Lumbosacral spondylosis

More information

MORE FOR BACKS PROGRAM. User guide for chiropractors and chiropractic code list (ICD-10-AM codes)

MORE FOR BACKS PROGRAM. User guide for chiropractors and chiropractic code list (ICD-10-AM codes) MORE FOR BACKS PROGRAM User guide for chiropractors and chiropractic code list (ICD-10-AM codes) MAY 2018 WELCOME TO THE MORE FOR BACKS PROGRAM This program reimburses 100% of the agreed charge for an

More information

ICD-10 CM Training. Orthopaedic

ICD-10 CM Training. Orthopaedic ICD-10 CM Training Orthopaedic ICD-10-CM Compliance Dates ICD-10-CM will be valid for dates of service on or after October 1, 2015 Outpatient dates of service of October 1, 2015 and beyond. Inpatient hospital

More information

MORE FOR BACKS PROGRAM. User guide for osteopaths and osteopathy code list (ICD-10-AM codes)

MORE FOR BACKS PROGRAM. User guide for osteopaths and osteopathy code list (ICD-10-AM codes) MORE FOR BACKS PROGRAM User guide for osteopaths and osteopathy code list (ICD-10-AM codes) APRIL 2017 WELCOME TO THE MORE FOR BACKS PROGRAM This program reimburses 100% of the agreed charge for an initial

More information

This Material is Copyright Protected

This Material is Copyright Protected Proper Utilization of ICD-10 Codes in the Chiropractic Office Mario Fucinari DC, CCSP, APMP, MCS-P, CPCO Certified Professional Compliance Officer (CPCO) Certified Medical Compliance Specialist (MCS-P)

More information

ICD Months In Are You Doing it Right?

ICD Months In Are You Doing it Right? ICD-10--3 Months In Are You Doing it Right? Presented by: Kathy Mills Chang, MCS-P, CCPC What Now? Most commonly asked questions Based on hundreds of questions to the Help Desk and at seminars Proactively

More information

2014 Iowa Chiropractic Society

2014 Iowa Chiropractic Society 2014 Iowa Chiropractic Society SESSION 1 ICD-10-CM TED A. ARKFELD, DC, MS, CPC 1 Disclaimer Advanced Compliance Technologies, PLLC, denies responsibility or liability for any erroneous opinions, analysis,

More information

Chiropractic Code Set Chiropractor (150) Effective July 2003 Last Updated July 1, 2014

Chiropractic Code Set Chiropractor (150) Effective July 2003 Last Updated July 1, 2014 Chiropractic Code Set Chiropractor (150) Effective July 2003 Last Updated July 1, 2014 1. Tables 1 through 4 identify the procedure codes that should be billed to the Indiana Health Coverage Programs (IHCP)

More information

Making ICD-10 Have a Place in Your Audit

Making ICD-10 Have a Place in Your Audit Making ICD-10 Have a Place in Your Audit Presented by Evan M. Gwilliam, DC MBA BS CPC CCPC NCICS CCCPC CPC-I MCS-P CPMA Chief Product Officer New Auditing Challenges Auditors can no longer identify common

More information

This Material is Copyright Protected

This Material is Copyright Protected Proper Utilization of ICD-10 Codes in the Chiropractic Office Mario Fucinari DC, CCSP, APMP, MCS-P, CPCO Certified Professional Compliance Officer (CPCO) Certified Medical Compliance Specialist (MCS-P)

More information

Icd 10 upper back sprain

Icd 10 upper back sprain P ford residence southampton, ny Icd 10 upper back sprain Below is a list of common ICD - 10 codes for Physical Therapy. This list of codes offers a great way to become more familiar with your most-used

More information

ICD-10 Common Codes per CMS

ICD-10 Common Codes per CMS Abdominal Pain (ICD09-CM 789.00 TO 789.09 range) R10.0 Acute abdomen R10.10 Upper abdominal pain, unspecified R10.11 Right upper quadrant pain R10.12 Left upper quadrant pain R10.13 Epigastric pain R10.2

More information

Prescription Drug Monitoring and Toxicology ICD-10-CM. resource guide. Provided as a service of Quest Diagnostics. 1 ICD-10-CM Resource Guide

Prescription Drug Monitoring and Toxicology ICD-10-CM. resource guide. Provided as a service of Quest Diagnostics. 1 ICD-10-CM Resource Guide Prescription Drug Monitoring and Toxicology ICD-10-CM resource guide Provided as a service of Quest Diagnostics 1 ICD-10-CM Resource Guide Table of contents About ICD-10 3 Pain Management: Top Mappings

More information

Jurisdiction New Mexico. Retirement Date N/A

Jurisdiction New Mexico. Retirement Date N/A Local Coverage Determination (LCD): Chiropractic Services (L34816) Contractor Information Contractor Name Novitas Solutions, Inc. opens in new Contract Number 04212 Contract Type A and B MAC J - H LCD

More information

ICD-10-CM Resource Guide

ICD-10-CM Resource Guide Prescription Drug Monitoring and Toxicology ICD-10-CM Resource Guide Provided as a service of Quest Diagnostics 1 ICD-10-CM Resource Guide Table of Contents About ICD-10 3 Pain Management: Top Mappings

More information

2017 Spring Convention

2017 Spring Convention 2017 Spring Convention ICD-10 Billing for DCs and Billing Staff Paul Andrews Please scan IN at the start of class Please scan OUT at the end of class You must attend the entire session to earn your credit(s)

More information

presented by the APMA Coding Committee LIVE: January 9, pm ET

presented by the APMA Coding Committee LIVE: January 9, pm ET Welcome to the APMA ICD-10 is Here Webinar Series presented by the APMA Coding Committee LIVE: January 9, 2014 8pm ET 1 Tonight s Webinar: ICD-10-CM Timelines / Rules / Basics 2 Welcome to the APMA ICD-10-CM

More information

Local Coverage Determination (LCD) for Chiropractic Services (L34816) (Posted for Notice)

Local Coverage Determination (LCD) for Chiropractic Services (L34816) (Posted for Notice) Local Coverage Determination (LCD) for Chiropractic Services (L34816) (Posted for Notice) Print Contractor Information Contractor Name Novitas Solutions, Inc. Contractor Numbers 04911, 07101, 07102, 07201,

More information

CLINICAL CONCEPTS FOR ORTHOPEDICS. CMS Clinical Concepts

CLINICAL CONCEPTS FOR ORTHOPEDICS. CMS Clinical Concepts CLINICAL CONCEPTS FOR ORTHOPEDICS CMS Clinical Concepts ICD 10 LESSONS FROM OFFICE DOCUMENTATION Presented by Dr. Frankeny OUR CHALLENGE: CHANGING OUR DOCUMENTATION ICD 10 Learn the nomenclature Documenting

More information

Additional File 1. ICD9 Codes for chronic pain related diagnoses Dx Diagnosis Description Codes

Additional File 1. ICD9 Codes for chronic pain related diagnoses Dx Diagnosis Description Codes Additional File 1. ICD9 Codes for chronic pain related diagnoses Dx Diagnosis Description Dx Diagnosis Description Codes Codes 327.52 Sleep related leg cramps 717 Old bucket handle tear of medial 333.84

More information

ICD-10 Bootcamp for Chiropractors

ICD-10 Bootcamp for Chiropractors ICD-10 Bootcamp for Chiropractors Presented by Evan M. Gwilliam DC MBA BS CPC CCPC NCICS CCCPC CPC-I MCS-P CPMA Vice President, ChiroCode 1 Dr. Evan Gwilliam Education Bachelor s of Science, Accounting

More information

Low back pain, radiculopathy left leg icd 10 code

Low back pain, radiculopathy left leg icd 10 code Home Search Low back pain, radiculopathy left leg icd 10 code 2018 ICD - 10 code for Radiculopathy is M54.1. Lookup the complete ICD 10 Code details for M54.1.. Low back pain ; M54.6 - Pain in thoracic

More information

EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN

EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN UnitedHealthcare Oxford Clinical Policy Policy Number: PAIN 019.21 T2 Effective Date: October 1, 2017 Table of Contents Page INSTRUCTIONS FOR USE...

More information

MEDICAL POLICY Acupuncture

MEDICAL POLICY Acupuncture POLICY: PG0382 ORIGINAL EFFECTIVE: 12/13/16 LAST REVIEW: 06/12/18 MEDICAL POLICY Acupuncture GUIDELINES This policy does not certify benefits or authorization of benefits, which is designated by each individual

More information

Contractor Information

Contractor Information Local Coverage Determination (LCD): Chiropractic Services (L34242) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information Contractor

More information

Is dx code m54.12 billable code for 2017

Is dx code m54.12 billable code for 2017 Is dx code m54.12 billable code for 2017 The Borg System is 100 % Is dx code m54.12 billable code for 2017 847.2 ICD-9 & 10 Dx Sprain Lumbar Region Code for Chiropractor. ICD-9 (847.2) and ICD-10 (S33.5XXA)

More information

About Your Faculty. National Alliance of Medical Auditing Specialists (NAMAS) ICD-10-CM CM Introduction. Take a Deep Breath!

About Your Faculty. National Alliance of Medical Auditing Specialists (NAMAS) ICD-10-CM CM Introduction. Take a Deep Breath! National Alliance of Medical Auditing Specialists (NAMAS) ICD-10-CM CM Introduction Presented by: John Burns, CPC, CPMA, CPC-I, CEMC Approved NAMAS Instructor ICD-10 Ambassador & AHIMA Approved ICD-10

More information

All Chiropractors and Chiropractic Clinics

All Chiropractors and Chiropractic Clinics P R O V I D E R B U L L E T I N B T 2 0 0 3 2 3 M A Y 1, 2 0 0 3 To: All Chiropractors and Chiropractic Clinics Subject: Overview The Office of Medicaid Policy and Planning (OMPP) has published new rules

More information

ICD-10 Boot Camp for Chiropractors

ICD-10 Boot Camp for Chiropractors ICD-10 Boot Camp for Chiropractors Presented by Evan M. Gwilliam DC MBA BS CPC CCPC NCICS CCCPC CPC-I MCS-P CPMA Vice President, ChiroCode 1 Dr. Evan Gwilliam Education Bachelor s of Science, Accounting

More information

Contractor Information. LCD Information. Local Coverage Determination (LCD): Chiropractic Services (L34585) Document Information

Contractor Information. LCD Information. Local Coverage Determination (LCD): Chiropractic Services (L34585) Document Information Local Coverage Determination (LCD): Chiropractic Services (L34585) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information Contractor

More information

ICD 10 Readiness analysis

ICD 10 Readiness analysis Case Study ICD 10 Readiness analysis nirmal.raja@qbsshealth.com Introduction Physician documentation for ICD-10-CM will need to be more specific and detailed than is required for ICD-9- CM. The codes will

More information

Use the Physician Extender modifier for non-physician services. Additional acupuncture information is available later in this chapter.

Use the Physician Extender modifier for non-physician services. Additional acupuncture information is available later in this chapter. Chapter 18 Chiropractic Services Definition Chiropractic services are medically necessary therapies that employ manipulation and specific adjustment of body structures, such as the spinal column, provided

More information

ICD 10 CM DOCUMENTATION TIPS & CODE EXAMPLES

ICD 10 CM DOCUMENTATION TIPS & CODE EXAMPLES WORKSHOP 2: Orthopedic / Podiatry / Spine ICD 10 CM DOCUMENTATION TIPS & CODE EXAMPLES Ready. Set. Code! ICD 10 CM by Specialty NJHA Healthcare Business Solutions ARTERIOSCLEROSIS OF EXTREMITIES When documenting

More information

Icd-10 code for low back pain with radiculopathy left leg

Icd-10 code for low back pain with radiculopathy left leg P ford residence southampton, ny Icd-10 code for low back pain with radiculopathy left leg Diagnosis Codes (ICD-10) Commonly Used in the Chiropractic Office This section was compiled by Frank M. Painter,

More information

Icd 10 degenerative joint disease back

Icd 10 degenerative joint disease back Icd 10 degenerative joint disease back Search This article appeared in the January issue of the Radiology Coding & Compliance Expert. Many imaging studies are ordered because the patient is experiencing

More information

Documentation for Chiropractic Evaluations (DeskBook Chapter 4.2)

Documentation for Chiropractic Evaluations (DeskBook Chapter 4.2) Documentation for Chiropractic Evaluations (DeskBook Chapter 4.2) Presented by Evan M. Gwilliam, DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP Vice President 1 Dr. Evan Gwilliam Education Bachelor s of

More information

Common Radiology Diagnoses: ICD-9 to ICD-10 Mapping

Common Radiology Diagnoses: ICD-9 to ICD-10 Mapping PERFORMANCE THAT MATTERS NUMBER OF CODES 14,000 69,000 ICD-9 DIAGNOSIS CODES ICD-10 DIAGNOSIS CODES CODE STRUCTURE ICD-9-CM CODE FORMAT ICD-10-CM CODE FORMAT CATEGORY ETIOLOGY, ANATOMIC SITE, MANIFESTATION

More information

RHABDOMYOLYSIS; EXERTIONAL

RHABDOMYOLYSIS; EXERTIONAL 1 MISC 20 RHABDOMYOLYSIS; EXERTIONAL Background This case definition was developed by the Armed Forces Health Surveillance Branch (AFHSB) for the purpose of epidemiological surveillance of exertional rhabdomyolysis.

More information

Icd 10 code for failed lumbar syndrome

Icd 10 code for failed lumbar syndrome Search Search Icd 10 code for failed lumbar syndrome 1-2-2001 Reader Question: Failed Back Syndrome such as a herniated lumbar disk (722.10).. ICD-10 Charts ; Code Connect With AMA CPT. 12-2-2016 I work

More information

ICD- 10- CM General Coding Guidelines and Mapping

ICD- 10- CM General Coding Guidelines and Mapping PECAA Professional Eye Care Associates of America ICD- 10- CM General Coding Guidelines and Mapping Introduction The International Classification of Diseases, 10 th revision, Clinical Modifications (ICD-

More information

Our Goals 10/2/2013. ICD-10 Transition: Five Phases. Hot Topics in Billing and Coding: Transitioning to ICD-10

Our Goals 10/2/2013. ICD-10 Transition: Five Phases. Hot Topics in Billing and Coding: Transitioning to ICD-10 Hot Topics in Billing and Coding: Transitioning to ICD-10 HCCA HAWAII 2013 REGIONAL CONFERENCE Jeri Leong, RN, CPC, CPC-H, CPC-I, CPMA Healthcare Coding Consultants of Hawaii LLC 1 Our Goals Introduce

More information

Icd 10 code for low back pain with radiculopathy to legs

Icd 10 code for low back pain with radiculopathy to legs P ford residence southampton, ny Icd 10 code for low back pain with radiculopathy to legs WebMD experts and contributors provide answers to your health questions. Table: CPT Codes / HCPCS Codes / ICD -

More information

New Authorization Requirements for Outpatient Physical, Occupational, and Speech Therapy (Eff. 1/1/18)

New Authorization Requirements for Outpatient Physical, Occupational, and Speech Therapy (Eff. 1/1/18) New Authorization Requirements for Outpatient Physical, Occupational, and Speech Therapy (Eff. 1/1/18) Effective January 1, 2018, Martin s Point Health Care will require providers to submit initial and

More information

Medical Billing and Coding Online free resources on Education, Certifications (AHIMA, AAPC), Schools, Jobs, Salary, Softwares, CPT, ICD 9, ICD 10.

Medical Billing and Coding Online free resources on Education, Certifications (AHIMA, AAPC), Schools, Jobs, Salary, Softwares, CPT, ICD 9, ICD 10. Medical Billing and Coding Online free resources on Education, Certifications (AHIMA, AAPC), Schools, Jobs, Salary, Softwares, CPT, ICD 9, ICD 10. Bertolotti's syndrome is an atypical cause of axial low

More information

MORE FOR MUSCLES PROGRAM

MORE FOR MUSCLES PROGRAM MORE FOR MUSCLES PROGRAM User guide for physiotherapists and physiotherapy code list (ICD-10-AM codes) MAY 2018 WELCOME TO THE MORE FOR MUSCLES PROGRAM The program reimburses 100% of the agreed charge

More information

Payment Policy. Chiropractic Care. Policy Specific Section: September 10, 2012 November 10, 2012

Payment Policy. Chiropractic Care. Policy Specific Section: September 10, 2012 November 10, 2012 Payment Policy Chiropractic Care Type: Payment Policy Policy Specific Section: Payment Original Policy Date: Effective Date: September 10, 2012 November 10, 2012 Description Chiropractic is a branch of

More information

ICD-10 FOR NEUROSURGERY NERVES- Part II

ICD-10 FOR NEUROSURGERY NERVES- Part II ICD-10 FOR NEUROSURGERY NERVES- Part II J O H N F B I S H O P, P A - C, C P C, C P M A, C G S C, C P R C D I R E C T O R S U R G I C A L C O D I N G A N D A U D I T I N G S E R V I C E S S E N I O R M

More information

FirstCare Health Plans (FirstCare) is on track to be ICD-10 ready by the October 1, 2015 deadline.

FirstCare Health Plans (FirstCare) is on track to be ICD-10 ready by the October 1, 2015 deadline. Overview In July 2014, the U.S. Department of Health & Human Services (HHS) issued a rule finalizing October 1, 2015 as the new compliance date for health care providers, health plans, and health care

More information

INNOVATION IN HEALTHCARE

INNOVATION IN HEALTHCARE INNOVATION IN HEALTHCARE (CMAPPro) is a combination of hardware and software that objectively captures information about the interactivity of muscles and nerves while a patient is in motion. A CMAPPro

More information

Icd 10 right upper back pain

Icd 10 right upper back pain Icd 10 right upper back pain The Borg System is 100 % Icd 10 right upper back pain Free, official information about 2013 (and also 2015) ICD-9- CM diagnosis code 724.5, including coding notes, detailed

More information

Neurostimulators and Neuromuscular

Neurostimulators and Neuromuscular Neurostimulators and Neuromuscular Stimulators Chapter.1 Enrollment..................................................................... -2.2 Benefits, Limitations, and Authorization Requirements...........................

More information

Chronic thoracic back pain icd 9 code

Chronic thoracic back pain icd 9 code Search Search Chronic thoracic back pain icd 9 code 30-9-2015 Free, official information about 2013 (and also 2015) ICD - 9 -CM diagnosis code 724.1, including coding notes, detailed descriptions, index

More information

MP.094.MH Transcutaneous Electrical Nerve Stimulators

MP.094.MH Transcutaneous Electrical Nerve Stimulators MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.094.MH Transcutaneous Electrical Nerve Stimulators This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP

More information

OP-8: MRI LUMBAR SPINE FOR LOW BACK PAIN

OP-8: MRI LUMBAR SPINE FOR LOW BACK PAIN Description of Measure OP-8: MRI LUMBAR SPINE FOR LOW BACK PAIN This measure calculates the percentage of MRI of the Lumbar Spine studies with a diagnosis of low back pain on the imaging claim and for

More information

Icd 9 lumbar radiculopathy

Icd 9 lumbar radiculopathy Icd 9 lumbar radiculopathy Search Short description: Lumbar disc displacement. ICD - 9 -CM 722.10 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however.

More information

o an alphabetical list of terms and corresponding code Tabular List

o an alphabetical list of terms and corresponding code Tabular List ICD-10 Coding Guidelines Coding Guidelines Conventions General Guidelines Eye Chapter Specific 18 total 18 total 1 total Coding Guidelines 1. The Alphabetic Index and Tabular List Conventions for ICD-10-CM

More information

ICD-10 Service Line Overview Musculoskeletal

ICD-10 Service Line Overview Musculoskeletal ICD-10 Service Line Overview Musculoskeletal ICD-10 incorporates much greater clinical detail and specificity as well as updated terminology to be consistent with current clinical practices. ICD-10-CM

More information

ICD-10-CM. International Classification of Diseases, 10th Revision, Clinical Modification

ICD-10-CM. International Classification of Diseases, 10th Revision, Clinical Modification ICD-10-CM International Classification of Diseases, 10th Revision, Clinical Modification ICD-10 stands for the International Statistical Classification of Diseases and Related Health Problems, 10 th revision

More information

ICD-10 Documentation and Cash Flow. Webinar Subscription Access Expires December 31.

ICD-10 Documentation and Cash Flow. Webinar Subscription Access Expires December 31. ICD-10 Documentation and Cash Flow Questions Answers Webinar Subscription Access Expires December 31. How long can I access the on demand version? You will find that in the same instructions box you utilized

More information

Financial Implications of ICD 10 in 2016

Financial Implications of ICD 10 in 2016 Financial Implications of ICD 10 in 2016 Matthew Menendez Takeaways 1. ICD 10 is not finished it has just begun 2. Continue to refine your ICD 10 strategy 3. What percentage of specified codes is your

More information

Answer: To report this service use: Z Encounter for screening for other musculoskeletal disorders

Answer: To report this service use: Z Encounter for screening for other musculoskeletal disorders Scoliosis Screening March 17, 2016 How do you report screening for scoliosis when the patient is sent by the school nurse or the pediatrician but, after the examination, there is no scoliosis identified?

More information

Icd 10 chronic low back pain

Icd 10 chronic low back pain Icd 10 chronic low back pain The Borg System is 100 % Icd 10 chronic low back pain 11-2-2009 I am struggling with coding the icd.9 for the facility. If a patient is dx with acute on chronic low back pain,

More information

10/22/ ,000 codes (155,000 with PCS) 14,000 codes

10/22/ ,000 codes (155,000 with PCS) 14,000 codes ICD 10 for Auditors Presented by Evan M. Gwilliam, DC CPC CCPC NCICS CCCPC CPC-I MCS-P CPMA Director of Education and Consulting for FindACode DrG@FindACode.com Education Introduction Bachelor s of Science,

More information

ICD-10-CM 101 9/19/2016

ICD-10-CM 101 9/19/2016 Presented by Cathy Jennings, BS, CPC, CPC-I, CEDC, CHONC AHIMA Approved ICD-10-CM/PCS Trainer Managing Consultant October 5, 2016 Disclaimer The speaker has no financial relationship to any products or

More information

Prior authorization will not be required for outpatient speech therapy.*

Prior authorization will not be required for outpatient speech therapy.* POLICY CHANGE: Authorization for All Outpatient Speech Therapy and Pediatric Outpatient Physical and Occupational Therapy NOT REQUIRED by Martin s Point Health Care Effective June 25, 2018 Thank you for

More information

UTILIZING CPT AND HCPCS CODES FOR HEALTHCARE REIMBURSEMENT: A guide to billing and reimbursement of SpiderTech kinesiology tape products

UTILIZING CPT AND HCPCS CODES FOR HEALTHCARE REIMBURSEMENT: A guide to billing and reimbursement of SpiderTech kinesiology tape products UTILIZING CPT AND HCPCS CODES FOR HEALTHCARE REIMBURSEMENT: A guide to billing and reimbursement of SpiderTech kinesiology tape products Billing and coding of taping and strapping services can be a complex

More information

9/27/2011. Improving Revenue Capture: Best Practices in Coding, Documentation and Charge Capture. Educational Breakout Session PRESENTERS

9/27/2011. Improving Revenue Capture: Best Practices in Coding, Documentation and Charge Capture. Educational Breakout Session PRESENTERS Educational Breakout Session Improving Revenue Capture: Best Practices in Coding, Documentation and Charge Capture Becker s ASC Conference, Breakout Session, October 29, 2011 PRESENTERS Yvonda Moore Director

More information

Latest Press Release. Mylan a1 blue pill real vs fake

Latest Press Release. Mylan a1 blue pill real vs fake corp@stantec.com Latest Press Release Mylan a1 blue pill real vs fake S Approximate Synonyms. Cervical (neck) radiculitis; Cervical (neck) radiculopathy; Cervical radiculitis; Cervical radiculopathy; Ulnar

More information

Transitioning to ICD-10-CM: General Coding Guidelines & Mapping

Transitioning to ICD-10-CM: General Coding Guidelines & Mapping Transitioning to ICD-10-CM: General Coding Guidelines & Mapping 2 Introduction 1975 - International Classification of Diseases, 9th revision was originated 1979 - The United States began using ICD-9 1990

More information

ICD-10, Ready or Not, Here it Comes! Presented by: Mary Bort, CPC, CANPC, CASCC, COSC Director of Coding, Surgical Notes

ICD-10, Ready or Not, Here it Comes! Presented by: Mary Bort, CPC, CANPC, CASCC, COSC Director of Coding, Surgical Notes ICD-10, Ready or Not, Here it Comes! Presented by: Mary Bort, CPC, CANPC, CASCC, COSC Director of Coding, Surgical Notes Today s Webinar Topics ICD-10 Timeline - Critical Dates to be Aware of ICD-10 Changes

More information

Countdown to ICD-10: Top 10 Things to Do to Prepare for ICD-10

Countdown to ICD-10: Top 10 Things to Do to Prepare for ICD-10 Countdown to ICD-10: Top 10 Things to Do to Prepare for ICD-10 Presentation to: Providers, Trading Partners and Billing Firms Presented by: Camillia Harris, ICD-10 Communications Lead Erica Baker, ICD-10

More information

2017 Spring Convention

2017 Spring Convention 2017 Spring Convention CPT Coding & Modifiers Paul Andrews Please scan IN at the start of class Please scan OUT at the end of class You must attend the entire session to earn your credit(s) for this class

More information

Musculoskeletal System

Musculoskeletal System Musculoskeletal System CPT CPT copyright 2011 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the

More information

MedStar Health considers Trigger Point and Transforaminal Epidural Injections medically necessary for the following indications:

MedStar Health considers Trigger Point and Transforaminal Epidural Injections medically necessary for the following indications: MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.098.MH Trigger Point and Transforaminal Epidural Injections This policy applies to the following lines of business: MedStar Employee (Select) MedStar

More information

4. ICD-10-PCS is used to code and classify data from hospital inpatient records only. a. diagnosis

4. ICD-10-PCS is used to code and classify data from hospital inpatient records only. a. diagnosis 1. The International Classification of Diseases (ICD) is published by the World Health Organization (WHO) and is used to classify data from death certificates. a. disease b. morbidity c. mortality d. procedure

More information

Diagnostic Imaging Exams

Diagnostic Imaging Exams Guide for Chiropractors Diagnostic Imaging Exams CREATED FOR OUR CHIROPRACTIC PARTNERS This document has been prepared by the specialized, board-certified radiologists who interpret patient exams for Center

More information

DIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE:

DIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE: DIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE: THE BASICS Preferred Clinical Services for Leading Age Florida August 26-27, 2015 WHAT IS ICD-10-CM? International Classification of Diseases, 10 th Revision,

More information

0RTHOPEDIC MASSAGE. Orthopedic Massage Benefits. Orthopedic Massage Applications

0RTHOPEDIC MASSAGE. Orthopedic Massage Benefits. Orthopedic Massage Applications 0RTHOPEDIC MASSAGE Orthopedic Massage involves therapeutic assessment, manipulation, and movement of locomotor soft tissues to eliminate pain and dysfunction throughout the body. It is more than a technique.

More information

Mountain State Blue Cross Blue Shield (Otherwise referred to as the Plan) CORPORATE POLICY AND PROCEDURES

Mountain State Blue Cross Blue Shield (Otherwise referred to as the Plan) CORPORATE POLICY AND PROCEDURES Mountain State Blue Cross Blue Shield No: MP Supersedes No.: N/A Original Effective Date: 0/0/0 Standards: Date of Last Review: 0//0 Related Policies: Date of Last Revision: DRAFT ( ) INTERIM ( ) FINAL

More information

Special Thanks. What is ICD-10-CM? CDQ Education Department. Coding on the River Executive Committee. Seth Canterbury Stacey Dingman Wanda Brown

Special Thanks. What is ICD-10-CM? CDQ Education Department. Coding on the River Executive Committee. Seth Canterbury Stacey Dingman Wanda Brown Special Thanks CDQ Education Department Seth Canterbury Stacey Dingman Wanda Brown Coding on the River Executive Committee Virginia Outlaw What is ICD-10-CM? Clinical modification of the WHO s ICD-10 morbidity/mortality

More information

Icd 10 code for tear labrum

Icd 10 code for tear labrum Icd 10 code for tear labrum Free, official coding info for 2018 ICD - 10 -CM S43.43 - includes detailed rules, notes, synonyms, ICD -9-CM conversion, index and annotation crosswalks, DRG grouping. guidance.

More information

Osteoarthrosis, unspecified whether generalized or localized, lower leg. Osteoarthrosis, localized, not specified whether primary or secondary, pelvic

Osteoarthrosis, unspecified whether generalized or localized, lower leg. Osteoarthrosis, localized, not specified whether primary or secondary, pelvic Page 1 Appendix TABLE E-1 Codes (and Definitions) in Humana Database Used for Study Inclusion and Exclusion of Patients Who Underwent,, or 1 to 2-Level Inclusion ICD-9-P-8154 Total knee replacement ICD-9-D-71596

More information

COOLIEF* COOLED RADIOFREQUENCY REIMBURSEMENT GUIDE

COOLIEF* COOLED RADIOFREQUENCY REIMBURSEMENT GUIDE COOLIEF* COOLED RADIOFREQUENCY REIMBURSEMENT GUIDE Revised 06/2016 HALYARD* Pain Management Cooled RF Systems Reimbursement Guide Table of Contents Introduction... 2 COOLIEF* TRANSDICAL* Disc Biacuplasty

More information

Icd 10 code for failed back surgery syndrome lumbar

Icd 10 code for failed back surgery syndrome lumbar Icd 10 code for failed back surgery syndrome lumbar Spinal stenosis can be a late complication after laminectomy for disc herniation or when surgery was performed for the primary pathologic condition of

More information