Tag: ICD-10-CM Codes

Should-ICD-10-CM-Feature-Codes-for-Every-Genetic-Condition

Should ICD-10-CM Feature Codes for Every Genetic Condition?

It may become common practice to identify genetic abnormalities prior to the development of manifestations. The March 2023 ICD-10-CM Coordination and Maintenance Committee Meeting presented me with a dilemma (Topic packet March 8, 2023, ICD-10-CM Coord & Maint Cmte Meeting). Now that we have the technology to unravel the genetic basis for conditions, are we […]
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Important Changes to ICD-10-CM Codes and Guidelines

New codes and updates become effective April 1. The updates to ICD-10-CM and ICD-10-PCS that become effective April 1 were released in mid-January. The updates include 42 new diagnosis codes. The significant changes to the ICD-10-CM guidelines are the following: A.19 – Code Assignment and Clinical Criteria This section has added a new sentence: “If […]
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HCC Coding for Post-Sepsis Syndrome

HCC Coding for Post-Sepsis Syndrome

Capture risk adjustment payment for physicians who treat patients with late effects of sepsis. In the United States, more than 1.4 million people survive sepsis every year. Up to 60 percent of sepsis survivors experience worsened cognitive and/or physical function. Of all sepsis survivors, one third are rehospitalized within three months of the initial diagnosis […]
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How to avoid medical necessity denials

How to avoid medical necessity denials and ensure timely payment. Sick visit on the same day as an annual wellness visit (AWV) Reason for denial: Lack of clear clinical documentation regarding why the physician had to go above and beyond what is normally addressed during an AWV. How to avoid it:“I often tell doctors to […]
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2023 Update to Diagnosis Codes Is Substantial

Exactly 1,468 new diagnosis codes will be added to the ICD-10-CM code set for fiscal year (FY) 2023. Moreover, 251 codes will be deleted, 35 code descriptors will be revised, and 36 codes will be converted to parent codes. The changes go into effect Oct. 1. Review the Latest Files The diagnosis code files and […]
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Selecting the Principal Diagnosis Lies at the Heart of Inpatient Coding

The heart of the principal diagnosis selection is pivotal to accuracy and compliance. Since February is known as “National Heart Month,” a discussion on the heart of inpatient coding is appropriate, that being the “principal diagnosis.” When learning inpatient coding, a large amount of time is spent on understanding the guidelines, conventions, and application of […]
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When To Report an Incidental Finding

DOJ lawsuits may be your road map to risk adjustment compliance. The growing prevalence of risk adjustment in healthcare has forged new processes in documentation practices that have resulted in many organizations adopting practices that bend the cast iron rules for ICD-10-CM coding. We are starting to see some of the long-term dangers of ambitiously […]
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Get Caught Up on Coding and Billing News

New COVID-19 vaccine status codes, changes and corrections to the 2022 CPT code set, Medicare Physician Fee Schedule (MPFS) payment changes, and prior authorization code list changes — that’s what’s on the agenda this month. Read all about it! 3 New Codes Improve COVID-19 Vaccination Status An April 1, 2022, update to the 2022 ICD-10-CM […]
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New COVID-19 ICD-10-CM and PCS Codes Coming in 2022

The package includes three ICD-10-CM and seven procedure codes. The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS) have both stated that in April 2022, we will have three new ICD-10-CM codes and seven new procedure codes for COVID-19 therapeutics and vaccines. You may recall that in […]
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