Documentation for the IRF Provider
|
|
|
- Martin Sherman Gray
- 5 years ago
- Views:
Transcription
1 Documentation for the IRF Provider Timothy N. Brundage, MD, CCDS Certified Clinical Documentation Specialist 1 Medicare controls the ball field If you want to play ball, you have to play by their rules Many Payors follow the Center for Medicaid and Medicare Services (CMS) guidelines 2 1
2 Diagnosis based coding language Problem-specific H&P s, consultations, daily progress notes, etc. Do not document?diagnosis PMHx needs to be in the correct location of the H&P If its in the assessment and plan please use active language Acute Acute on Chronic Sequelae of Stroke (not h/o) Hypertension should be documented if antihypertensive medications are reviewed as a part of the H&P Possible, Probable, Likely, Suspected... NOT acceptable language for coding at IRF level Tiering Tier Tier 2 Tier 1 Sick Sicker Sickest Morbid obesity C. diff Paralysis of vocal cords Anoxic brain damage Pseudomonas infection Tracheostomy Left heart failure Dysphagia ESRD on HD 4 2
3 IRF Specific Documentation 5 ICD-10 code Description Tier J8.01 Paralysis of vocal cords and larynx, unilateral 1 J8.02 Paralysis of vocal cords and larynx, bilateral 1 J8.4 Edema of the larynx 1 (Edema of glottis, subglottic edema, supraglottic edema) Z9.0 Tracheostomy status 1 Z99.2 Dependence on renal dialysis 1 Z4.0 Encounter or attention to tracheostomy 1 J8.00 Paralysis of vocal cords and larynx, unspecified 6
4 ICD-10 code Description Tier B96.5 Pseudomonas aeruginosa as the cause of diseases classified 2 elsewhere A04.7 Enterocolitis due to Clostridium difficile 2 I69.91 Dysphagia following CVA 2 R1.10 Dysphagia, unspecified 2 R1.11 Dysphagia, oral phase 2 R1.12 Dysphagia, oropharyngeal phase 2 R1.1 Dysphagia, pharyngeal phase 2 R1.14 Dysphagia, pharyngoesophageal phase 2 R1.19 Dysphagia, other 2 K91.2 Postsurgical malabsorption, not classified elsewhere 2 7 ICD-10 code Description Tier E66.01 Morbid obesity due to excess calories N17.9 Acute Kidney Failure, unspecified N17.0 ATN E10.9 DM type 1 without complication E11.21 Type 2 with diabetic nephropathy / diabetic CKD E11.69 Type 2 DM with other specified complication J18.9 Pneumonia, unspecified organism G81.90 Hemiplegia, unspecified affecting unspecified side G81.92 Hemiplegia, unspecified affecting L dominant side I50.2 Chronic diastolic heart failure (HFpEF) I50.22 Chronic systolic heart failure (HFrEF) G9.1 Anoxic brain damage (includes anoxic encephalopathy) E11.9 Type 2 DM without complications -- 4
5 Central nervous system infarction is defined as brain, spinal cord or retinal cell death attributable to ischemia Neuropathological Neuroimaging Clinical evidence of permanent injury Dysphagia following stroke is a Tier 2 Hemiplegia is a Tier Document if dominant side for ICD-10 AHA/ASA Expert Consensus Document An Updated Definition of Stroke for the 21 st Century Published May Site: Artery Vertebral Basilar anterior and posterior Communicating middle cerebral Anterior and posterior cerebral carotid Laterality Etiology Hemorrhage Occlusion Stenosis Thrombosis Embolism Linkage to underlying condition Atrial fibrillation Hypertension Linkage to alcohol, drug or tobacco Use Abuse Dependence 10 5
6 ICD-10 code Description PDx/Tier I6.9 Cerebral infarction, unspecified (stroke NOS) I6.11 Cerebral infarction due to thrombosis of R MCA I6.12 Cerebral infarction due to thrombosis of L MCA I6.19 Cerebral infarction due to thrombosis of unspecified MCA I6.411 Cerebral infarction due to embolism of R MCA I6.412 Cerebral infarction due to embolism of L MCA I6.419 Cerebral infarction due to embolism of unspecified MCA I6.511 Cerebral infarction due to unspecified occlusion or stenosis of R MCA I6.512 Cerebral infarction due to unspecified occlusion or stenosis of L MCA I6.519 Cerebral infarction due to unspecified occlusion or stenosis unspecified MCA Diagnoses Hemiplegia Hemiparesis Monoplegia of lower limb Monoplegia of upper limb Monoplegia, unspecified Ambidextrous patients default is dominant Right side dominant is the default Left side non-dominant is the default 12 6
7 ICD-10 code Description Tier I69.91 Dysphagia following cerebral infarction 2 I Dysphagia following other cerebrovascular disease 2 G81.91 Hemiplegia, unspecified affecting R dominant side G81.92 Hemiplegia, unspecified affecting L dominant side 1 Laterality Right Left Unspecified Type Concussion Traumatic cerebral edema Diffuse traumatic brain injury Focal traumatic brain injury Unspecified Contusion & Laceration Traumatic hemorrhage Contusion, laceration & hemorrhage Epidural hemorrhage Traumatic subdural hemorrhage Traumatic subarachnoid hemorrhage Other specified Injury of Specify complication with With LOC (document time in minutes/hours) With or without return to previous LOC With or without death W/o LOC Site Cerebrum Cerebellum Brainstem Internal carotid A Intracranial portion unspecified Timing Initial Subsequent Sequela 14 7
8 Site Carotid siphon & bifurcation MCA Ant communicating A. Post Communicating A. Vertebral A. Other intercranial As. Unspecified Ruptured berry aneurysm Ruptured cerebral aneurysm Other Unspecified Laterality Right Left Unspecified 15 ICD-10 code Description G5 Multiple Sclerosis G61.0 Guillain-Barré syndrome G61.81 Chronic inflammatory demyelinating polyneuritis G12.21 Amyotrophic lateral sclerosis 16 8
9 KDIGO: increase in the patient s serum creatinine of 0. mg/dl or more over their normal baseline level Link Dehydration Azotemia Do Not document Acute Renal Insufficiency Acute Renal Failure is a Tier 17 ICD-10 code Description Tier N17.9 Acute Kidney Injury Tier N17.0 ATN Tier N28.9 Acute Renal Insufficiency Disorder of Kidney, unspecified E86.0 Dehydration -- E86.1 Hypovolemia -- E86.9 Volume Depletion N19 Unspecified Kidney Failure (Uremia NOS)
10 Acute or Chronic Acute on Chronic Exacerbation Decompensated Systolic (EF < 40%) HFrEF Diastolic (normal EF) HFpEF Both Simply writing EF= % is not sufficient 19 ICD-10 code Description Tier I50.20 Systolic HF I50.21 Acute Systolic HF I50.22 Chronic Systolic HF I50.2 Acute on Chronic Systolic HF I50.0 Diastolic HF I50.1 Acute Diastolic HF I50.2 Chronic Diastolic HF I50.40 Combined Systolic & Diastolic HF I50.41 Acute Combined Systolic & Diastolic HF I50.9 CHF
11 Type 1 or Type 2 or due to underlying condition Drug induced (steroids) or gestational Postpancreatectomy (Whipple) With hypo or hyperglycemia With coma Without coma With DKA Diabetes related complications: Diabetic peripheral neuropathy Diabetic nephropathy Diabetic vasculopathy, etc. 21 ICD-10 code Description Tier E10.21 / E10.22 DM type 1 with diabetic nephropathy / diabetic CKD E10.40 DM type 1 with diabetic neuropathy E10.52 DM type 1 with diabetic gangrene E DM type 1 with hypoglycemia w/o coma E10.65 DM type 1 with hyperglycemia E10.9 DM type 1 without complications 22 11
12 ICD-10 code Description Tier E11.21/ E11.22 DM type 2 with diabetic nephropathy / diabetic CKD E11.40 DM type 2 with diabetic neuropathy E11.52 DM type 2 with diabetic gangrene E DM type 2 with foot ulcer E DM type 2 with hypoglycemia w/o coma E11.69 DM type 2 with other specified complication E11.9 DM type 2 without complications -- 2 Morbid Obesity BMI > 40 Physician must ascribe clinical relevance to the BMI Cannot be taken from a calculated BMI BMI > 40 Morbid obesity BMI < 19 Underweight malnourished 24 12
13 ICD-10 code Description Tier E66.9 Obesity, unspecified -- E66.01 Morbid Obesity due to excess calories E66.1 Morbid Obesity with alveolar hypoventilation Myopathy Disuse Steroid Alcoholic Uremic Acute muscle weakness from onset of acute illness Chronic inactivity leading to muscle disuse Extremity weakness that results from muscular atrophy A clinical diagnosis Suggested Impairment Group IGC 0.8 Neuromuscular disorders 26 1
14 ICD-10 code Description Tier G72.9 Myopathy, unspecified -- (includes disuse myopathy) G72.0 Drug-induced myopathy -- G72.1 Alcoholic myopathy -- G72.81 Critical illness myopathy -- G62.81 Critical illness polyneuropathy K91.2 Post GI surgery with malabsorption Noted frequently, but not diagnosed TPN may be a link to this diagnosis ICD-10 code Description Tier K91.2 Postsurgical malabsorption, 2 not classified elsewhere 28 14
15 Predicted Mortality Rates for some disease processes: Community Acquired Pneumonia = 0.5% Sepsis = 10% Septic shock = 40% If the patient survives, your ratings will be much higher in the public quality reporting data because you took care of a sicker patient Goal: actual mortality lower than expected mortality
ICD-9 to ICD-10 Conversion Sample for Physical, Occupational and Speech Therapy - SNF Setting
1 ICD-9 to ICD-10 Conversion Sample for Physical, Occupational and Speech Therapy - SNF Setting ICD-9 Code ICD-9 Description New ICD-10 New ICD-10 Description DM with Neuropathy E11.21 Type 2 diabetes
ICD-9 to ICD-10 Crosswalk Adult Codes
ICD- to ICD- Crosswalk Adult Codes On October 1, 2015, the Centers for Medicare & Medicaid Services (CMS) transitioned to the new International Classification of Diseases, th Revision System (ICD-), which
2015 HCPro, a division of BLR. All rights reserved. These materials may not be duplicated without express written permission.
Diagnostic Criteria 101: Criteria to Diagnose 15 Common Hospital Medicine Diagnoses Timothy N. Brundage, MD, CCDS Medical Director Brundage Medical Group, LLC Redington Beach, Florida 2 Learning Objectives
CMS Limitations Guide - Radiology Services
CMS Limitations Guide - Radiology Services Starting October 1, 2015, CMS will update their existing medical necessity limitations on tests and procedures to correspond to ICD-10 codes. This limitations
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
Cognitive Rehabilitation
Last Review Date: March 10, 2017 Number: MG.MM.ME.58Cv2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth
CMS Limitations Guide MRA Radiology Services
CMS Limitations Guide MRA Radiology Services Starting July 1, 2008, CMS has placed numerous medical necessity limits on tests and procedures. This reference guide provides you with all of the latest changes.
79 HCCs CMS-HCC Risk Adjustment Model. ICD-10-CM to CMS-HCC Crosswalk. Over 9,500 ICD-10-CM codes map to one or more.
2017 CMS-HCC Risk Adjustment Model Over 9,500 ICD-10-CM codes map to one or more 79 HCCs ICD-10-CM to CMS-HCC Crosswalk CMS-HCC Model On April 4, 2016, the Centers for Medicare & Medicaid Services (CMS)
Supplemental Digital Content: Definitions Based on the International Classification of Diseases, Ninth Revision, Clinical Modification
Supplemental Digital Content: Definitions Based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Diagnose and Procedures Codes 1. ICD-9-CM definition of
Asthma 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
ICD-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
Emergency Department Stroke Registry Indicator Specifications 2018 Report Year (07/01/2017 to 06/30/2018 Discharge Dates)
2018 Report Year (07/01/2017 to 06/30/2018 Discharge Dates) Summary of Changes I62.9 added to hemorrhagic stroke ICD-10-CM diagnosis code list (table 3) Measure Description Methodology Rationale Measurement
Nicolas Bianchi M.D. May 15th, 2012
Nicolas Bianchi M.D. May 15th, 2012 New concepts in TIA Differential Diagnosis Stroke Syndromes To learn the new definitions and concepts on TIA as a condition of high risk for stroke. To recognize the
InterQual Level of Care 2018 Index
InterQual Level of Care 2018 Index Rehabilitation Criteria Index Words by Subset The Index is an alphabetical listing of conditions and/or diagnoses designed to guide the user to the criteria subset where
Lnformation Coverage Guidance
Lnformation Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity Abstract: B-type natriuretic peptide (BNP) is a cardiac neurohormone produced mainly in the left ventricle. It
Medical Review Guidelines Magnetic Resonance Angiography
Medical Review Guidelines Magnetic Resonance Angiography Medical Guideline Number: MRG2001-05 Effective Date: 2/13/01 Revised Date: 2/14/2006 OHCA Reference OAC 317:30-5-24. Radiology. (f) Magnetic Resonance
Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are
page 1 Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.
Contractor Information. LCD Information. Local Coverage Determination (LCD): Magnetic Resonance Angiography (L34424) Document Information
Local Coverage Determination (LCD): Magnetic Resonance Angiography (L34424) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information Contractor
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
The determination of eligible population for this measure requires administrative claims data.
Overuse of Imaging Measure 6: Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Headache Description This measure assesses the ratio
Supplement Table 1. Definitions for Causes of Death
Supplement Table 1. Definitions for Causes of Death 3. Cause of Death: To record the primary cause of death. Record only one answer. Classify cause of death as one of the following: 3.1 Cardiac: Death
CHAPTER 6 NERVOUS SYSTEM G00-G99. Presented by Jan Halloran
CHAPTER 6 NERVOUS SYSTEM G00-G99 Presented by Jan Halloran 1 LEARNING OUTCOMES After studying this chapter you should be able to: Explain the difference between the central and peripheral nervous systems
ICD-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
ICD-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
Current Clinical Trials for Stroke Survivors in NJ and Philadelphia Areas
Current Clinical Trials for Survivors in NJ and Philadelphia Areas For more information go to https://clinicaltrials.gov/ and search for the title in search box Condition / Disease 1. Spatial Neglect and
Heat-Related Deaths in Hot Cities: Estimates of Human Tolerance to High Temperature Thresholds
Supplementary Information Heat-Related Deaths in Hot Cities: Estimates of Human Tolerance to High Temperature Thresholds Selection of ICD-10 Codes Indicating Conditions and Diseases that Might Be Directly
Cerebrovascular Disorders. Blood, Brain, and Energy. Blood Supply to the Brain 2/14/11
Cerebrovascular Disorders Blood, Brain, and Energy 20% of body s oxygen usage No oxygen/glucose reserves Hypoxia - reduced oxygen Anoxia - Absence of oxygen supply Cell death can occur in as little as
Using 3-Digit ICD-9-CM Codes with the Elixhauser Comorbidity Index
Congestive Heart Failure 398.91 Rheumatic heart failure (congestive) 398 Other rheumatic heart disease 402.01, 402.11, 402.91 402 Hypertensive heart disease 404.01, 404.03, 404.11, 404.13, 404.91, 404.93
Appendix e-1. University HealthSystem Consortium (UHC) database description
Appendix e-1. University HealthSystem Consortium (UHC) database description UHC is an alliance of academic medical centers and their affiliated hospitals. Member institutions have the goal of sharing clinical,
Documenting in the World of ICD-10 Capturing all your CCs and MCCs Crystal Coen, RN, MSN, FNP-BC NPSS Asheville, NC
Documenting in the World of ICD-10 Capturing all your CCs and MCCs Crystal Coen, RN, MSN, FNP-BC 2017 NPSS Asheville, NC Objectives Understand the importance of documenting to the highest specificity Understand
ACOFP 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
Head MRA/MRV studies of the head may be considered medically necessary for the following strongly suspected vascular diseases:
Original Issue Date (Created): July 1, 2002 Most Recent Review Date (Revised): January 28, 2014 Effective Date: September 5, 2014 I. POLICY Head MRA/MRV studies of the head may be considered medically
2018 Diagnosis Coding Fact Sheet
The information contained in this document is provided for informational purposes only and represents no statement, promise, or guarantee by Cordis Corporation concerning levels of reimbursement, payment,
For HCPCS codes A0425, A0426, A0427, A0428, A0429, A0433 and A0434: Covered for Ambulance Transportation Services to the Site of Medical Care:
For HCPCS codes A0425, A0426, A0427, A0428, A0429, A0433 and A0434: Covered for Ambulance Transportation Services to the Site of Medical Care: 789.39 ABDOMINAL OR PELVIC SWELLING MASS OR LUMP OTHER SPECIFIED
Appendix Criteria used for the automated chart review
Appendix Criteria used for the automated chart review A. Heart attack i. 410.01 (Acute myocardial infarction of anterolateral wall initial episode of ii. 410.11 (Acute myocardial infarction of other anterior
Neuropsychological Testing
Last Review Date: June 27, 2017 Number: MG.MM.ME.18fv2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth
Documentation Improvement at the LTAC Level of Care
Documentation Improvement at the LTAC Level of Care Timothy Brundage, MD, CCDS Medical Director Brundage Group This is the Full Title of a Session St. Petersburg, Florida 1 Learning Objectives At the completion
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.049.MH Visually Evoked Response Test This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP CSNP MedStar CareFirst
ICD 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
SAMPLE. Laboratory Services. An essential coding, billing, and reimbursement resource for laboratory and pathology services ICD-10
Coding and Payment Guide www.optumcoding.com Laboratory Services An essential coding, billing, and reimbursement resource for laboratory and pathology services 2017 ICD-10 A full suite of resources including
Neurology. Instructions: Bookmarks:
Instructions: To best navigate the list, first download this PDF file to your computer. Then navigate the document using the bookmarks feature in the left column. The bookmarks expand and collapse. Finally,
CEREBRO VASCULAR ACCIDENTS
CEREBRO VASCULAR S MICHAEL OPONG-KUSI, DO MBA MORTON CLINIC, TULSA, OK, USA 8/9/2012 1 Cerebrovascular Accident Third Leading cause of deaths (USA) 750,000 strokes in USA per year. 150,000 deaths in USA
CHEST Inpatient/Facility List
CHEST Inpatient/Facility List 799.02 Hypoxemia R09.02 Hypoxemia 486 J18.9 518.82 - J98.4 J80 occupational exposure to environmental tobacco smoke (Z57.31 518.81 Acute respiratory failure J96.00 Other disorders
For The Critters Present
For The Critters Present Be sure to Sepsis Sepsis secondary to UTI Bacteremia SIRS secondary to infection For More Info-Contact Your Documentation Specialist Pat Spadaro, R.N. 6796 Rosanne Garofano, R.N.
Complex Case Management Trigger Events and Diagnosis Codes Adult/Pediatric/High-Risk Maternity
Complex Case Management Trigger Events and Diagnosis Codes Adult/Pediatric/High-Risk Maternity Horizon Blue Cross Blue Shield of New Jersey s Complex Case Management Program is a free, voluntary service
Annual High Claims Survey. Year Ending 31 December 2016
Annual High Claims Survey Year Ending 31 December 2016 Released July 2017 Summary The Private Healthcare Australia Annual High Claims Survey Report analyses the nature and magnitude of high claims met
Contractor Information. LCD Information. Local Coverage Determination (LCD): HOMOCYSTeine Level, Serum (L34419) Document Information
Local Coverage Determination (LCD): HOMOCYSTeine Level, Serum (L34419) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information Contractor
JAWDA Guidelines for Pre-hospital Emergency Medical Service (EMS)
JAWDA Guidelines for Pre-hospital Emergency Medical Service (EMS) January 2019 Page 1 of 17 Table of Contents Executive Summary... 3 About this Guidance... 4 Emergency Medical Service Performance Indicators...
[(PHY-3a) Initials of MD reviewing films] [(PHY-3b) Initials of 2 nd opinion MD]
![[(PHY-3a) Initials of MD reviewing films] [(PHY-3b) Initials of 2 nd opinion MD]](/thumbs/89/98619893.jpg "[(PHY-3a) Initials of MD reviewing films] [(PHY-3b) Initials of 2 nd opinion MD]")
2015 PHYSICIAN SIGN-OFF (1) STUDY NO (PHY-1) CASE, PER PHYSICIAN REVIEW 1=yes 2=no [strictly meets case definition] (PHY-1a) CASE, IN PHYSICIAN S OPINION 1=yes 2=no (PHY-2) (PHY-3) [based on all available
Medical Necessity Guidelines: Rehabilitative Services: Speech Therapy
Medical Necessity Guidelines: Rehabilitative Services: Speech Therapy Effective: November 8, 2017 Clinical documentation and prior authorization required Applies to: Coverage guideline, no prior authorization
FOLLOW-UP AFTER EMERGENCY DEPARTMENT VISIT FOR PEOPLE WITH HIGH-RISK MULTIPLE CHRONIC CONDITIONS (FMC) HEDIS (Administrative)
FOLLOW-UP AFTER EMERGENCY DEPARTMENT VISIT FOR PEOPLE WITH HIGH-RISK MULTIPLE CHRONIC CONDITIONS (FMC) APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD
Lipids Testing
Previously Listed as Edit 12 190.23 - Lipids Testing Lipoproteins are a class of heterogeneous particles of varying sizes and densities containing lipid and protein. These lipoproteins include cholesterol
Acute Coronary Syndrome
ACUTE CORONOARY SYNDROME, ANGINA & ACUTE MYOCARDIAL INFARCTION Administrative Consultant Service 3/17 Acute Coronary Syndrome Acute Coronary Syndrome has evolved as a useful operational term to refer to
Ministry of Health. BC Chronic Disease and Selected Procedure Case Definitions. Chronic Disease Information Working Group. Date Created: June 29, 2015
Ministry of Health BC Chronic Disease and Selected Procedure Case Definitions Author: Chronic Disease Information Working Group Date Created: June 29, 2015 Last Updated: February 01, 2018 Version: Email:
Cerebrovascular accident icd 10
Cerebrovascular accident icd 10 I69.21 is a billable ICD code used to specify a diagnosis of cognitive deficits following other nontraumatic intracranial hemorrhage. A 'billable code' is detailed. Conventions.
GET CREDIT FOR SEVERITY OF ILLNESS BY ACCURATELY REPORTING SECONDARY DIAGNOSES
GET CREDIT FOR SEVERITY OF ILLNESS BY ACCURATELY REPORTING SECONDARY DIAGNOSES Administrative Consultant Service Updated 3/17 What Qualifies? The documentation of a condition that qualifies as a complication
Process Measure: Screening for Adult Obstructive Sleep Apnea
Process Measure: Screening for Adult Obstructive Sleep Apnea Measure Description Description Type of Measure All patients aged 18 years and older at high risk for obstructive sleep apnea (OSA) with documentation
ICD-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
Risk 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
Cerebral Vascular Diseases. Nabila Hamdi MD, PhD
Cerebral Vascular Diseases Nabila Hamdi MD, PhD Outline I. Stroke statistics II. Cerebral circulation III. Clinical symptoms of stroke IV. Pathogenesis of cerebral infarcts (Stroke) 1. Ischemic - Thrombotic
Vascular Disorders. Nervous System Disorders (Part B-1) Module 8 -Chapter 14. Cerebrovascular disease S/S 1/9/2013
Nervous System Disorders (Part B-1) Module 8 -Chapter 14 Overview ACUTE NEUROLOGIC DISORDERS Vascular Disorders Infections/Inflammation/Toxins Metabolic, Endocrinologic, Nutritional, Toxic Neoplastic Traumatic
Appendix 2 (as supplied by the authors): ICD codes to identify high-risk children
Appendix 2 (as supplied by the authors): ICD codes to identify high-risk children ICD-9 codes to identify high risk children in physician claims database Category of condition Condition ICD-9 code Bacterial
Coding Hints 2 nd Edition
Coding Hints 2 nd Edition Medicare s guidelines state, Code all documented conditions which co-exist at the time of the visit that require or affect patient care or treatment. Beyond the Basics Incomplete
What Are We Going to Do? Fourth Year Meds Clinical Neuroanatomy. Hydrocephalus and Effects of Interruption of CSF Flow. Tube Blockage Doctrine
Fourth Year Meds Clinical Neuroanatomy Ventricles, CSF, Brain Swelling etc. David A. Ramsay, Neuropathologist, LHSC What Are We Going to Do? Hydrocephalus and some effects of the interruption of CSF flow
Intrathecal Baclofen for CNS Spasticity
Intrathecal Baclofen for CNS Spasticity Last Review Date: October 13, 2017 Number: MG.MM.ME.31bC7 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary
PTA 106 Unit 1 Lecture 3
PTA 106 Unit 1 Lecture 3 The Basics Arteries: Carry blood away from the heart toward tissues. They typically have thicker vessels walls to handle increased pressure. Contain internal and external elastic
Online Supplementary Data. Country Number of centers Number of patients randomized
A Randomized, Double-Blind, -Controlled, Phase-2B Study to Evaluate the Safety and Efficacy of Recombinant Human Soluble Thrombomodulin, ART-123, in Patients with Sepsis and Suspected Disseminated Intravascular
CMS Limitations Guide - Cardiovascular Services
CMS Limitations Guide - Cardiovascular Services Starting October 1, 2015, CMS will update their existing medical necessity limitations on tests and procedures to correspond to ICD-10 codes. This limitations
HEART AND SOUL STUDY OUTCOME EVENT - MORBIDITY REVIEW FORM
REVIEW DATE REVIEWER'S ID HEART AND SOUL STUDY OUTCOME EVENT - MORBIDITY REVIEW FORM : DISCHARGE DATE: RECORDS FROM: Hospitalization ER Please check all that may apply: Myocardial Infarction Pages 2, 3,
1. The episode should be classified according to the primary reason for the current episode of rehabilitation care
IMPAIRMENT CODING GUIDELINES The aim of these guidelines is to assist in correctly classifying a rehabilitation episode according to impairment groups. There are 2 over-riding rules that need to be considered
Lumbosacral plexus lesion Lumbosacral plexus disorders G54.1 Neuralgic amyotrophy Neuralgic amyotrophy G
ICD-9-CM and ICD-10-CM NEUROMUSCULAR DIAGNOSIS CODES Focal Neuropathy ICD-9-CM ICD-10-CM Mononeuropathy G56.00 Carpal tunnel syndrome 354.00 Other median nerve lesion 354.10 Lesion of ulnar nerve 354.20
Transition to ICD-10-CM Cardiovascular System
Transition to ICD-10-CM Cardiovascular System Patricia W. Tulloch RN, BSN, MSN, HCS-D RBC Limited Healthcare & Management Consultants P: 845-889-8128 E: rbc@netstep.net www.rbclimited.com Integrated OASIS
Michigan Quality Improvement Consortium Measurement Specifications
Page 1 of 22 Michigan Quality Improvement Consortium Measurement Specifications Introduction Who is MQIC? The Michigan Quality Improvement Consortium (MQIC) is a group of physicians from Michigan health
Supplementary Online Content
Supplementary Online Content Lau WCY, Chan EW, Cheung CL, et al. Association between dabigatran vs warfarin and risk of osteoporotic fractures among patients with nonvalvular atrial fibrillation. JAMA.
Neuropathology lecture series. III. Neuropathology of Cerebrovascular Disease. Physiology of cerebral blood flow
Neuropathology lecture series III. Neuropathology of Cerebrovascular Disease Physiology of cerebral blood flow Brain makes up only 2% of body weight Percentage of cardiac output: 15-20% Percentage of O
HAAD quality KPI; waiting time
Type: Waiting Time Indicator Indicator Number: WT001 Primary Care Appointment- Outpatient Setting Time to see a HAAD licensed family physician or member of their team (GP) Time of request (walk-in or by
Overview of Stroke: Etiologies, Demographics, Syndromes, and Outcomes. Alex Abou-Chebl, MD, FSVIN Medical Director, Stroke Baptist Health Louisville
Overview of Stroke: Etiologies, Demographics, Syndromes, and Outcomes Alex Abou-Chebl, MD, FSVIN Medical Director, Stroke Baptist Health Louisville Disclosure Statement of Financial Interest Within the
Michigan Quality Improvement Consortium Measurement Specifications
Page 1 of 19 Michigan Quality Improvement Consortium Measurement Specifications Introduction Who is MQIC? The Michigan Quality Improvement Consortium (MQIC) is a group of physicians from Michigan health
3. Correct coding practice is to select the code with the greater number of characters available.
Final Exam Part I: Chapters 1 6, Understanding the Fundamentals 1. ICD-10 codes are issued by the World Health Organization (WHO), and updates are published by the Centers for Medicare & Medicaid Services
Cerebrovascular diseases-2
Cerebrovascular diseases-2 Primary angiitis of CNS - Other causes of infarction i. Hypercoagulable states ii. Drug-abuse such as amphetamine, heroin and cocain Note - The venous side of the circulation
CEREBROVASCULAR DISEASES. By: Shifaa AlQa qa
CEREBROVASCULAR DISEASES By: Shifaa AlQa qa Cerebrovascular diseases Brain disorders caused by pathologic processes involving blood vessels 3 pathogenic mechanisms (1) thrombotic occlusion, (2) embolic
ASSIGNMENT 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
DRG Pitfalls: What to look for in Documentation to Code Comorbid Conditions. Heather Greene, MBA, RHIA, CPC, CPMA
DRG Pitfalls: What to look for in Documentation to Code Comorbid Conditions Heather Greene, MBA, RHIA, CPC, CPMA Agenda Acronyms & Definitions MCD & MS-DRG Hierarchies MCC/CC Documentation Acronyms &
Cardiothoracic 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
Cerebrovascular accident icd 10
Cerebrovascular accident icd 10 Search 1-10-2017 Free, official coding info for 2018 ICD - 10 -CM I69.398 - includes detailed rules, notes, synonyms, ICD -9-CM conversion, index and annotation crosswalks,
Specialty Mapping Guides ICD-9 to ICD-10
Specialty Mapping Guides ICD-9 to ICD-10 The conversions contained within this crosswalk were the most current version at the time of development. All efforts should be made by the attendee to stay current
Table S1: Diagnosis and Procedure Codes Used to Ascertain Incident Hip Fracture
Technical Appendix Table S1: Diagnosis and Procedure Codes Used to Ascertain Incident Hip Fracture and Associated Surgical Treatment ICD 9 Code Descriptions Hip Fracture 820.XX Fracture neck of femur 821.XX
UNITED STATES FIRE INSURANCE COMPANY. Instructions for completing the Attached Disclosure Form
UNITED STATES FIRE INSURANCE COMPANY Instructions for completing the Attached Disclosure Form HIPAA Privacy permits the release of Protected Health Information (PHI) for the purpose of evaluating and accepting
Comorbidity or medical history Existing diagnoses between 1 January 2007 and 31 December 2011 AF management care AF symptoms Tachycardia
Supplementary Table S1 International Classification of Disease 10 (ICD-10) codes Comorbidity or medical history Existing diagnoses between 1 January 2007 and 31 December 2011 AF management care I48 AF
ICD-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
HYPERTENSIVE ENCEPHALOPATHY
HYPERTENSIVE ENCEPHALOPATHY Reversible posterior leukoencephalopathy syndrome Cause Renal disease Pheochromocytoma Disseminated vasculitis Eclampsia Acute toxemia Medications & illicit drugs (cocaine)
How to Think like a Neurologist Review of Exam Process and Assessment Findings
Lehigh Valley Health Network LVHN Scholarly Works Neurology Update for the Non-Neurologist 2013 Neurology Update for the Non-Neurologist Feb 20th, 5:10 PM - 5:40 PM How to Think like a Neurologist Review
Rules of Engagement: Adapting to Change
Rules of Engagement: Adapting to Change Stephanie Johnson, CCS Coding Supervisor, Education, Training, and Consultation Uniform Data System for Medical Rehabilitation Carol Harper, COTA/L Manager, Education,
Common Codes for ICD-10
Common Codes for ICD-10 Specialty: Cardiology *Always utilize more specific codes first. ABNORMALITIES OF HEART RHYTHM ICD-9-CM Codes: 427.81, 427.89, 785.0, 785.1, 785.3 R00.0 Tachycardia, unspecified
IV. Cerebrovascular diseases
IV. Cerebrovascular diseases - Cerebrovascular disease denotes brain disorders caused by pathologic processes involving the blood vessels. - The three main pathogenic mechanisms are: 1. Thrombotic occlusion
Stroke School for Internists Part 1
Stroke School for Internists Part 1 November 4, 2017 Dr. Albert Jin Dr. Gurpreet Jaswal Disclosures I receive a stipend for my role as Medical Director of the Stroke Network of SEO I have no commercial
ICD-10: Don t Let Risk Adjustments Be An Afterthought
1 ICD-10: Don t Let Risk Adjustments Be An Afterthought Tuesday, October 28, 2014 1:30-2:30PM PST Presented by: Kim Browning, CHRS, PMP, CHC Executive Vice President, Cognisight, LLC Barb Nutting, RHIT,
Diabetes Mellitus. and coding the complications that can occur
Diabetes Mellitus and coding the complications that can occur As a coder.don t get stuck in neutral You have to keep moving forward with the new compliances and codes Diabetes Mellitus with. let s take
Supplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Krumholz HM, Wang K, Lin Z, et al. Hospital-readmission risk