** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.
Tips & Expertise: Liver Disease & Treatment
Q: Question about fatty liver disease. It’s my understanding that fatty liver disease is often the first stage in liver disease and can progress to cirrhosis. If the provider documents fatty liver disease as well as cirrhosis, should you code both or is the...
Ten Things to Know About 2021 E/M Changes
Ten Things to Know About 2021 E/M Changes Publication: Haugen Consulting GroupPublished on October 1, 2020 Download Tip Sheet Now
Tips & Expertise: 2021 IPPS Updates
Q: You mentioned that Yescarta and Kymriah would group to the new MS-DRG 018 for CAR T-cell therapies. There are 2 new codes for CAR T-cell therapies from the new technology section in 2021. Will those codes also group to MS-DRG 018?A: Two new CAR T-cell therapies...
Digging into MS-DRG’s
Blog Post: Digging into HIM & Coding
Are you looking for opportunities for focused audit reviews or coder education? At HCG, we track our audit data throughout the year to identify trends in the industry and opportunities to educate coders in specific problem areas. So far, in 2020, we have identified 4 MS-DRG’s that stand out with the highest number of coding errors that affected the MS-DRG assignment. Digging deeper into the audit data, we were able to identify specific coding opportunities where coders could improve their diagnosis coding and limit the MS-DRG changes in those areas. Continue reading to learn more about the MS-DRG’s identified. | Read more.
Tips & Expertise: 2021 ICD-10-CM Updates
Q: For alcohol and drug withdrawal, what is the default code if the doctor does not document use or dependence? A: The alphabetic index lists dependence as the default and this is reiterated in Coding Clinic, Second Quarter 2015: Page 15. However, if documentation...
Tips & Expertise: 2021 ICD-10-PCS Updates
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...
Understanding 2020’s Unexpected Updates
Blog Post: Digging into HIM & Coding
Last week, the Centers for Medicare and Medicaid Services (CMS) released 12 new ICD-10-PCS codes to report the administration of therapeutic substances in the treatment of COVID-19. All these codes are in the New Technology (X) section and allow for reporting of four specific and one nonspecific substance. | Read More.
Critical Questions for Critical Care
Blog Post: Digging into HIM & Coding
This blog post has been a long time coming, as this topic has been top-of-mind since 2018, when critical care services were placed on the Office of Inspector General (OIG) work plan. Since that time, I have had an opportunity to review hundreds of critical care charts from multiple facilities. To say that I have become passionate about good critical care documentation is an understatement. Fortunately, the Centers for Medicare & Medicaid Services (CMS), the American Medical Association (AMA), and other specialty societies publish a lot of guidance on critical care documentation. Although there are multiple facets to critical care billing, this article is focused on the one thing I repeatedly find lacking in charts: medical necessity.
Tips & Expertise: ICD-10-PCS for Replacement Procedures
Q: A patient with a previous hemiarthroplasty (say, right hip) comes in for a THR. Do you code the removal and replacement of the device (head/stem) and just replacement of the liner/cup? Q: How do you code polyethylene exchange of the left total knee. They took out the old one and placed a new one. Continue Reading to learn more!
Sniffing Out Sinus CPT Coding
Blog Post: Digging into HIM & Coding
Did you know there are two separate nasal cavities, eight sinuses, and six turbinates to consider when coding sinus surgery?! This can make for quite a coding challenge! Most sinus surgeries performed are called Functional Endoscopic Sinus Surgery (FESS), which are procedures performed to open up sinus cavities to promote airflow and drainage. Properly coding these procedures requires understanding of sinus anatomy and being familiar with the parenthetical notes in this section of the CPT book. Here are five tips to get you started in correct code selection.
