Coding Tips

CY 2022 OPPS Proposed Rule

By Mary Stanfill / August 9, 2021

On July 19th the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2022 Outpatient Prospective Payment System (OPPS) proposed rule. [1] After a comment period, the final rule will be published in November 2021. Notable changes proposed for CY 2022 include: A net increase in OPPS payment rates of 2.3% over…

New FY22 Code: Non-Traumatic Cardiac Injury

By Natalie Sartori / July 28, 2021

With the current ICD-10-CM code set, there is no specific code corresponding to non-traumatic myocardial injury. Given the high severity of illness typical of patients with non-ischemic myocardial injury, appropriate classification of these patients is paramount in terms of aligning appropriate diagnostic and treatment strategies while avoiding inappropriate approaches that would otherwise be suggested by…

New FY22 Code: Gastric Intestinal Metaplasia

By Natalie Sartori / July 15, 2021

Intestinal metaplasia (IM) occurs when cells in the tissues of the upper digestive tract, often in the stomach or esophagus, change and become more like cells from the intestines. Intestinal metaplasia in the esophagus is also called Barrett’s esophagus. Intestinal metaplasia is more common in people who have chronic acid reflux or gastroesophageal reflux disease (GERD). The…

Medical Coding

FY 2022 ICD-10-CM Updates

By Staff / July 13, 2021

Abnormal Findings on Neonatal Screening Currently there is only a single code to capture any or all types of newborn screenings that may have positive or abnormal results. The American Academy of Pediatrics requested expansion of category P09 Abnormal findings on neonatal screening, to specifically show which screening categories were abnormal. Table 1 shows the…

Glasgow Coma Scale – July 2021 Coding Tip

By Marcy Blitch / July 12, 2021

The Glasgow Coma Scale (GCS) is a clinical scale used to measure a person’s level of consciousness after a brain injury. The scoring is determined by three factors: amount of eye opening, verbal responsiveness, and motor responsiveness. The Glasgow Coma Scale has an adult version and a pediatric version. The pediatric version is also composed…

New FY22 Code: Measurement of Flow in a Cerebral Fluid Shunt

By Natalie Sartori / July 8, 2021

There are currently no unique ICD-10-PCS codes to describe the noninvasive measurement of flow through a cerebrospinal fluid (CSF) shunt. Hydrocephalus is a debilitating neurological disorder that results from the overproduction and/or impaired reabsorption of cerebrospinal fluid (CSF) in the ventricles of the brain. Hydrocephalus affects over 1 million people in the United States alone….

Spinal Fusions Advanced Applications – UASI Lunch and Learn

By Natalie Sartori / June 23, 2021

Click the button below to download a PDF of Natalie Sartori’s Lunch and Learn, “Spinal Fusions Advanced Applications.”

Medical Coding

New FY22 Code: Coronary Intravascular Lithotripsy (IVL)

By Natalie Sartori / June 22, 2021

Currently, there is no unique ICD-10-PCS code to identify the use of intravascular lithotripsy (IVL) to treat calcified lesions in the coronary arteries. Percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation is the most frequent mode of coronary revascularization. Advanced age and an increasing frequency of diabetes mellitus, hypertension, and renal insufficiency contribute to…

Medical Coding

Critical Limb Ischemia – June 2021 Coding Tip

By Marcy Blitch / June 17, 2021

Critical limb ischemia, also known as chronic limb-threatening ischemia, is a clinical syndrome of peripheral artery disease of the lower limbs with ischemic pain at rest and ischemic tissue such as nonhealing ulcers or gangrene. Critical limb ischemia (CLI) does not happen overnight and does occur over time. Patients are at a much higher risk…

New FY22 Code: Vertebral Body Tethering

By Natalie Sartori / June 14, 2021

Overview: The fiscal year 2022 ICD-10-PCS code set updates [1] address the lack of a specific code for vertebral body tethering performed in the treatment of scoliosis. Scoliosis is a condition that manifests in a significant number of skeletally immature patients annually and is generally defined as an abnormal curvature of the spine greater than…