Blog & Publications

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ICD-10 Remix: What the Heck is a DRG and Why Should I Care About Case Mix?

Blog Post: Digging into HIM & Coding

So you want to be a coder. And not just that, you want to be a hospital coder because, on average, they make more money than physician coders. And you don’t just want to be a hospital coder, you want to be an inpatient hospital coder because then you get to look at the whole chart and piece together the patient’s clinical picture. If this is your goal, then everything you need to know you will not learn in school. And that’s mainly because there is so much to learn and practical experience is key.

If you want to be an inpatient coder, you need to know diagnosis-related groups (DRGs) because in hospitals, it’s all about DRGs and case mix – and compliance. If you have no idea what I’m talking about, fear not – here’s a primer on DRGs! I wish I could say I cover it all here, but this is just a beginning! | Read More.

Top 10 Things to Know About 2021 E/M Changes

Blog Post: Digging into HIM & Coding

E/M changes are coming. Lucky for us, we have almost a whole year to figure them out! They are set to take effect on January 1, 2021. The American Medical Association (AMA) has published the changes, as well as numerous tools to assist us. Let’s take a closer look at our Top 10 List of Things you need to know about these new changes! | Read More.

Diagnostic Coronary Imaging vs. Guiding Shots

Blog Post: Digging into HIM & Coding

One of the most complex areas of coding for cardiac catheterization procedures is determining when to code a diagnostic heart angiogram (imaging) separate from a percutaneous coronary intervention (PCI). The guidelines for reporting separate diagnostic imaging are found under the heading Therapeutic Cardiovascular Services and Procedures on the Coronary Vessels (92920-92979) in the CPT book. The National Correct Coding Initiative (NCCI) manual gives guidance that has left many scratching their heads wondering what is medically necessary. Continue reading to learn what the NCCI has to say as well as a couple of hard and fast rules to guide you. | Read More.

Your Ultimate Guide for CPT Coding Resources

Blog Post: Digging into HIM & Coding

When coding CPT, have you ever wondered where to look for official coding guidance, or whose rules you should be following? Back in 1992, when I first started coding, the 1995 and 1997 guidelines didn’t even exist! We didn’t have any rules back then, or at least none that I can remember.
Today, lots of entities have their own sets of rules, and each set is different. Then, to add another layer, different payers have their own opinions and rules which adds stickiness to the situation. Boy have times changed! | Read More.

Coding Adventures in Bleeding Disorders and Conditions

Blog Post: Digging into HIM & Coding

If you look in the index you will find that under “hemorrhage” there are entries for at least 16 of the 19 chapters in ICD-10-CM! It is a miracle of anatomy that we have this complex, personal ocean of cells, nutrients, and substances coursing through our bodies keeping us alive minute by minute but there are many causes for hemorrhage and many problems that occur when our blood ends up in places where it doesn’t belong! | Read More.

Can Midline Catheters Placed by Vascular Nurses Be Reported?

Blog Post: Digging into HIM & Coding

Midline catheters (MLCs) are similar to peripherally inserted central catheters (PICC lines) but they are shorter and the tip doesn’t reach the central venous system. Previous CPT coding advice was to code MLCs as PICC lines with a modifier for reduced services, but as of 2019, new instructional notes direct that MLCs are reported with the following CPT codes | Read More.

The 10-Year Coder Challenge: Growing Your Skills Beyond CCs and MCCs

Publication: ICD10 Monitor

At the beginning of the year, Facebook’s 10-year challenge hit the web with users posting comparison profile pictures from 2009 alongside their 2019 selfies. I’ve seen a recent resurgence of the 10-year challenge over the last week and will admit that even I took part by posting a drawn image of a 2009 stick figure alongside a plumper 2019 version holding tacos. That got me thinking about the coding industry, what’s happened in the last 10 years, and where we’re headed in the next decade. | Read More.

Regenerative Peripheral Nerve Interface (RPNI)

Blog Post: Digging into HIM & Coding

What is this new procedure, where a free muscle graft is wrapped around a cut nerve ending, like a piece of sashimi around the end of a piece of spaghetti? The muscle graft doesn’t “do” anything active to the nerve, it just acts as a target for reinnervation by the nerve, so things stay organized and neuroma is less likely to form. This creates a challenge in choosing a PCS root operation. So if you’re hungry for the PCS coding implications, read on! | Read More.

Unique HIM Solutions at Wray Community District Hospital

Blog Post: Digging into HIM & Coding

Wray Community District Hospital recently engaged Haugen Consulting Group (HCG) to conduct an assessment of the Health Information Management (HIM) department. The assessment identified several opportunities within the department. The bigger challenge was implementing changes without leadership in the department. | Read More.

CPT Coding: Saline Infusions For Diagnosis and Therapy

Blog Post: Digging into HIM & Coding

Pay close attention to the descriptor for 96365: “Intravenous infusion, for therapy, prophylaxis, or diagnosis.” A provocative test is one in which the patient is subjected to a substance, stimulus, or maneuver which then elicits a measurable response, which can take the form of a positive lab test, a positive physiological measurement, or occurrence of a symptom. Let’s look at some examples we might encounter while coding where a diagnostic or therapeutic saline infusion would be correctly assigned 96365 instead of the hydration code 96360. | Read More.

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