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ICD Codes

COVID-19 MS-DRG Assignment

New COVID-19 MS-DRG Assignment, Effective April 1

By YES HIM Consulting / March 24, 2020 / 0 Comments

ICD-10-CM code U07.1 COVID-19 will be in effect as of April 1 in the US, which was pushed up from the normal effective date of October 1 for new codes. The reasoning for this unprecedented change is for the urgent need of immediate data collection. CMS has released a new update on 3/23/2020: “The ICD-10 MCE Version 37.1 R1 uses edits for the ICD-10 codes reported to validate correct coding on claims for discharges on or after April 1, 2020″ (2020). The ICD-10 MS-DRG Grouper software package to accommodate this new code, Version 37.1 R1, is effective for discharges on or after April 1, 2020.

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Coding

An Introduction To Medical Coding & Basic Terminology

By YES HIM Consulting / March 23, 2020 / 0 Comments

Medical coding is the process of assigning numeric or alphanumeric codes to the diseases, injuries, treatments, and procedures that healthcare providers perform to record each encounter accurately and correctly bill the patient (Healthcare Business & Technology, 2019). Medical coding directly ties into medical billing, which includes “preparing billing claims and submitting them to insurance providers,” as noted in our previous article, “What Is Medical Coding and Billing? How Does It Streamline a Hospital’s Financial Performance?” Ensuring the encounter was coded correctly with the right terminology is essential for correct payment and an accurate patient medical history.

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Medical Trends

Emerging Medical Trends in Response to COVID-19

By YES HIM Consulting / March 20, 2020 / 0 Comments

Preparations are underway for the incoming financial, organizational, and human burden that will be thrust upon hospitals and medical facilities across the nation due to the spread of the Novel Coronavirus and its corresponding disease (COVID-19). Health services worldwide are taking exceptional measures in order to better adapt to the pandemic. With certain problematic developments unfolding in foreign contexts determined to be ahead of the US in the timeline of coronavirus transmission, administrative officials in domestic medical facilities are undertaking efforts to shore up perceived shortcomings at local and regional levels. These are the emerging medical trends we will see in the coming weeks.

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COVID-19 code

Update: New ICD-10 Code For COVID-19 Effective April 1

By Teri Jorwic / March 18, 2020 / 0 Comments

The United States will begin using code U07.1 COVID-19 as of April 1 – rather than the usual effective date for new codes of October 1. This new code is being fast-tracked to allow for the urgent need of immediate data collection. Interim coding guidelines from the CDC are still to be used between now and the effective date (CDC, 2020). Review our previous article, “Coding for Coronavirus Outbreak: Interim Guidance from the CDC,” for additional information about code U07.1.

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COVID-19

Medical Coding & Billing Tips for COVID-19

By YES HIM Consulting / March 16, 2020 / 0 Comments

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).

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Coronavirus

Coding for Coronavirus Outbreak: Interim Guidance from the CDC

By Ann Zeisset / February 28, 2020 / 0 Comments

On January 30, 2020, the World Health Organization (WHO) declared the 2019 Novel Coronavirus (COVID-19) disease outbreak a public health emergency of international concern (CDC, 2020). This outbreak of the respiratory disease caused by the novel (new) coronavirus was first detected in Wuhan City, Hubei Province, China. It has rapidly spread, and, according to the CDC, has been detected in 37 locations internationally, including cases in the United States. 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.

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Vaping

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

By Ann Zeisset / January 28, 2020 / 0 Comments

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. In the United States, a Supplement to the ICD-10-CM Guidelines, entitled “Coding Encounters Related to E-cigarette, or Vaping, Product Use,” was posted on October 17, 2019. The guideline update provided valuable information on the proper assigning of codes, but did not provide a unique code for vaping in ICD-10-CM.

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ProFee Coding

Weighing the Differences and Similarities of ProFee and Facility Coding

By Vanessa Youmans / January 21, 2020 / 0 Comments

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?

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M.E.A.T. Criteria

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

By Karen Youmans / January 13, 2020 / 0 Comments

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.

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CPT Updates

CPT Changes for 2020 – Part Two

By Teri Jorwic / January 10, 2020 / 0 Comments

CPT 2020 changes took effect on January 1, 2020. In Part 2, we continue with a discussion of revisions in the Evaluation and Management, and Medicine sections, along with an overview of updates in the Radiology, Pathology and Laboratory, and the new Category III codes.

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