Tips & Expertise: 2023 IPPS Updates

Q:  Can you summarize how MS-DRG grouper logic works?A:  The first step in grouping an MS-DRG is the assign the case to a major diagnostic category (MDC). This is done by classifying the principal diagnosis into one of 25 MDCs based on body system and case similarity....

Tips & Expertise: 2023 ICD-10-CM Updates

Q:  Does acute/chronic respiratory acidosis really code as acute/chronic respiratory failure? Can a code for respiratory acidosis be reported with the respiratory failure codes?A:  Yes, that is how it is indexed in ICD-10-CM. There is an Exclude2 note for code E87.29,...

Tips & Expertise: 2023 ICD-10-PCS Updates

Q:  When should the new qualifier M for Monoclonal Antibody in the 3E0 table be used? Can it be used to report cancer or COVID MAB therapy?A:  The qualifier M for Monoclonal Antibody is only available when the 6th character substance value C, Other Therapeutic...

Tips & Expertise: CPT Coding for Wound Repair

Q: How do you code for a through and through lip laceration when the mucosa, subcutaneous tissue, and skin are all repaired? Can you report code 40650 with a code for the skin repair?​A: Assign only code 40650 for repair of a through and through lip laceration. This...