Q:  Question in regards to the COVID-19 new PCS codes.  I am getting push back about coding these PCS codes when the drugs can be picked up via the charge master.  What are your thoughts?

A:  While your organization may be able to pull this data from the charge master, Haugen Consulting Group recommends utilizing the new technology ICD-10-PCS codes for the COVID-19 therapies.  These codes were developed in record time and implemented immediately to track therapies related to the COVID pandemic.  While tracking medication usage through the charge master may be useful for internal analysis, that level of line item reporting is not included in reported data.  As one of the data elements available under the Uniform Hospital Discharge Data Set (UHDDS), ICD-10-PCS codes are individually reported, whereas individual line item detail of the charges from the charge master is not.

Q:  The new technology drug XENLETA has a code for oral administration.  Our facility doesn’t currently code any oral medications.  Should we make an exception for this drug?

A:  Facilities may use their own discretion when establishing coding policies, including the list of ICD-10-PCS codes that should and should not be coded.  It is recommended that any code that impacts reimbursement be assigned.  While the final rule for the inpatient prospective payment system is not available at the time of this writing, the proposed rule for fiscal year 2021 does include a proposal to establish a new technology add-on payment (NTAP) for XENLETA.  If this proposal is finalized, Haugen Academy recommends assigning codes for XENLETA to obtain the NTAP.

Q:  With the new guideline about coding extension of a percutaneous endoscopic approach as percutaneous endoscopic, does this change the Coding Clinic advice for hand-assisted laparoscopic nephrectomy?  According to that reference, the approach is open.

A:  In Third Quarter 2014, Coding Clinic stated that the creation of a “hand port” for laparoscopic-assisted approach to nephroureterectomy codes to the open approach.  In this procedure, the distal ureter was removed via open incision with the assistance of a hand port for removal of the proximal ureter and kidney.  In this procedure, the laparoscope was used to assist in open resection.  This is different than a completely laparoscopic procedure where the port incision is extended to accommodate removal of an organ.  We do not anticipate that this new guideline will affect the advice previously published in Coding Clinic, but, as always, we recommend staying up-to-date with Coding Clinic articles, as this represents official coding advice.

Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer

Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer

Senior Consultant

Kristi is a senior consultant with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.

Kristi has served the Colorado Health Information Management Association (CHIMA) as board Director, co-chair of the Data Quality Committee, and co-chair for the ICD-10 Task Force. She is also a past president of the Northern Colorado Health Information Management Association (NCHIMA). Kristi is the proud recipient of the 2011 AHIMA Triumph Award for Mentoring for her voluntary work as the “Coder Coach.” She has also received awards from CHIMA for Distinguished Member (2018) and Outstanding Volunteer (2013) and from AHIMA for Roundtable Achievement in Coding Excellence (RACE).

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