CODING. Network News. Volume 13 Number 1 Jan Feb - Mar What You Need to Know about ICD-10

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1 Professional Association of Healthcare Coding Specialists (PAHCS) CODING Network News In this edition I-9 and I-10 comparison PAHCS I-10 training CPT changes for year members PAHCS happenings June conference in Orlando, FL CMS resources Mar 19 free I-10 webinar Volume 13 Number 1 Jan Feb - Mar 2014 What You Need to Know about ICD-10 All the hype surrounding ICD-10 gives one the impression it s going to be VERY difficult to learn and VERY costly. The facts are that ICD-10 isn t difficult to learn or use and most of the cost associated with its implementation will be caused by a general slowdown due to the software providers, insurance companies, providers and coders all doing something different. Reimbursements may slow and software may be an issue, depending on the system you are using and the assistance you get from your vendor(s). To lessen the impact on a practice, we recommend having 6 months of cash available so a minor glitch doesn t become a catastrophe. Some simple ways to lessen the impact of ICD-10 implementation: Begin now by purchasing a 2014 ICD-9 codebook that has ICD-10 codes listed (or an ICD-10 DRAFT copy). Coders and Billers in the practice should learn the ICD-10 codes for the specialty and communicate any new documentation requirements to the provider(s). Providers need to work with coders and billers and take the initiative to learn what new documentation (if any) will be required for your specialty. Make sure everyone who now uses ICD-9 knows what will be expected when ICD-10 happens. External to the office, contact insurance companies and software providers to ensure they have a plan and will be ready. Keep in mind, for approximately 6 months coders, billers, insurance companies and software providers will need to use both ICD-9 and ICD-10. Visit and view factsheets and other ICD-10 information, straight from the source. Be a member of PAHCS, we will help you by providing free training. NOTE: All claims with date of service before October 1st will use ICD-9. If any of those claims are denied and require resubmission the ICD-9 code will still be used, even after the October 1, 2014 transition. Most of the conventions used for deciding which code to use and how to find them are almost identical between ICD-9 and ICD-10. PAHCS recommends coders review terms of anatomy relevant to their specialty. Practitioners, in most cases, will be required to document to a higher level of specificity than they may be currently comfortable with and coders will need to communicate with them when more information is needed. Under ICD-10, providers will face the most difficult challenges because they may have to change documentation procedures they have been using since they came into the profession. We recommend providers find out now if there are any new documentation requirements for their specialty and, if so, begin documenting to those standards. Mistakes can be made, found and fixed now, after October 1, 2014 those mistakes will cause slower coding and reimbursement issues. The sky is not falling. Practices proactively getting ready to transition to ICD-10-CM will easily make the conversion. Take advantage of all free ICD-10-CM programs available on line. ICD-10-CM isn t going to be that difficult to learn or to implement, if you prepare now. Don t wait, the clock is ticking.

2 ICD-9 and ICD-10 Chapter comparisons ICD-9-CM Descriptor ICD-10-CM Descriptor Infectious and Parasitic Diseases A00-B99 Certain infectious and parasitic diseases Neoplasms C00-D48 Neoplasms Endocrine, Nutritional, and Metabolic Diseases and Immunity Disorders D50-D89 Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism Diseases of Blood and Blood Forming Organs E00-E90 Endocrine, nutritional and metabolic diseases Mental Disorders F00-F99 Mental and behavioural disorders Diseases of Nervous System and Sense Organs G00-G99 Diseases of the nervous system Diseases of Circulatory System H00-H59 Diseases of the eye and adnexa Diseases of Respiratory System H60-H95 Diseases of the ear and mastoid process Diseases of Digestive System I00-I99 Diseases of the circulatory system Diseases of Genitourinary System J00-J99 Diseases of the respiratory system Complications of Pregnancy, Childbirth, and the Puerperium K00-K93 Diseases of the digestive system Diseases Skin and Subcutaneous Tissue L00-L99 Diseases of the skin and subcutaneous tissue Diseases of Musculoskeletal and Connective Tissue M00-M99 Diseases of the musculoskeletal system and connective tissue Congenital Anomalies N00-N99 Diseases of the genitourinary system Newborn (Perinatal) Guidelines O00-O99 Pregnancy, childbirth and the puerperium Signs, Symptoms and Ill-Defined Conditions P00-P Injury and Poisoning Q00-Q99 Classification of Factors Influencing Health Status and Contact with Health V01-V89 Service R00-R99 Certain conditions originating in the perinatal period Congenital malformations, deformations and chromosomal abnormalities Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified E800-E999 Supplemental Classification of External Causes of Injury and Poisoning S00-T98 Injury, poisoning and certain other consequences of external causes V01-98 External causes of morbidity and mortality Z00-Z98 U00-U99 Factors influencing health status and contact with health services Codes for special purposes Page 2 PAHCS Coding Network News Jan-Feb-Mar 2014

3 PAHCS ICD-10 TRAINING 2014 Webinars, On Demand Videos, PDF Documents CODING Network News Volume 13, Number 1 ISSN Coding Network News is a quarterly publication of the Professional Association of Healthcare Coding Specialists (PAHCS). Entire contents copyrighted All rights reserved; reproduction in whole or in part is prohibited. Subscriptions are provided as one of the many benefits of PAHCS membership. For information on advertising, deadlines for article submission or reprint permission, FAX the PAHCS National Office STAY IN TOUCH Local: Toll Free: Fax: Mail: 218 E. Bearss Ave., #354 Tampa, FL Web Site: pahcs@pahcs.org On Demand already available on PAHCS Website Honest Facts about ICD-10 Documentation for ICD-10 Coding with ICD-10 Trainings coming in 2014 Anatomy, Terminology & Physiology ICD-10 documentation for the Provider Content & Format of ICD-10-CM The Coding Process for ICD-10-CM ICD-10-CM Conventions and Guidelines Guidelines for Coding: Diabetes Signs & Symptoms External Causes Neoplasms Specialty Specific Coding with ICD-10 Gastro Ob/Gyn Cardio/Pulmonary - Circulatory/Respiratory Ortho - Musculoskeletal & Connective Tissue Diseases of the Nervous System Integumenary System - Skin & Subcutaneous Tissue Jan-Feb-Mar 2013 PAHCS Coding Network News Page 3

4 NEW CPT CODE HIGHLIGHTS FOR 2014 In this limited space we are showing new and deleted codes for 2014 for specialties most affected. For revised codes and full descriptions of the new codes make sure to check your 2014 CPT book. ADDITIONS/DELETIONS ENT 4 new and 1 deleted MUSCULOSKELETAL (ORTHO) 3 new and 2 deleted NEUROLOGY 8 new codes and 2 deleted OB/GYN 1 deleted code PULMONARY 1 new code UROLOGY 1 new code and 1 deleted VACCINES, TOXOIDS 5 new codes CHECK YOUR 2014 CPT BOOK FOR CHANGE DETAILS E/M Interprofessional Telephone/Internet Consultations INTEGUMENTARY Image-guided fluid collection drainage by catheter, percutaneous Biopsy, breast with placement of breast localization device. Inpatient Neonatal Intensive Care Services & Pediatric & Neonatal Critical Care Services Placement of breast localization device, percutaneous DELETED CODES Page 4 PAHCS Coding Network News Jan-Feb-Mar 2014

5 CARDIO VASCULAR Transcatheter aortic valve replacement transapical exposure (eg, left thoracotomy) Endovascular repair of visceral aorta Transcatheter placement of an intravascular stent(s), interathoracic common carotid artery or innominate artery by retrograde treatment, via open ipsilateral cervical carotid artery exposure Transcatheter placement of intravascular stent(s) (except lower extremity, cervical carotid, exxtracranial vetebraor ) open or percutaneous Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping Percutaneous transcatheter closure of patent ductus arteriosus DELETED CODES SEE YOUR 2014 CPT BOOK FOR FULL DESCRIPTIONS AND GUIDELINES DIGESTIVE SYSTEM Esophagoscopy, rigid, trnasora; diagnostic, including collection of specimen Esophagoscopy with endoscopic mucosal resection; with placement of endoscopic stent.; with dialation of esophagus by balloon.; or with dialation of esophagus with balloon Esophagoscopy with ablation of tumor(s), polyp(s) or other lesions Esophagoscopy with dilation of esophagus with balloon Esophagoscopy with transendoscopic ultrasound guided transmural injection of diagnostic or therapeutic substance(s). Or with endoscopic mucosal resection Esophagoscopy with placement of endoscopic stent Esophagoscopy with ablation of tumor(s), polyp(s), or other lesions with placement of endoscopic stent into biliary or pancreatic duct ; with removal of foreign body(s).; with removal and exchange of stent(s), biliary or pancreatic duct ; with trans-endoscopic balloon dilation of biliary/pancreatic duct(s)..; or with ablation of tumor(s), polyp (s) or other lesion(s) Laparoscopy introduction, revision, removal peritoneal or retroperitoneal.. DELETED CODES SEE YOUR 2014 CPT BOOK FOR FULL DESCRIPTIONS & GUIDELINES Jan-Feb-Mar 2013 PAHCS Coding Network News Page 5

6 10 Year members who attended the PAHCS 2013 National Conference in Orlando, FL Left to Right: Anna Torres, RMC - Marie Demastus COCS - Jo Dick, CENTCS, CMSCS, Marge McQuade, CMSCS, CHCI - Arlene Morrow, CMM, CPC, CMSCS - Joan Browder, CMM, COBGCS - Linda Jackson, CGCS and Dawn Cloud, CPC, CMSCS, CHCI. PAHCS HAPPENINGS 1. Our 2014 National Conference will be June and 27 in Orlando, FL We feel this is necessary due to the ICD-10 implementation date of October 1st. Topics, speakers and hotel locations will be announced by the end of February. Conference fees will remain a $350 per attendee, we hope to see you there. 2. ICD-10-CM free training can be accessed on line. If you can t attend a live webinar, you can watch it as a video on demand. We also will be providing downloadable documents and specialty material. Visit for more information. 3. We need your help to get the word out. PAHCS keeps our prices low and continues to add value to your membership because we don t spend lots of money on advertisements. We hope you ll take some time this year and tell your peers about PAHCS and what we offer: Our ICD-10-CM training, no mandatory ICD-10 test requirement to keep credentials, low cost webinars, PAHCS Continuing Education University (CE University) where many CEUs are offered free, PAHCS Network (formerly the list serve) where coders can ask other coders questions and get real answers...and those are just a few of your membership benefits. 4. Certified coders get one free pay per view webinar annually, use the code freewebinar2014 when checking out. Page 6 PAHCS Coding Network News Jan-Feb-Mar 2014

7 CMS has free recourses for ICD-10 Have questions about the ICD-10 transition? PAHCS recommends visiting the CMS website at here you will find resources for providers, vendors, and payers that will be invaluable as you work toward preparing for the transition to ICD-10. CMS has fact sheets available for educating staff and others about the transition, they include: The ICD-10 Transition: An Introduction ICD-10 Basics for Medical Practices Talking to Your Vendors About ICD-10 Tips for Medical Practices Compliance timelines, materials from CMS-sponsored calls and conferences, and links to resources Keep up-to-date with CMS on ICD-10 topics at PAHCS ICD-10 training offers a January Webinar Don t be afraid of ICD-10 on January 22, 2013 Noon EST Presenter Steve Verno, CMMC, CMMB, NREMT-P, CEMCS, CMSCS Overview of the differences between ICD-10 and ICD-9 guidelines, coding process, content and format. March Webinar ICD-10 Documentation for Providers on March 19, 2013 Noon EST Presenter Dawn Cloud, CPC, CHCI, CMSCS What your providers will need to know about ICD-10 documentation. Visit PAHCS sponsors on line: TurboCoder offers PAHCS members a FREE 2 week trial (log into the member section at so you ll also get a discount if you purchase TurboCoder). There s no obligation to buy, looking is free. Also visit other PAHCS sponsors: BC for coding information and inexpensive CEUs. InGauge Healthcare for coding materials. PAHCS National Conference June , 2014 Orlando, FL $350 per attendee Jan-Feb-Mar 2013 PAHCS Coding Network News Page 7

8 First quarter 2014 Answer all questions below correctly to receive 1 PAHCS CEU. answers to coder@pahcs.org. Be sure to include your name in the . a. 1. Coding Convention NEC stands for which of the following: Not Evaluated Clinically c. Not always classifiable. b. Negatively E/M Classification First quarter 2014 d. Not elsewhere classifiable SMARTER CODING: Two heads are better than one 2. A combination code is a single code used to classify a. two diagnoses c. A diagnosis with an associated complication b. A diagnosis with an associated secondary process (manifestation) d. All of the above 3. Words contained within the brackets [ ], provide the coder with: a. opposite phrases c. synonyms, alternative wording, explanatory phrases b. incomplete terms d. modified terms 4. The colon : in the Tabular list tells the coder: a. the terms below complete the term to make it assignable to a given category b. the correct code is found in Volume 3 c. the terms are synonyms, alternative wording, or explanatory phrases d. the preceding term is not otherwise specified 5. Symbols, abbreviations, punctuation, and notations in ICD-9-CM are: a. grammar checks c. conventions b. guidelines Professional Assn of Healthcare Coding Specialists 218 E. Bearss Ave. #354 Tampa, FL d. edits 9 Months to ICD-10 1) Take advantage of all FREE training. 2) Visit CMS.gov for the latest info 3) Visit PAHCS.org 4) Practice coding to ICD-10 standards. 5) Work with staff so everyone knows ICD-10 standards