Top 10 ICD-10 Coding Errors (and how to fix them!) Presented by Jennifer Warfield, BSN, HCS-D, COS-C Education Director, PPS Plus
|
|
- Delphia Martin
- 5 years ago
- Views:
Transcription
1 (and how to fix them!) Presented by Jennifer Warfield, BSN, HCS-D, COS-C Education Director, PPS Plus
2 Top 10 ICD-10 Coding Errors (and how to fix them!) Top 10 Primary Diagnoses In ICD-10 ICD-10 Codes ICD-10 Description ICD-10 Frequency ICD-9 Code ICD-9 Frequency In ICD-9 Top 10? Z47 Orthopedic Aftercare 6.6% V54 7.9% Yes I50 Heart Failure 6.1% % Yes Z48 Encounter for Other Post-op Aftercare 5.7% V58 7.2% Yes E11 Type 2 Diabetes Mellitus 5.6% % Yes J44 Chronic Obstructive Pulmonary Disease 4.9% % Yes I10 Essential (primary) Hypertension 3.6% % Yes L89 Pressure Ulcer 3.5% % Yes M62 Other Disorders of Muscles 3.4% % Yes I69 Sequelae of Cerebrovascular Disease 3.2% % Yes R26 Abnormalities of Gait & Mobility 2.4% % No Top 10 ICD-10-CM Issues since ICD-10 Implementation 1. Utilizing acute injury 7th character A codes 2. Diagnoses not supported by medical record documentation 3. The POC includes codes for resolved conditions 4. Non-specific codes used when the medical record supported a higher specificity 5. Etiology/manifestation conditions coded as separate and non-related conditions 6. Sequencing of diagnoses does not support the service intensity or Focus of Care 7. Supportive diagnosis or condition codes were not included for Therapies 8. Failure to include Tobacco Use or history when required for cardio-pulmonary diagnoses 9. Use of Z codes for complicated wounds 10. Failure to include conditions with potential to affect the patient s response to treatment 7th Character Use Since 2013, most were taught that home health would never use the 7th character A. We learned that A would only be used for the initial episode acute care settings (hospitals, ERs, doctor s offices) and D was reserved for subsequent episodes of care (home health) Initial grouper didn t even accept A in home health Focus on the word "active" rather than "initial" Clarifications The coding clinic has since clarified the use of the 7th character - 7th character A while used for the initial encounter should be used when a patient is actively receiving treatment for a condition - use when patient is actively getting care for conditions such as wounds or IV therapy Grouper has been updated to accept A in certain conditions Active treatment can begin in the inpatient or physician office setting and continue when the patient is discharged to home and still be considered the Initial Encounter, even if the patient has been seen by multiple providers. 1
3 Never use 7th character A for injuries, use characters denoting subsequent encounter or sequela. Once a patient has received treatment for an injury by a physician, emergency department or inpatient facility, home health provides routine care for the healing or recovery phase. In the routine or recovery phase, the 7th character D is used The most common home health examples requiring subsequent encounter 7th characters are healing traumatic or pathological fractures. There are 12 different 7th characters for subsequent encounter to choose from, depending on the healing status or type of complication. Most used in home health: - A active treatment - D routine aftercare - S sequela For complication codes, active treatment refers to treatment for the condition described by the code, even though it may be related to an earlier precipitating problem Examples Patient with fractured R distal ulna. Has severe swelling. Casting delayed until edema subsides. - S52.601A Patient with fractured R distal ulna from a fall. Arm is in a cast. - S52.601D Patient with healed fracture of distal R ulna a year ago. Bone has not aligned correctly causing chronic pain. - S52.601S Patient with an infection of a cholecystectomy incision referred to home health for wound care and IV antibiotics - T81.4XXA Patient with disruption of abdominal incision. Not infected and has been left to heal by secondary intention. - T81.31XD Documentation to Support Diagnoses The fi rst 6 diagnoses on the POC must match the OASIS and the Final Bill. All diagnoses must be supported by the provider s documentation If there is documentation of a manifestation but the etiology has not been documented by the physician, coder must get verifi cation from provider. i.e., stasis ulcer with no etiology. Coding from medication list or patient statement. Keep in mind that many medications are used off formulary so diagnoses must be verifi ed Do not code possible, borderline, or suspected diagnoses. Code symptoms until defi nitive diagnosis is made Coding Resolved Conditions Resolved conditions should be coded as history of if still relevant to current POC - patient with current lung neoplasm had mastectomy for breast cancer two years ago. - patient with primary diagnosis of HTN had a TIA six months ago - patient with a foley catheter has a history of frequent UTIs Do not code resolved conditions that have no impact on current POC - resolved breast cancer two years ago for a patient with TKA - UTI a year ago in a patient admitted for fractured arm 2
4 Unspecified Codes Codes titled other or other specified are for use when the information in the medical records provides detail for which there is no code listed. Codes titled unspecified are for use when the information in the medical record is insufficient to assign a more specified code. Some unspecified codes in a category are not case-mix codes and will affect HHRG score. - I69.3 codes is the default code for CVA or stroke but I69.3 codes with a 6th character of 9 are not case mix as they are codes that do not specify an affected side (should always be documented) Unspecified codes should be reported when they are the codes that most reflect what is known and documented by the provider. It is inappropriate to select a specific code that is not supported by the medical record documentation or conduct medically unnecessary diagnostic testing in order to determine a more specific code. Unspecified Examples: - Anemia D Abdominal Pain R Angina I COPD J Alzheimer's G30.9 Other & Unspecified Codes Documentation states Diabetic Osteomyelitis - Diabetes with other specified complications E Osteomyelitis M86.- Using E11.8 Diabetes with unspecified complications is incorrect. If a complication is the result of diabetes (or any other condition) there must be documentation of the complication. Etiology & Manifestation Codes Certain diagnosis codes are only to be used as the manifestation of a documented etiology. Manifestation codes can never be primary. In most cases there are: - Notes at etiology codes requiring a manifestation that state use additional code - Notes at manifestation codes that state code first Sequence with the manifestation immediately following the etiology code - Alzheimer's - G Dementia in conditions classified elsewhere - F02.- There are some manifestation situations that that will not have the wording in diseases classified elsewhere with the etiology code. Instead, code will usually have the use additional code. Example: Atherosclerosis of native arteries of R leg with ulceration of thigh - I Non-pressure chronic ulcer of R thigh limited to skin breakdown - L Not a true etiology/manifestation coding but is a mandatory multiple coding situation 3
5 Sequencing of Codes Some coding rules indicate that one code must be coded before another code as in: 1. Conditions due to an underlying condition Diabetes due to underlying condition E08 code first the underlying disease 2. Etiology/Manifestation Pairing Dementia in conditions classified elsewhere - F02.- code first the etiology code 3. Use additional code scenarios Hypertensive CKD - I12 code also the stage of the CKD If mandatory sequencing not specified, code conditions according to POC. If the use of a Z code is required and not mandated as primary, they can be sequenced at the bottom of list. There is no requirement in HH that all diagnoses be coded. Only code those that have a direct impact or the potential to have an impact on the POC. Codes to Support Therapy There are no truly therapy diagnoses. There are many diagnoses that support the need for therapy. Ultimately, the therapist s evaluation and documentation will support the need for therapy. Conditions that are integral to a disease process or injury being addressed by therapy are not coded separately. If episode is therapy only, code the condition or problem that is causing the condition that therapy will be addressing. - Severe weakness due to exacerbation of COPD. Abnormalities of Gait - Ataxic Gait - R Paralytic Gait - R Difficulty in walking, NEC R26.2 (not case mix) - Unspecified abnormalities of gait & mobility - R Other abnormalities of gait & mobility - R Unspecified abnormalities - R26.9 (not case mix) Suggest discussing with therapist or reviewing evaluation for specifics Repeated falls - Falling or tendency to fall - R29.6 Use for encounters when a patient has recently fallen and the reason for the fall is being investigated Can be used as primary diagnosis History of falls - History of falls - Z At risk for falls - Z91.81 Use when a patient has fallen in the past and/or is at risks for falls May be used in conjuction with each other 4
6 Tobacco Use Codes Some Cardiac and most Respiratory conditions in ICD-10 require the addition of Tobacco Use when applicable Exposure to environmental tobacco smoke (Z77.22) Exposure to tobacco smoke during the prenatal period (P68.81) History of tobacco use (Z87.89) Occupational exposure to environmental spoke (Z57.31) Tobacco dependence (must be specified by provider) (F17.- ) Tobacco use (Z72.0) Z Codes Used for circumstances other than disease, injury or external causes that are listed as problems. History, aftercare, status, encounters, etc. Some Z codes can only be primary, some can only be secondary and still others can be either (reference PX/SX next to code in tabular list of manual). Never use for complications (infected or dehisced wounds). Use the appropriate T81 code instead. Aftercare Z Codes Never use for aftercare of injuries or fractures. Use instead the original injury code with the appropriate 7th character from Chapter 19 Generally listed as primary to indicate the reason for the encounter But can be used as a secondary code to indicate that aftercare is being provided as well as the primary reason for the admission Example: Patient admitted to HH following an MI. Also had a pacemaker inserted. Acute MI - I21.- Aftercare following surgery to circulatory system - Z Comorbidities Comorbidities are the simultaneous presence of two chronic diseases or conditions in a patient May be long-standing, occurred at the time of or at any time after the primary condition Usually coded as a secondary diagnoses if it affects the POC even if it is not the focus of the current episode of care Must be documented by the provider 5
3/20/2017. CONNECTING THE LATEST GUIDANCE FY2017 FOR ICD-10 MATTERS Kyla D. Harrison, RN, BSN, HCS-D, COS-C Visiting Nurse Association of Kansas City
CONNECTING THE LATEST GUIDANCE FY2017 FOR ICD-10 MATTERS Kyla D. Harrison, RN, BSN, HCS-D, COS-C Visiting Nurse Association of Kansas City Coding needs met in many different ways: 1. Fulltime Coders HCS-D
More informationICD What Are You Waiting For? Presented by Jennifer Warfield, BSN, HCS-D, COS-C Education Director, PPS Plus Software
ICD-10... What Are You Waiting For? Presented by Jennifer Warfield, BSN, HCS-D, COS-C Education Director, PPS Plus Software ICD-10... What Are You Waiting For? What is it? International classification
More informationICD-10-CM Coding and Documentation for Long Term Care
ICD-10-CM Coding and Documentation for Long Term Care June 3, 2014 Chris Hoskins, MA, RHIA, CTR, CHC Karen Fabrizio, RHIA CHTS-CP AHIMA Approved ICD-10-CM/PCS Trainers Objectives Review 2014 Coding Guidelines
More informationPhysical Therapy Diagnosis and Documentation Tips
1 This tool is designed to assist the Physical Therapist in consultation with the physician, in the selection of an appropriate according to Medicare coverage guidelines. The documentation tips will add
More informationICD 10 CM Coding and Documentation
ICD 10 CM Coding and Documentation Adult Day Health Care Council Karen L. Fabrizio, RHIA, CHTS CP, CPRA April 10, 2014 Presented by: Karen Fabrizio, RHIA CHTS CP CPRA is an AHIMA Approved ICD 10 CM/PCS
More informationICD-10-CM Countdown: Are You Ready?
ICD-10-CM Countdown: Are You Ready? Prevalence of conditions Number of codes be converted Number of new patients per month Number of bills sent each month Scope of the Implementation ICD-10-CM Official
More informationICD-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 informationWho is Using ICD-10-CM?
Conventions and Guidelines You Need to Know Presented by Brenda Edwards, CPC, CPMA, CPB, CPC-I, CEMC, CRC Who is Using ICD-10-CM? 1 Objectives of Presentation Review new conventions and chapter specific
More informationNavigating the Challenges of Hospice Coding. Coding has never been so important for the hospice industry.
Navigating the Challenges of Hospice Coding Coding has never been so important for the hospice industry. Presentation team: Dawn B. Cheek RN, BSN Clinical Consulting Manager, McBee Associates, Inc. Elizabeth
More informationICD-10 Physician Education. General Surgery
ICD-10 Physician Education General Surgery 1 Training Objectives ICD-9 to ICD-10 Comparison Documentation Tips Additional Educational Opportunities Questions 2 ICD-9 to ICD-10 Comparison Code Structure
More informationA chapter by chapter look at the ICD-10-CM code set Coding Tip Sheet
Coding Tip Sheet Chapter 1 - Certain Infectious and Parasitic Diseases Terminology changes: The term Sepsis (ICD-10-CM) has replaced the term Septicemia (ICD-9-CM) Urosepsis is a nonspecific term and is
More information2 Master the ICD 10 Payment System to Prevent Revenue Losses
Master the ICD 10 Payment System to Prevent Revenue Losses Tricia A. Twombly BSN RN HCS D HCS O COS C CHCE AHIMA Approved ICD 10 CM Trainer Senior Director, DecisionHealth Chief Executive Officer, BMSC
More informationICD-10 Scenarios. Infectious disease Chapter 1 Scenario 1
ICD-10 Scenarios Infectious disease Chapter 1 Scenario 1 Miss Matilda, an 88 yr old, has cellulitis of right lower leg that is infected with E coli. She is receiving IV antibiotics. 1 Infectious disease
More informationDetermining Wound Diagnosis and Documentation Tips Job Aid
Determining Wound Diagnosis and Job Aid 1 Coding Is this a traumatic injury from an accident? 800 Codes - Injury Section of the Coding Manual Code by specific site of injury. Only use for accidents or
More informationCheryl Ericson, MS, RN, CCDS, CDIP, AHIMA Approved ICD 10 CM/PCS Trainer Clinical Documentation Program Manager for ezdi.
A Venture of Cheryl Ericson, MS, RN, CCDS, CDIP, AHIMA Approved ICD 10 CM/PCS Trainer Clinical Documentation Program Manager for ezdi HIPAA Code Sets HIPAA legislation required use of the International
More informationo 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 informationICD- 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 informationFY 2017 ICD-10-CM Guideline Updates. Melanie Endicott, MBA/HCM, RHIA, CHDA, CDIP, CCS, CCS-P, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer
FY 2017 ICD-10-CM Guideline Updates Melanie Endicott, MBA/HCM, RHIA, CHDA, CDIP, CCS, CCS-P, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer How to Review Guideline Changes 1. Download the FY 2017 ICD-10-CM
More informationDIAGNOSIS 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 informationICD-10-CM Recertification Prep: Proper Prepping Isn t as Bad as You Think
ICD-10-CM Recertification Prep: Proper Prepping Isn t as Bad as You Think Julie Orton Van, CPC, CPC-P, CEMC Product Manager Coding Solutions 2015 AAPC HEALTHCON, Las Vegas NV Publisher s Notice: Although
More information11/24/2014. Code category I21 for initial MI less than or equal to 4 weeks old Code category I22 for subsequent MI. 9.
9.2 CVD Case Study I25.110 Angina see Arteriosclerosis, coronary (artery), native vessel with angina pectoris, unstable I69.351 Hemiplegia, following, cerebrovascular disease, cerebral infarction Z95.1
More informationASSIGNMENT 5-1 REVIEW QUESTIONS
ASSIGNMENT 5-1 REVIEW QUESTIONS Part I Fill in the Blank on ICD-9-CM 1. primary, principal 2. Systematized Nomenclature of Human and Veterinary Medicine (SNOMED) International. 3. International Classification
More informationRisk Adjustment Documentation & Coding Improvement Reference Information for 2017
Risk Adjustment Documentation & Coding Improvement Reference Information for 2017 In today s quality and patient-centered health care environment, the importance of accurate, specific and thorough medical
More informationICD-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 informationICD-10-CM - Session 2. Cardiovascular Conditions, Neoplasms and Diabetes
ICD-10-CM - Session 2 Cardiovascular Conditions, Neoplasms and Diabetes Agenda General coding guidelines Acute myocardial infarction Hypertension Cerebrovascular accidents and sequelae Neoplasm and history
More informationICD-9-CM Home Health Coding Impact on Reimbursement
ICD-9-CM Home Health Coding Impact on Reimbursement Presented by HealthCare ConsultLink Linda Parker, RN, BSN, COS-C, HCS-D Objectives Identify principles for determining primary/secondary diagnoses Identify
More informationLearning Objectives. Guidance Hierarchy. AHA Coding Clinic Update
1 AHA Coding Clinic Update Nelly Leon Chisen, RHIA Director, Coding and Classification Executive Editor, Coding Clinic American Hospital Association Chicago, IL Learning Objectives At the completion of
More informationICD-10-CM Official Guidelines for Coding and Reporting 2016
ICD-10-CM Official Guidelines for Coding and Reporting 2016 Narrative changes appear in bold text. Items underlined have been moved within the guidelines since the 2014 version. Italics are used to indicate
More informationICD-10-CM Coding Conventions & Guidelines
ICD-10-CM Coding Conventions & Guidelines Presenter: Gail Harrington, RHIT, CCS, CIRCC AVP, Coding Compliance RegionalCare Hospital Partners 2011 ICD-10-CM is available at http://www.cdc.gov/nchs/icd/icd10cm.htm
More informationDIABETES CODING AND DOCUMENTATION COMPLIANCE
BC ADVANTAGE AUDIO SERIES: DIABETES CODING AND DOCUMENTATION COMPLIANCE 1 Presented by: Darlene Boschert, RHIA, CPC, CPC-H, CPC-I Providing LOW-COST educational resources for Medical office Professionals
More informationHome Health Prospective Payment System. Overview
Overview Version 6117 January 2017 PBL-046 Java is a registered trademark of Oracle and/or its affiliates. Table of Contents Overview of the... 5 Background and versioning... 5 Changes for this version...
More information11/24/2014. Do NOT code signs/symptoms integral to the disease or condition Congestive heart failure. Bronchitis. Examples: Edema, SOB.
Examples: Do NOT code signs/symptoms integral to the disease or condition Congestive heart failure Edema, SOB Bronchitis cough Examples: DO code signs/symptoms even when integral if so instructed Acute
More informationICD-10-CM Official Guidelines for Coding and Reporting 2014
Appendix VII ICD-10-CM Official Guidelines for Coding and Reporting 2014 Narrative changes appear in bold text Items underlined have been moved within the guidelines since the 2013 version Italics are
More informationPrepared by: Pam Scott, RHIT, CCS, CRC, CCDS AHIMA Approved ICD-10-CM/PCS Trainer First Class Solutions, Inc
Long Term Care Coding Prepared by: Pam Scott, RHIT, CCS, CRC, CCDS AHIMA Approved ICD-10-CM/PCS Trainer First Class Solutions, Inc 1 Speaker Information Pamela L. Scott, RHIT, CCS, CRC, CCDS Senior Compliance
More informationDiagnosis Coding Problematic Areas: Coding & Sequencing
Diagnosis Coding Problematic Areas: Coding & Sequencing OBJECTIVES Guideline information Sepsis, Severe Sepsis, Septic Shock HIV Diabetes Under/Over-dosing Hypertension Ulcers Burns INCLUDES, USE ADDITIONAL
More informationCanadian Coding Standards for ICD-10-CA and CCI Errata
Canadian Coding Standards for ICD-10-CA and CCI Errata alter term General Coding Standards Page 23 If, after an episode of health care, the MRDx is still recorded by the physician as suspected, questionable,
More informationICD-10-CM Coding Tips
ICD-10-CM Coding Tips for clients of: www.teamtsi.com 800.765.8998 Content developed and presented by: 3030 N. Rocky Point Drive, Suite 240 Tampa, FL 33607 800.275.6252 www.polaris-group.com ICD-10-CM
More informationCardiothoracic and Cardiothoracic Surgery ICD-10-CM 2014: Reference Mapping Card
2014: Reference Mapping Card 162.3 Malignant neoplasm upper lobe lung 162.5 Malignant neoplasm lower lobe lung 162.9 lung/bronchus 396.2 396.3 Mitral insufficiency, aortic stenosis Mitral aortic valve
More informationAppropriate Use of 7 th Character in ICD 10 CM
Appropriate Use of 7 th Character in ICD 10 CM Jameel Ahmed RHIA,CCS Corporate, Group HIM Manager SEHA - Abu Dhabi Health Services Co SEHA: Abu Dhabi Healthservices 18,000 Employees 12 Hospitals 57 Ambulatory
More informationWELCOME to a PMI WEBINAR PRESENTATION
WELCOME to a PMI WEBINAR PRESENTATION PMI presents: Nancy Maguire on the topic: Primary Care and ICD-10-CM Diagnosis Coding Welcome to Practice Management Institute s Webinar and Audio Conference Training.
More informationChapter 10: Diseases of the Respiratory System J 00-J99
Chapter 10: Diseases of the Respiratory J 00-J99 J00 J06 Acute upper respiratory infections J10 J18 Influenza and pneumonia J20 J22 Other acute lower respiratory infections J30 J39 Other diseases of upper
More informationMeet the Presenter. Welcome to PMI s Webinar Presentation. ICD-10-CM Code Updates - Effective October 1. On the topic:
Welcome to PMI s Webinar Presentation Brought to you by: Practice Management Institute pmimd.com Meet the Presenter On the topic: Tom Stevens, CMC, CMIS, CMOM, CCS-P, CPC ICD-10-CM Code Updates - Effective
More informationAdvanced ICD 9 CM Guidelines Misused or Forgotten. Disclaimer
Advanced ICD 9 CM Guidelines Misused or Forgotten Jill Young, CPC, CEDC, CIMC Young Medical Consulting, LLC East Lansing, MI 1 Disclaimer This material is designed to offer basic information for coding
More informationICD-10-CM Official Guidelines for Coding and Reporting 2011 Page 2 of 111
Narrative changes appear in bold text Items underlined have been moved within the guidelines since the 2010 version Italics are used to indicate revisions to heading changes The Centers for Medicare and
More informationICD-10 Physician Education. Palliative Care SIP
ICD-10 Physician Education Palliative Care SIP 1 Training Objectives ICD-9 to ICD-10 Comparison Documentation Tips Additional Educational Opportunities Questions 2 ICD-9 to ICD-10 Comparison Code Structure
More informationCHAPTERS OF ICD-10-CM
CHAPTERS OF ICD-10-CM Chapter Description Category Chapter 1 Certain Infectious and parasitic diseases A00-B99 Chapter 2 Neoplasms C00-D49 Chapter 3 Diseases of the blood and blood-forming organs and certain
More informationABF and Implications for Coding Helen Nolan
ABF and Implications for Coding Helen Nolan 11 th May 2017 1 ABF explained What is ABF What are DRGs What are MDCs 2 What is Activity Based Funding (ABF) ABF is a way of funding hospitals for the number
More informationTransitioning 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 informationICD-9-CM Official Guidelines for Coding and Reporting
Narrative changes appear in bold text Items underlined have been moved within the guidelines since April 2005 The guidelines include the updated V Code Table The Centers for Medicare and Medicaid Services
More informationTHE SCIENCE OF DIAGNOSTIC CODING PART 2
THE SCIENCE OF DIAGNOSTIC CODING PART 2 Judy Adams, RN, BSN, HCS-D, HCS-O Adams Home Care Consulting, Inc. Presented for: Hospice Fundamentals June 28, 2013 Objectives: Part 2 of 2 part series Identify
More informationJune 7, 2010 VIA ELECTRONIC MAIL
VIA ELECTRONIC MAIL, MPH, RHIA Medical Systems Administrator National Center for Health Statistics 3311 Toledo Road Room 2402 Hyattsville, Maryland 20782 Dear Ms. Pickett: The American Health Information
More information9/1/2015. Studies (AHIMA)
9/1/2015 IC CD 10 Coding Supplemental Case Studies Amy Franklin, RN, RAC MT, ICD 10 CM/PCS Trainer (AHIMA) 1. DM Case Study 62 y.o. Mr. X has DM with insulin in use, DM Neuropathy and DM Renal insufficiency.
More informationSupplementary Online Content
Supplementary Online Content Dharmarajan K, Wang Y, Lin Z, et al. Association of changing hospital readmission rates with mortality rates after hospital discharge. JAMA. doi:10.1001/jama.2017.8444 etable
More informationICD-10 Back Up The Truck. Andrea Romero, RHIT, CCS, CPC NMHIMA Leadership Conference April 10, 2014
ICD-10 Back Up The Truck Andrea Romero, RHIT, CCS, CPC NMHIMA Leadership Conference April 10, 2014 ICD-10 IS DELAYED AGAIN Classification Structure ICD-9-CM Infectious and Parasitic Diseases (001 139)
More informationICD-10-CM: The Sage Continues
ICD-10-CM: The Sage Continues UHIMA Kathy DeVault, MSL, RHIA, CCS, CCS-P, FAHIMA UASI Kathy.devault@uasisolutions.com Objectives Review quality documentation Discuss use of unspecified codes Discuss opportunities
More informationFY 2017 Updates to the ICD-10- CM and ICD-10-PCS Official Guidelines for Coding and Reporting
FY 2017 Updates to the ICD-10- CM and ICD-10-PCS Official Guidelines for Coding and Reporting Nelly Leon-Chisen, RHIA Director, Coding and Classification American Hospital Association Guidelines Accompany
More informationMaking 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 informationICD-10. An Introduction
ICD-10 An Introduction ICD-10 Worldwide Other countries have been using ICD-10 for many years. Coding professionals there were better prepared with: Human Anatomy and Physiology Understanding of disease
More informationICD-10-CM: What Does Your Coder Really Need To Know Part I. Your Speaker A SHORT HISTORY LESSON
ICD-10-CM: What Does Your Coder Really Need To Know Part I IAHHC 2014 ANNUAL COFERENCE Wednesday, May 7, 2014 1:00 p.m.-2:30 p.m. Copyright 2014 FR&R Healthcare Consulting Inc. 1 Your Speaker Bonny Kohr,
More informationEACTS Adult Cardiac Database
EACTS Adult Cardiac Database Quality Improvement Programme List of changes to Version 2.0, 13 th Dec 2018, compared to version 1.0, 1 st May 2014. INTRODUCTORY NOTES This document s purpose is to list
More informationMapping ICD 9 CM to ICD 10: Lessons Learned
Mapping ICD 9 CM to ICD 10: Lessons Learned Gail I. Smith, MA, RHIA, CCS P Gail I. Smith Consulting 1 Topics Process for Decision Making Mapping and Decision Trees Documentation for Coding Decisions Root
More informationICD-10 for Beginners Four-Part Series
ICD-10 for Beginners Four-Part Series www.jluhealth.com 1 ICD-10-CM: Introduction to Coding Fundamentals PRESENTER: Joan L. Usher, BS, RHIA, ACE AHIMA Approved ICD-10-CM Trainer JLU HEALTH RECORD SYSTEMS
More informationICD-10-CM Official Guidelines
FY2018 FY2018 FY2018 FY2018 FY2018 FY2018 FY2018 FY2018 FY2018 FY2018 FY2018 FY2018 FY2018 FY2018 ICD-10-CM Official Guidelines for Coding and Reporting FY2018 *Note: These FY2018 guidelines are the most
More informationAgenda. ICD-10 CM ICD-10 PCS Prior Auth Guidelines Claims Processing
ICD-10 OVERVIEW Agenda ICD-10 CM ICD-10 PCS Prior Auth Guidelines Claims Processing ICD 10 goes live All HIPAA-covered entities, including health plans, clearinghouses, and healthcare providers must adopt
More informationFinancial & Management Aspects of OASIS C2
Financial & Management Aspects of OASIS C2 Presented By: Melinda A. Gaboury, COS C Healthcare Provider Solutions, Inc. 615 399 7499 info@healthcareprovidersolutions.com WHAT DOES OASIS C2 IMPACT? HHRG/HIPPS
More informationICD-9-CM Volumes 1 and 2 Diagnosis Coding for Outpatient Facilities. Chapter 4. Chapter Outline
ICD-9-CM Volumes 1 and 2 Diagnosis Coding for Outpatient Facilities Chapter 4 1 Introduce students to Chapter Outline 1. Medical terms associated with ICD-9-CM coding 2. Format of ICD-9-CM code book 3.
More informationHighlights of the NEW 2017 Codes ICD-10- CM
Highlights of the NEW 2017 Codes ICD-10- CM Maine HIMA September 22, 2016 ICD-10-CM o 1943 New Codes o 422 Revised Codes o 305 Deleted Codes Overall Picture o Which revisions apply most to your facility?
More informationChapter 10 Respiratory System J00-J99. Presented by: Jesicca Andrews
Chapter 10 Respiratory System J00-J99 Presented by: Jesicca Andrews 1 Respiratory System 2 Respiratory Infections A respiratory infection cannot be assumed from a laboratory report alone; physician concurrence
More informationManaging Non-Routine Medical Supplies
Managing Non-Routine Medical Supplies DecisionHealth Teleconference September 23, 2008 Lynda Laff Laff Associates 117 Club Course Drive Hilton Head Island, South Carolina 29928 (843) 671-4170 llaff@laffassociates.com
More informationPAHCS CEUniversity ICD-10-CM 2015
PAHCS CEUniversity ICD-10-CM 2015 THIS PACKET CAN ONLY BE USED 1 TIME FOR CEU You will receive.5 ceu for each 5 correct answers If you achieve 3.5 ceu s you will also be considered ICD-10 proficient ICD-10-CM
More informationMeet the Presenter. Welcome to PMI s Webinar Presentation. Understanding the ICD- 10-CM Guidelines. On the topic:
Welcome to PMI s Webinar Presentation Brought to you by: Practice Management Institute pmimd.com Meet the Presenter On the topic: Understanding the ICD- 10-CM Guidelines Libby Purser, CHI, CMC, CMIS, CMOM,
More informationFY 2017 ICD-10-CM Code Updates
FY 2017 ICD-10-CM Code Updates Webinar I Presented by: Melanie Endicott, MBA/HCM, RHIA, CHDA, CDIP, CCS, CCS-P, FAHIMA AHIMA- Approved ICD-10-CM/PCS Trainer Senior Director, HIM Practice Excellence, AHIMA
More informationCopyright 2011 South Carolina Health Information Management Association. All rights reserved.
1. The Alphabetic Index and Tabular List The ICD-10-CM is divided into the Alphabetic Index, an alphabetical list of terms and their corresponding code -the Alphabetic Index consists of the following parts:
More informationICD-10 Diagnosis Coding for Patient-Driven Payment Model
ICD-10 Diagnosis Coding for Patient-Driven Payment Model Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, DNS-MT, RAC-MTA President/CEO Celtic Consulting www.celticconsulting.org 1 Maureen McCarthy, RN, BS, RAC-MT,
More informationIntroduction to ICD-9 Code Selection. Laura Sullivan, CPC Coordinator Corporate Compliance Auditing & Education Summer 2010
Introduction to ICD-9 Code Selection Laura Sullivan, CPC Coordinator Corporate Compliance Auditing & Education Summer 2010 1 Legal Stuff The information provided here is personal opinion only and should
More informationPlease note that the Coding Advisory Service Telephone Number is The number is manned Tuesday to Thursday from to hrs.
CODING GUIDELINES No. 12 September, 2002 Please note that the Coding Advisory Service Telephone Number is 0131-552-7325. The number is manned Tuesday to Thursday from 09.00 to 17.00 hrs. CODING GUIDELINES
More informationOfficial Coding Guidelines
ICD-9-CM Official Guidelines for Coding and Reporting Effective October 1, 2008 The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), two departments
More informationICD-9-CM Coding Fundamentals Part 2. Developed By:
ICD-9-CM Coding Fundamentals Part 2 Developed By: 2009, The Long Term Care Consortium for HIPAA (LTCC). These materials may be reproduced and used only by long term health care providers and their health
More informationICD 10 CM. What does it mean to YOU? It s all about specificity
ICD 10 CM What does it mean to YOU? It s all about specificity ICD TIMELINE ICD-9 Published by WHO in 1978 ICD-10 Endorsed by WHO in 1990 ICD-10-CM draft released in 1995 ICD-10 Used for mortality in the
More informationICD-9-CM CODING FUNDAMENTALS CODING EXERCISES
Steps to Accurate Coding Underline the main term, then locate code: Stenosis of Carotid Artery Transient Ischemic Attack Gastrointestinal hemorrhage Degenerative Joint Disease Coronary Artery Disease Alcoholic
More informationICD-9-CMCoding I Common Course Outline
ICD-9-CMCoding I Common Course Outline Course Information Organization South Central College Revision History 2008-2009 Course Number HC 1920 Department Health Careers Total Credits 3 Description This
More informationChapter 2 Neoplasms C00-D49 November 11, Chapter 2: Neoplasms Category: C00-D49 Official Coding Guidelines: Section 1.C.2, p.
Chapter 2: Neoplasms Category: C00-D49 Official Coding Guidelines: Section 1.C.2, p. 22 1 C00 C75 Malignant neoplasms, stated or presumed to be primary, of specified sites, except of lymphoid, hematopoietic
More information4/1/2014 ICD-10 CM/PCS. Benefits to ICD-10. Fewer queries and/or requests for additional clarification. Fewer denials based on medical necessity
Clinical Documentation and ICD-10 Presented by: Altegra Health 1 ICD-10 CM/PCS ICD-10 will be the official HIPAA-transaction set to communicate all patient conditions and all inpatient treatments, beginning
More informationTOTAL HIP AND KNEE REPLACEMENTS. FISCAL YEAR 2002 DATA July 1, 2001 through June 30, 2002 TECHNICAL NOTES
TOTAL HIP AND KNEE REPLACEMENTS FISCAL YEAR 2002 DATA July 1, 2001 through June 30, 2002 TECHNICAL NOTES The Pennsylvania Health Care Cost Containment Council April 2005 Preface This document serves as
More informationScottish Clinical Coding Standards
Scottish Clinical Coding Standards Number 17 March 2018 Scottish Clinical Coding Standards ICD-10 Contents Scottish Clinical Coding Standards ICD-10...1 Sepsis...1 Sepsis Use of Z codes...5 Sepsis is a
More informationPresentation Objectives
ICD 10 Documentation Preparation and Leveraging Documentation Templates and Coding Queries Shatondra Surulere, MBA, RHIA, CCS, CCS P, CHTS PW, AHIMA Approved Trainer and Ambassador Senior Consultant, Revenue
More informationThis way to ICD 10 1
This way to ICD 10 1 Quick Review We currently report diagnoses with ICD 9 codes Effective with date of service 10 1 14 we must report services using ICD 10 diagnosis codes Many more codes to choose from
More informationMaking Inpatient Audits FAIR Again
2016 GHIMA Annual Meeting & Exhibit "Charting the Course...A World of Opportunities." Making Inpatient Audits FAIR Again By: Sabrina A. Clark, RHIA HRA Strategies, LLC 770 317 3697 OUTLINE Inpatient Coding
More informationCOUNTDOWN TO ICD-10. Transitioning from ICD-9 to ICD-10 4/6/2015. April 7, Suzy Harvey, RN Managing Consultant
COUNTDOWN TO ICD-10 Transitioning from ICD-9 to ICD-10 April 7, 2015 Suzy Harvey, RN Managing Consultant sharvey@bkd.com Deborah Lake, RN Senior Managing Consultant ddlake@bkd.com 1 TO RECEIVE CPE CREDIT
More informationPresent-on-Admission (POA) Coding
1 Present-on-Admission (POA) Coding Michael Pine, MD, MBA Michael Pine and Associates, Inc 2 POA and Coding Guidelines (1) Unless otherwise specified, a POA modifier must be assigned to each principal
More informationICD-10-CM Official Guidelines for Coding and Reporting FY 2019 (October 1, September 30, 2019)
(October 1, 2018 - September 30, 2019) Narrative changes appear in bold text Items underlined have been moved within the guidelines since the FY 2018 version Italics are used to indicate revisions to heading
More informationACOFP 55th Annual Convention & Scientific Seminars. How Complicated is Your Panel? Effective Risk Coding in Primary Care. Alison Mancuso, DO, FACOFP
8 ACOFP 55th Annual Convention & Scientific Seminars How Complicated is Your Panel? Effective Risk Coding in Primary Care Alison Mancuso, DO, FACOFP How Complicated is Your Panel?: Effective Risk Coding
More informationICD-10-CM Tabular List of Diseases and Injuries
ICD-10-CM Tabular List of Diseases and Injuries Chapter 1. Certain Infectious and Parasitic Diseases (A00 B99) Chapter Specific Guidelines with Coding Examples The chapter specific guidelines from the
More informationICD-9-CM Official Guidelines for Coding and Reporting
Narrative changes appear in bold text Items underlined have been moved within the guidelines since November 15, 2006 The guidelines include the updated V Code Table The Centers for Medicare and Medicaid
More informationRisk Adjustment and Hierarchical Condition Category Coding
Risk Adjustment 101 Agenda Risk Adjustment Model Hierarchical Condition Categories (HCC) Patient Example Documentation MEAT Documentation Guidance Chronic Conditions Risk Score Calculations Steps for Physician
More informationAsthma J45.20 Mild, uncomplicated J45.21 Mild, with (acute) exacerbation J45.22 Mild, with status asthmaticus
A Fib & Flutter I48.0 Paroxysmal atrial fibrillation I48.1 Persistent atrial fibrillation I48.2 Chronic atrial fibrillation I48.3 Typical atrial flutter Asthma J45.20 Mild, uncomplicated J45.21 Mild, with
More informationAPR-DRG Description Ave Charge
Abdominal Pain 16,500.25 2.8 6,000.09 Acute & Subacute Endocarditis 15,339.30 3.0 5,113.10 Acute Myocardial Infarction 17,687.46 2.6 6,802.87 Alcohol Abuse & Dependence 19,126.64 4.2 4,553.96 Alcoholic
More informationDocumentation Tips for Pulmonary/Critical Care
Documentation Tips for Pulmonary/Critical Care ICD-10 classifications: The HARD WAY! J44 Other chronic obstructive pulmonary disease Includes: asthma with chronic obstructive pulmonary disease chronic
More information3/14/2012. the Tabular List, a chronological list of codes divided into chapters based on body system or condition.
the Tabular List, a chronological list of codes divided into chapters based on body system or condition. 1. The Alphabetic Index and Tabular List The ICD-10-CM is divided into the Alphabetic Index, an
More informationICD-9-CM Official Guidelines for Coding and Reporting Effective October 1, 2010 Page 2 of 105
Narrative changes appear in bold text Items underlined have been moved within the guidelines since October 1, 2009 The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health
More information