The volatility brought about by the COVID pandemic has gradually transitioned towards a semblance of stability in the coding landscape. Particularly noteworthy is CMS’s unexpected revelation of the smallest count of codes in recent times. A sum of 395 new billable codes has been incorporated for the year 2024, accompanied by 25 removals and 13 […]
In the 2024 ICD-10-CM, there are noteworthy changes to the SDoH codes Z55-Z65 that are worth mentioning. Instead of discussing minor formatting and grammatical adjustments made by CMS, I will concentrate on the significant changes. Here are the updates. ● Under the category of problems related to social environment (Z60.8), the ICD-10-CM now includes more […]
Risk adjustment coding plays a vital role in the healthcare sector by capturing and documenting the severity of patient conditions. Its primary purpose is to guarantee precise reimbursement and risk adjustment scores. Given the ever-changing healthcare landscape, it is imperative for healthcare providers and coding professionals to remain adaptable and well-informed about the evolving requirements. […]
On Friday, June 16, the Centers for Disease Control and Prevention (CDC) unveiled the ICD-10-CM codes for the upcoming fiscal year 2024 (FY 2024). This latest release introduces 395 new additions, removes 25 codes, and includes 13 revised codes. The removals are a result of the expansion of diagnosis codes. In total, there will be […]
Having been on the receiving end of audits, and also having been an individual who has conducted them, I know the mindset from both sides of this equation. The one element to this equation that has changed over time is the increase in payer denials: those that are now clinical- and coding-focused, often resulting in […]
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 […]
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 […]
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 […]
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 […]
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 […]