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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....

Behind the Mystery of the Biliary Tree

The liver, gallbladder, and pancreas play important roles in digestion through the release of bile and digestive enzymes. The ductwork that connects these organs to each other and ultimately to the alimentary canal of the gastrointestinal tract, is often a mysterious...

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...