ICD-10 Coding Tips

Medical Coding & Billing Tips for COVID-19

By YES HIM Consulting / March 16, 2020 / Comments Off on Medical Coding & Billing Tips for COVID-19

With the number of COVID-19 (2019-Novel Coronavirus) cases expected to rise in North America, the Centers for Medicare & Medicaid Services (CMS) has provided information on how to medically code and bill all encounters related to COVID-19 for Medicare beneficiaries (CMS, 2020).

Coding for Coronavirus Outbreak: Interim Guidance from the CDC

By Ann Zeisset / February 28, 2020 / Comments Off on Coding for Coronavirus Outbreak: Interim Guidance from the CDC

The World Health Organization (WHO) declared the 2019 Novel Coronavirus (COVID-19) disease outbreak a public health emergency of international concern on January 30, 2020 (CDC, 2020). As a result of the public health emergency, the document, “Announcement New ICD-10-CM Code 2019 Novel Coronavirus (COVID-19),” was released to provide guidance on coding this virus.

New ICD 10 Code For Vaping-Related Disorders – Effective April 1

By Ann Zeisset / January 28, 2020 / Comments Off on New ICD 10 Code For Vaping-Related Disorders – Effective April 1

The WHO Family of International Classifications (WHOFIC) Network Classification and Statistics Advisory Committee (CSAC) convened to establish a new emergency code to be used by WHO. This new emergency code, U07.0 – Vaping-related disorder, was implemented and valid for immediate use as of September 24, 2019, for ICD-10.

Weighing the Differences and Similarities of ProFee Coding and Facility Coding

By Vanessa Youmans / January 21, 2020 / Comments Off on Weighing the Differences and Similarities of ProFee Coding and Facility Coding

Physician group acquisition by major health systems remains a common trend in the industry. One survey of over 8,700 physicians indicates that only 31% of physicians surveyed identify as an independent practice owner or partner as of 2018. This is down from 48.5% in 2012, a whopping 35% decrease in independently owned practices in only 6 years (Merritt Hawkins, 2018). In these acquisitions, the question remains: Who will manage the physician group?

HCC Chronic Conditions and M.E.A.T. Criteria

By Karen Youmans / January 13, 2020 / Comments Off on HCC Chronic Conditions and M.E.A.T. Criteria

As a follow-up to our previous articles “The HCC Coding Specialist: Benefiting payers, providers, and patients” and “HCC Medicare Advantage background and overview,” we now review HCC chronic conditions and the M.E.A.T. documentation criteria.

Background & Overview of ICD-11 Before Implementation in 2022

By Karen Youmans / January 6, 2020 / Comments Off on Background & Overview of ICD-11 Before Implementation in 2022

The World Health Organization released the 11th edition of the International Classification of Diseases (ICD). This release was presented at the World Health Assembly on May 25, 2019 for adoption by member states, and will come into effect on January 1, 2022. However, note that it is still unknown when ICD-11 will be ready for implementation in the United States.

New Year, New Codes: 2020 CPT Code Changes

By Teri Jorwic / December 30, 2019 / Comments Off on New Year, New Codes: 2020 CPT Code Changes

As we turn the calendar to a new decade, the 2020 CPT code changes take effect. This year there are a total of 394 changes to CPT, bringing the total number of codes to 10,471. This includes 248 new codes, 71 deletions, and 75 code revisions, according to the American Medical Association (AMA). This is Part 1 of a 2-Part Series. In this article, we will discuss the changes in the Surgery Section.

Optimal Quality Coding Prevents Medical Claims Denials

By YES HIM Consulting / December 16, 2019 / Comments Off on Optimal Quality Coding Prevents Medical Claims Denials

Medical billing denials generate significant cost for providers and hospitals that could be avoided by improving claims data management and optimizing medical coding processes. Optimal quality coding effectively prevents medical claims denials by reducing the potential for manual error and addressing concerns over fast approaching time limits.

Clinical Documentation Integrity Significance in Revenue Cycle Management Success in Healthcare

By Mari Cely / November 6, 2019 / Comments Off on Clinical Documentation Integrity Significance in Revenue Cycle Management Success in Healthcare

Revenue Cycle Management can be thought of as the method of transportation to take an organization from one place to where it needs to go. For the transport to occur successfully and be operationally sound, the processes in place to support it must be accurate and deliberate.

2020 ICD-10-PCS Guideline Changes: Make Room for Exceptions

By Teri Jorwic / October 16, 2019 / Comments Off on 2020 ICD-10-PCS Guideline Changes: Make Room for Exceptions

Make Room for Exceptions: This years’ updates to the ICD-10-PCS Official Guidelines for Coding and Reporting include a new section, updates to an existing section, new guidance on a body part, some editorial changes and the introduction to the possibility of exceptions for special cases.